European Journal of Medical Research - Deutsche AIDS ...

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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
46 EUROPEAN JOURNAL OF MEDICAL RESEARCH June 27, 2007 measure the latter, a two-scaled “intercultural index” was constructed (values: A (very high IC) - E (no IC)). Results: Response rate of N1 was 89.3%, of N2 12.3%. In N1, 909 migrants were treated by 17/25 practices, in N2, only 46. Median proportion of migrants in N1 was 1.3%, 80.1% were men. Each with 3/17 practices of N1 had an degree of IC of A or B, 7 of C, 3 of D and 1 of E. IC was more pronounced in N1-practices with a higher proportion of MHA (tc= .611). Most important barriers of communication were "lack of language skills" (15/16 stated as important) and "cultural differences" (13/16). Interaction problems were higher in MHA without apprenticeship (6.9) than in such with apprenticeship (2.8, p
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