Culturally Responsive Sexual and Reproductive Health Education to Address HIV Risk Among African-Born Immigrant Women
Olihe Okoro, Shanasha WhitsonObjective
African-born immigrants (ABIs) represent a growing demographic in the United States, constituting nearly half of the foreign-born Black population. They face distinct health challenges, with ABI women experiencing disproportionately high rates of HIV incidence. A critical factor contributing to this health disparity is limited sexual and reproductive health (SRH) literacy. The primary objective of the study was to pilot and evaluate an intervention that employed a culturally responsive, community-led approach to sexual and reproductive health (SRH) education for HIV prevention among ABI women.
Methods
The community-based sexual and reproductive health education was implemented using the African Women Making Healthy Choices (AWMHC) curriculum which consists of 10 modules, delivered across 6 sessions. Sessions were facilitated by AB women and combined didactic and interactive learning elements. The primary outcomes measured were HIV-related health literacy and self-efficacy in protective sexual health behaviors. Ten ABI women were recruited through community-based organizations. Demographic and questionnaire data were summarized using frequencies and proportions. Changes in knowledge and perception of risk associated with HIV were assessed using paired t-tests.
Results
Among the 10 study participants, significant improvements were observed in HIV/SRH knowledge following the intervention, with mean scores increasing from 6.4 to 8.2 out of 10 (p<0.05). Additionally, participants demonstrated enhanced self-efficacy in multiple domains, including condom use negotiation, sexual violence reporting, and healthcare provider engagement. Assertiveness items showing the largest gains related to knowing how to report sexual violence and how to request exams and ask questions of a healthcare provider, each increasing from 6 to 10 affirmative responses.
Conclusion
The findings suggest that culturally tailored SRH education interventions can effectively enhance HIV-related knowledge and self-efficacy among ABI women. Addressing SRH literacy gaps - particularly around fertility, condom use, and sexual rights - appears to be a promising strategy for reducing HIV disparities in this population. The community-led delivery model, grounded in African cultural values, was central to participant engagement and may serve as a replicable framework for scaling up SRH programming with ABI communities. Additional research is warranted to evaluate the intervention’s long-term impact on behavioral outcomes.