On National HIV Testing Day, we must remember all messages about testing and prevention are not the same. Culture plays a major role in what motivates our behavior.
There are over a million African immigrants living in the United States today. While this group boasts a striking diversity in languages, traditions and experiences, there is one common experience that highlights a fairly universal challenge - adapting to the U.S. health care system and the stark reality that their own beliefs and American medicine are frequently at odds with each other.
Many African cultures have a holistic view of life and believe that life is a journey that each person takes. This journey is marked by different stages or phases, including birth, childhood, puberty (adolescence), youth, adulthood, old age and death. Through cultural norms and practices, society ensures that individuals understand their roles in their journey from stage to stage. Why is this important to awareness about HIV testing and prevention?
Folk religion and cultural practices, including belief in gods and ancestral spirits, is central to many African belief systems. Despite the spread of formal health care systems, some Africans, including those in the Diaspora, often bypass these systems for traditional providers - such as herbalists and priests - for a number of reasons. The traditional healers tend to be closer to the culture of the Africans patients, and this fosters a strong relationship between the patient and the healer.
Within the African religious system, diseases are thought to be caused by supernatural forces. For some Africans, diseases such as HIV/AIDS are believed to be punishment from a "higher being" and as such, they may not want to seek medical intervention. And for some Africans the textbook distinctions between "religion" and "medicine" are not relevant. For example, religious practices, including the use of amulets and visits to shrines, dominate the practice of folk medicine. It is therefore not uncommon to see Africans express views on health, illness and mortality in a spiritual rather than a medical way. As a result of this, Africans tend to be suspicious of western medicine. When it comes to HIV testing, some even believe that there is something sinister about blood draws, claiming, "they want to do something with my blood."
For clinicians, it's important to understand how this translates to behaviors - from reluctance to seek care to failure to adhere to prescribed treatments. In my work with organizations like the Adventist HealthCare Center on Health Disparities , we have observed that clinicians will likely get more history from an African patient through an informal conversation than by going down a checklist during the first visit, as storytelling is huge part of African cultures. Additionally, it helps if clinicians ask probing questions during the conversation show they care about the client not only the disease.
Culture and language influence attitudes and shape behaviors around health, healing and wellness. Both the provider and the patient bring their individual learned patterns of language and culture to the health care experience. To achieve equal access to quality health care for all, we must learn to transcend these disparate experiences and strengthen communication between patient and provider.
The Office of Minority Health Resource Center provides free resources, including cultural competency training, for providers working with African immigrant communities. For more information, please contact Margaret Korto at firstname.lastname@example.org.
Read more about African immigrant health issues at http://minorityhealth.tumblr.com/
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Mrs. Margaret Korto is a Health Education and a Senior Program Analyst at the Office of Minority Health Resource Center. She received her B.S. in Business Administration and Health Management with a minor in Paralegal Studies from University of Maryland and earned a Master in Business Administration and Healthcare Administration. Mrs. Korto is a native of Ghana and a proud mother of two.