Promoting HIV/STI testing for Afro Caribbean communities in the...


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Title Promoting HIV/STI testing for Afro Caribbean communities in the Netherlands through the internet
Period 07 / 2008 - unknown
Status Current
Research number OND1334413
Data Supplier ZonMw Projectenbank


The goals of this project are to develop and evaluate an internet based intervention to stimulate HIV/STI testing among Afro Caribbean communities.The specific goals are1. To study cultural, psychological and environmental determinants of HIV/STI testing among people of Surinamese, Antillean/Aruban and (if feasible) African descent;2. To develop an internet based culturally tailored intervention to stimulate HIV/STI testing among these groups;3. To evaluate the effects of this intervention on self reported testing and intentions to get an HIV/STI-test;4. To develop cooperation with (commercial) sites directed at migrant communities and other relevant sites to integrate the intervention to stimulate HIV/STI testing;5. To evaluate the possibilities and limitations of intervention development and evaluation on the internet;6. To explore the feasibility of an easily accessible online HIV/STI testing facility.
Among Surinamese, Antillean and African communities in the Netherlands HIV and STI are a growing problem. Prevalence figures for HIV vary from 1,4% among West Africans, from 1,8 to 0,8 - 3,2% among Dutch-Antilleans and to 0,8% among Surinamese communities. In addition to the increase in HIV-infections, another specific problem for people with HIV with a non-Dutch background is that HIV-infections are detected in a later stage. People get tested later, often when they already have symptoms related to the HIV-infection. Consequently, they receive medical care and treatment at a later stage of their disease. STI are found more frequent among ethnic communities; prevalence of Chlamydia is high, up to 12% among Surinamese / Antillean women between 15 29. Levels of unprotected sex among these communities are also high, with up to 20% having unprotected sex with more than two partners in the last six months. These figures indicate a potential spread of HIV and STI, especially within ethnic minority communities. Stimulating HIV/STI testing among Afro Caribbean communities is therefore urgently needed (a) to prevent the further spread of HIV/STI, (b) to treat STI s and (c) to improve early treatment of newly infected individuals.At the moment there are no specific interventions directed at the Surinamese, Antillean and African communities in the Netherlands to stimulate HIV/STI testing. In general, there is a lack of theory and evidence based HIV/STI preventive interventions directed at ethnic communities in the Netherlands. Internet has become a more popular medium among ethnic communities and also offers unique opportunities for personal and cultural tailoring. The proposed project is therefore aimed at stimulating HIV/STI testing for Afro Caribbean communities in the Netherlands through the Internet.Based upon the Intervention Mapping Protocol, in combination with PEN-3 to include cultural sensitivity, we distinguish six steps in the project. Step 1 is the needs assessment. The project will start with a literature review focusing on determinants of HIV/STI testing. We will conduct secondary analyses into determinants of testing and internet use in two recent studies which included large groups from ethnic communities. In addition 20 qualitative interviews will be conducted with members of the different communities to gain more insight in the different concepts. The combined results will give input to an internet based survey to establish the relative strength and importance of the potential determinants. In step 2 we will translate the general program goals into specific proximal program objectives. Step 3 consists of the identification and selection of theory based strategies to influence HIV/STI testing. These will probably include cultural tailoring, modelling, message framing, guided practices and action regulation. Based upon current insights from literature and ongoing projects the two most important elements will be social norm setting and action regulation. In step 4 we will develop the internet intervention. The intervention will be as much as possible incorporated in and linked to popular internet sites for the Afro Caribbean communities. Part of the intervention will be the application of virtual agents: tailored and cultural specific computational artefacts designed to build and maintain social emotional relationships with their users and suited for asking questions and giving feed back. The intervention will be pre-tested using cognitive interviewing. Step 5 includes the development of an implementation plan. To enhance implementation there will be two linkage groups one with community representatives and one with internet professionals. In step 6 the intervention will be evaluated through a randomized controlled trial. Participants will be recruited through popular sites among Afro Caribbean communities and after entering the intervention participants will be randomly assigned to the intervention arm (stimulating HIV/STI testing based upon social norm setting with cultural tailoring), or to the control arm (existing information about testing which is based upon individual risk assessment). From each community 410 participants will be included in each arm. Main outcome measures are self-reported HIV/STI tests, test intention and other determinants of testing behaviour.In a recent project we are testing the possibilities of online testing, whereby participants can register online, get online counselling, go to a laboratory for taking samples and receive the results also online. If such an approach proves feasible we will include it, as an extra arm in a specific region, in this project.If proven successful the intervention will be implemented by STI Aids Netherlands. Results will be shared with the communities and presented as peer reviewed articles.

Related organisations

Related people

Project leader Prof.dr. H.P. Schaalma
Project leader Dr. O. de Zwart


D23110 Infections, parasitology, virology
D24200 Health education, prevention

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