HIV infection among Somalis is increasing in Minnesota. Many Somalis living in Minnesota do not know they are infected and are not getting the medical treatment they need.
In 2009 the University of Minnesota and Midwest Community Development, Inc. launched a project to explore HIV risk and sexual behaviors in Somali women titled "Somali Women's Initiative for Sexual Health (SWISH)." On April 13, 2013, researchers shared their study results with the community.
This study is the first to examine HIV-related knowledge, attitudes, and behaviors of Somali women with the ultimate goal of meeting the critical need to reduce HIV and STD transmission among African-born Americans in Minnesota (and the US) as African-born Americans have the highest HIV/AIDS rates of any ethnic group. Participants were recruited through personal contacts as well as from Somali gathering places. Researchers interviewed 30 Somali women aged 18-40 from the Twin Cities area. Interviews were conducted in English (8) or Somali (22) by the project's bilingual Somali staff.
Key findings of the study include:
• HIV testing was done at high rates, primarily due to immigration requirements. It is unknown how that may differ for those who were born in US.
• Condoms are used, primarily for pregnancy prevention rather than disease prevention. This may be due to a perceived low risk for disease.
• Despite frequent mentions of prohibitions of many sexual behaviors, women also reported an encouragement within their religious tradition towards sexual pleasure within marriage.
• Women often spoke of a culture of privacy in which discussions of sexuality are saved for one's spouse.
• Vaginal intercourse seen as the only permissible form of sexual expression between spouses.
• The more severe circumcision correlated with reported vaginal pain with intercourse.
• This population reports a higher rate of pain with vaginal intercourse than the average US population (40% vs. 13%).
• Generally, women had negative attitudes towards circumcision and would not choose to circumcise their daughters, despite high rates of personal circumcision.
The principal investigator of SWISH, Bean Robinson, PhD, said, "For this project, it was essential that we had strong, engaged community partners. Due to language barriers, we were challenged to develop interview questions that made sense and really got to the heart of what we were asking. For example, there is no Somali word for female or male 'orgasm' and our attempt at a description of an orgasm ended up being 59 words long and few participants understood what we were asking. We were not able to use that data."
The community presentation event was part of the Community Dialogue Series co-hosted by the University of Minnesota's Program in Health Disparities Research and the Center for Health Equity. The research project was funded by the Program in Health Disparities Research, the University's IDEA Multicultural Research Award, and the UCare Fund. The information gathered during this pilot study will be used to secure a larger grant to further study the knowledge, attitudes, and behaviors related to HIV/STD transmission and prevention within the Somali community. Ultimately the group will translate this knowledge to develop interventions for Somali women.
The research team included Bean Robinson, PhD, principal-investigator; Amira Ahmed, BA, co-investigator, founder and executive director at Midwest Community Development Inc.; Jennifer Connor, PhD, co-investigator, St. Cloud State University; Shanda Hunt, BA, project coordinator; Fatah Ahmed, BA, interviewer and recruiter; Amanda Ciesinski, MS, volunteer, Megan Finsaas, BA, volunteer; Fatima Noor, volunteer translator, and Professional Interpreting Inc.. The project's Community Advisory Board assisted and advised the research team in study development, recruitment, and data analysis and interpretation.
Community report in English
Community report in Somali
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Photo: Bean Robinson, PhD, presenting; seated left to right: Amira Ahmed, BA; Shanda Hunt, MPH; Amanda Ciesinski, MS; Megan Finsaas, BA; Jennifer Connor, PhD
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