Exploring HIV Knowledge, Risk and Protective Factors Among West African Forced Migrants in New York City

Because of ongoing political and social instability throughout the continent, many Africans have become forced migrants. Unlike immigrants who choose to migrate, forced migrants flee their countries in search of safety and often endure multiple traumatic events during their migration. They are often unprepared for new risks in their adopted country. There is a high incidence of newly diagnosed HIV cases among West African immigrants in the New York City metropolitan area, but little research to date to understand why this might occur. In order to gain insight, the current pilot study explored HIV knowledge, risk and protective behaviors among 52 West African-born forced migrants in New York City. HIV risk behavior came primarily from unprotected heterosexual activities. While most participants were very knowledgeable about HIV transmission and risk factors, almost half reported that they had not used condoms during sexual activities in the past 6 months. Women were more knowledgeable about HIV transmission, yet reported significantly more STDs than men. Many participants did not know about HIV/AIDS treatments and could not identify HIV/AIDS services and resources within their immigrant communities. Factors influencing HIV risk and protective behaviors among this population are identified and discussed. Suggestions for future research and strategies to reduce risky behaviors while enhancing protective ones among forced West African migrants are highlighted

Displaced African Female Survivors Of Conflict-Related Sexual Violence: Challenges For Mental Health Providers

Conflict throughout Africa has created havoc for many. This overwhelming chaos has led to the disintegration of social order and generated widespread gender-based violence. As a result, African women have become casualties, experienced brutal acts of sexual violence, and been forced into exile. Drawing on the tribulations of displaced African female survivors of conflict-related sexual violence, this article discusses these women’s experiences and highlights the barriers and struggles encountered while seeking refuge. The article concludes by exploring the challenges of providing culturally informed, strength-focused mental health services to these women as they rebuild their lives in a new sociocultural context

Responding to Secondary Traumatic Stress: A Pilot Study of Torture Treatment Programs in the United States

Providers who care for torture survivors may be at risk for secondary traumatic stress, yet there has been little documentation of the effects of repeated exposure to traumatic issues on their emotional health or exploration of the support systems and resources available to address their emotional needs. This study assessed the secondary stress experiences of service providers (N = 43) within the National Consortium of Torture Treatment Programs in the United States and examined the supports offered by their organizations. The study found a significant correlation between rates of anxiety and depression among providers, r(34) = .49, p = .003. Although these participants reported that their work with survivors of torture was stressful, 91% indicated that their organizations offered a variety of stress-reduction activities. Overall, participants reported that their own personal activities were the most-effective stress reducers. The results are discussed in light of challenges that professionals who work with this population face and the effectiveness of support systems available to support their work

Promoting positive development among refugee adolescents

Of the estimated 35.3 million refugees around the world (UNHCR, Figures at a Glance, 2022), approximately 50% are children under the age of 18. Refugee adolescents represent a unique group as they navigate developmental tasks in an unstable and often threatening environment or in resettlement contexts in which they often face marginalization. In addition to physiological, social, and psychological changes that mark adolescence, refugee youth often face traumatic experiences, acculturative stress, discrimination, and a lack of basic resources. In this consensus statement, we examine research on refugee adolescents' developmental tasks, acculturative tasks, and psychological adjustment using Suárez-Orozco and colleague's integrative risk and resilience model for immigrant-origin children and youth proposed by Suárez-Orozco et al. Finally, we discuss recommendations-moving from proximal to more distal contexts

Exploring potential mental health spillover effects among caregivers and partners of youth in Sierra Leone: A qualitative study

Given the large mental health treatment gap in low- and middle-income countries (LMICs), particularly in post-conflict settings like Sierra Leone, and the limited healthcare infrastructure, understanding the wider benefits of evidence-based mental health interventions within households is critical. This study explored potential mental health spillover effects – the phenomenon of beneficial effects among nonparticipants – among cohabitating caregivers and partners of youth who participated in an evidence-based mental health intervention in Sierra Leone. We recruited a sub-sample of cohabitating caregivers and partners (N = 20) of youth intervention participants; caregivers had enrolled in a larger study investigating indirect benefits of the evidence-based intervention in Sierra Leone (MH117359). Qualitative interviews were conducted at two time points to explore the following: (a) potential mental health spillover effects and (b) through which mechanisms spillover may have occurred. Two trained coders reviewed transcripts and analyzed qualitative data, assisted by MaxQDA. Qualitative findings suggested that spillover effects likely occurred and supported three potential mechanisms: decreased caregiving burden, behavior changes among Youth Readiness Intervention participants and improved interpersonal relationships. Mental health spillover effects may occur following youth intervention participation in a post-conflict LMIC. Investing in evidence-based services may offer indirect benefits that extend beyond those directly receiving services

Associations between Mental Health and Ebola-Related Health Behaviors: A Regionally Representative Cross-sectional Survey in Post-conflict Sierra Leone

Background: Little attention has been paid to potential relationships between mental health, trauma, and personal exposures to Ebola virus disease (EVD) and health behaviors in post-conflict West Africa. We tested a conceptual model linking mental health and trauma to EVD risk behaviors and EVD prevention behaviors. Methods and Findings: Using survey data from a representative sample in the Western Urban and Western Rural districts of Sierra Leone, this study examines associations between war exposures, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, and personal EVD exposure (e.g., having family members or friends diagnosed with EVD) and EVD-related health behaviors among 1,008 adults (98% response rate) from 63 census enumeration areas of the Western Rural and Western Urban districts randomly sampled at the height of the EVD epidemic (January–April 2015). Primary outcomes were EVD risk behaviors (14 items, Cronbach’s α = 0.84) and EVD prevention behaviors (16 items, Cronbach’s α = 0.88). Main predictors comprised war exposures (8 items, Cronbach’s α = 0.85), anxiety (10 items, Cronbach’s α = 0.93), depression (15 items, Cronbach’s α = 0.91), and PTSD symptoms (16 items, Cronbach’s α = 0.93). Data were analyzed using two-level, population-weighted hierarchical linear models with 20 multiply imputed datasets. EVD risk behaviors were associated with intensity of depression symptoms (b = 0.05; 95% CI 0.00, 0.10; p = 0.037), PTSD symptoms (b = 0.10; 95% CI 0.03, 0.17; p = 0.008), having a friend diagnosed with EVD (b = −0.04; 95% CI −0.08, −0.00; p = 0.036), and war exposures (b = −0.09; 95% CI −0.17, −0.02; p = 0.013). EVD prevention behaviors were associated with higher anxiety (b = 0.23; 95% CI 0.06, 0.40; p = 0.008), having a friend diagnosed with EVD (b = 0.15; 95% CI 0.04, 0.27; p = 0.011), and higher levels of war exposure (b = 0.45; 95% CI 0.16, 0.74; p = 0.003), independent of mental health. PTSD symptoms were associated with lower levels of EVD prevention behavior (b = −0.24; 95% CI −0.43, −0.06; p = 0.009). Conclusions: In post-conflict settings, past war trauma and mental health problems are associated with health behaviors related to combatting EVD. The associations between war trauma and both EVD risk behaviors and EVD prevention behaviors may be mediated through two key mental health variables: depression and PTSD symptoms. Considering the role of mental health in the prevention of disease transmission may help fight continuing and future Ebola outbreaks in post-conflict Sierra Leone. This sample is specific to Freetown and the Western Area and may not be representative of all of Sierra Leone. In addition, our main outcomes as well as personal EVD exposure, war exposures, and mental health predictors rely on self-report, and therefore raise the possibility of common methods bias. However, the findings of this study may be relevant for understanding dynamics related to EVD and mental health in other major capital cities in the EVD-affected countries of West Africa

The relationship between accurate knowledge on HIV/AIDS transmission and adolescent pregnancy in Ghana : A further analyses of the 2017 multiple cluster indicator survey

Abstract: Background : The literature posits that HIV knowledge is associated with precautious sexual behaviour and practice. We hypothesised and investigated the association between knowledge of HIV transmission and adolescent pregnancy in Ghana, given that the relationship between HIV knowledge and adolescent pregnancy has not been extensively studied. Methods: We did analyses on 5836 cases (weighted as 5121) of 15–24 years old reproductive age women in the female dataset of the 2017 Multiple Cluster Indicator Survey. Adolescent pregnancy was operationalized as reproductive age women between 15-24 years who became pregnant before the age of 18 years. Accurate HIV knowledge was measured by computing the scores of correct responses on six questions exploring women's knowledge about HIV transmission. We accounted for sample design and weight before performing a Chi-square test of independence and Poisson regression. Results: The results indicate that having lower scores on the HIV transmission knowledge scale was correlated with a higher probability of girls becoming pregnant before their 18th birthday. After controlling for the moderating effect of socio-demographic characteristics of the participants, we found that accurate HIV transmission knowledge loses its statistical significance in determining adolescent pregnancy. The factors that remain significant in the adjusted model were formal education status, household wealth, and region of residence. HIV transmission knowledge was statistically significantly related to adolescent pregnancy in the model after the education level variable was omitted. This observation was due to the significant effect of school education on other variables in the model. This result demonstrates that HIV knowledge has a major impact on adolescent pregnancy, but this effect is predicated by formal education attainment of the adolescent girl. Conclusions: Given the results, adolescent pregnancy issues can be resolved by the government and other development partners by adequately educating adolescents about HIV transmissions. Also, because they have the potential to reduce pregnancy among adolescents in Ghana, we recommend that programs and initiatives should address existing disparities in formal educational attainment and household wealth