European Journal of Medical Research - Deutsche AIDS ...

June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH
45
A.50 (Poster)
Transferring intermediary training HIV/AIDS to
Hamburg: Signs of early success
Robben K. 1 , Wienold M. 2 , Brayer W. 1 , Salmann R. 2 ,
Migranten-Aids Projekt
1 Kinder- und Familienzentrum Schnelsen, Hamburg, Germany,
2 Ethno-medizinisches Zentrum Hannover, Hannover, Germany
Introduction: The number of newly diagnosed people with
HIV-infection from high prevalence countries has doubled in
Hamburg since 2000. There is evidence for migrants to be at a
particularly high risk of infection and to delay the use of German
institutions (e.g. AIDS-service organizations). A higher
level of discrimination of migrants with HIV is found in their
own communities. These issues have been addressed effectively
by training transcultural intermediaries in HIV/AIDS
prevention and care in Lower Saxony. Is a partnership able to
establish training following this model elsewhere?
Method: A proven model for HIV/AIDS prevention in migrants
was adjusted and transferred to the site in Hamburg
(11/05 to 02/07). Selected migrants were trained by experts
(epidemiology, medicine, sexuality, policy and psychology).
The project was evaluated through structured feedback during
the training and by evaluating the group sessions.
Results: 30 bilingual, socially integrated and committed migrants
were selected to participate in the training and campaign.
A curriculum based on 50 hrs of training was applied
and followed by supervised group session prepared and evaluated
each by two of the intermediator trainees. 24 intermediaries
completed the training and were certified as transcultural
HIV/AIDS intermediaries. The training provided insights into
the cultural background of HIV/AIDS in the countries of origin
(e.g. AIDS as a punishment in Africa). The campaign highlighted
the singular capacities of transcultural intermediaries to
(1) identify target groups and (2) successfully conduct community
group sessions in their respective ethnic communities.This
observation remained valid throughout the project (18 sessions).
Group sessions reached over 200 migrants in ten languages.
The project elicited highest public interest and further
demonstrated demand and opportunities for continuing the
campaign through new funding.
Conclusions: Intermediaries successfully served as HIV/
AIDS educators in their respective communities. Training
transcultural HIV/AIDS intermediaries is now publicly recommended
in Hamburg (Handlungsplan Integration des Hamburger
Senats). In order to provide a perspective for a selfsustainable
project in Hamburg further effort is needed.
A.51 (Poster)
Improved results of evaluation in intercultural
settings: Participation of intermediaries in quality
assurance and adaptation
Wienold M. 1 , Kimil A. 1 , Robben K. 2 , Menckhaus B. 3 ,
Sobiech C. 1 , Mönninghoff K. 1 , Salman R. 4
1 Ethno-Medizinisches Zentrum, MAP-Team, Hannover,
Germany, 2 Kinder- und Familienzentrum, Hamburg, Germany,
3 Ethno-Medizinisches Zentrum, MiMi-Projekt, Hannover,
Germany, 4 Ethno-Medizinisches Zentrum, Hannover,
Germany
Question: The heterogeneous population of migrants in Germany
(reflecting changing patterns in the history of immigration;
first and second generation) appear to know less about
health issues than the native German population. The Ethno-
Medical Centre in Hannover has established a model for evaluated
health promotion by migrants for migrants. How can the
tools be improved to better evaluate the impact of HIV/AIDS
prevention in migrant communties?
Methods: Evaluation developed for health prevention campaigns
in migrant communities in Germany (MiMi-Projekt)
were adapted to the HIV/AIDS field following principles of
continuous quality improvement and community orientation.
The tools were developed in a multi-cultural and multi-professional
team, followed by feedback from trained transcultural
intermediaries and than translated (by intermediaries).
The questionnaires for participants in community group sessions
were bilingual. The validity of evaluation results was
assessed. Data collected during a project in Hamburg (2006)
were analysed using quantitative and qualitative methods.
Results: The materials were reviewed and adapted by trained
intermediaries into e.g. Pidgin English. Questionnaires were
successfully applied in six languages. The bilingual texts allowed
evaluation in the team (German is the lingua franca of
the project). A total of 21 community group session resulted
in over 200 questionnaires returned reflecting ten different
ethnicities (language groups). A preliminary evaluation of
115 questionnaires showed valid results relating to gender, recruitment,
knowledge and feedback on quality of community
group sessions and on information provided:
(1)Female migrants were in the majority,
(2)recruitment into community group sessions mostly worked
through personal invitation,
(3)basic knowledge is highly variable with evidence for relevant
deficits (e.g. homophobia),
(4)the feedback was highly positive. Open questions required
translation into German for evaluation.
Conclusions: Evaluation tools can be improved by making
use of interemdiaries. Open questions remain to pose a particular
obstacle for evaluation in this context. Standard criteria
for community orientation in quality assurance may serve to
further improve outcomes.
A.52 (Poster)
Intercultural Competence (IC) in the scope of
outpatient medical care for migrants living with
HIV/Aids (MHA)
Jansen K. 1 , Kleiber D. 1
1 Free University Berlin, Institute for Public Health and psychosocial
Health Research, Berlin, Germany
Objective: MHA are said to be underrepresented in practices
specialised on HIV, but only few data are existent for the German
situation. As barriers for access and contenting diagnostics
and treatment for MHA, culturally differing theories of
sickness and social interaction, language problems as well as
material and legitimate restrictions are considered. A study
was carried out to clarify the extent and terms of outpatient
medical care for MHA. Factors of good medical practise regarding
MHA were surveyed, too.
Methods: In Berlin, all HIV specialised (N1=28) and a sample
of regular (N2=841) practices were surveyed via a standardised
questionnaire. Data were gained on structure of practices
and composition of their migrated clientele, on communication
and interaction problems (scale: 0 (no) - 9 (very
high)) with MHA and on degree of IC within the practices. To