But there are effective ways to help clients challenge those beliefs in a culturally sensitive way and strengthen the patient-provider relationship, says Ijeoma Otigbuo, PhD, Professor of Microbiology and Director of the AIDS Awareness Resource Center at Montgomery College in Maryland. Dr. Otigbuo works with the Center on Health Disparities at Adventist HealthCare's BEAT IT! project, which provides training to assist healthcare providers in delivering culturally appropriate care. (BEAT IT! stands for Becoming Empowered Africans through Improved Treatment of Diabetes, Hepatitis B, and HIV/AIDS and was funded through an award from the Office of Minority Health Resource Center).
Margaret Korto: Through the BEAT IT! Program, you train providers who care for clients from Africa who are HIV positive. What role does cultural competency play in the training?
Ijeoma Otigbuo: Cultural differences can create barriers that prevent individuals from achieving full participation in the benefits of society, especially those related to health and human services, education and medical treatment services. Many people possess a specific and distinctive mix of cultural, ethnic, religious, sexual orientation or linguistic history. Organizations oftentimes lack the ability to respond to the unique and complex needs of these populations and this may result in frustration, thereby diminishing the ability to deliver essential services.
Cultural competency training is designed to:
- Identify barriers and biases in treating HIV positive individuals from different cultures;
- Utilize culturally sensitive and appropriate interventions based on race, ethnicity and language;
- Identify resources that are available to eliminate language and communication barriers;
- And serve the culturally diverse needs of clients.
Margaret Korto: What are the most pervasive myths about sex and HIV that create a barrier between patient and provider?
Ijeoma Otigbuo: A very prevalent myth, especially in Sub-Saharan Africa, is that sexual intercourse with a virgin will cure AIDS. The "virgin cleansing myth" (also referred to as the "virgin cure myth," "virgin rape myth" or simply "virgin myth") is the mistaken belief that if a man infected with HIV/AIDS or other sexually transmitted infection has sex with a virgin girl, he will be cured of his disease. This myth has gained considerable notoriety as the perceived reason for some sexual abuse and child molestation occurrences, including the rape of infants, in Africa.
Another myth is that an HIV-infected mother cannot have children. Many people do not know that pregnant women with HIV can take medications to treat their infection and to protect their babies against the virus.
Margaret Korto: How do you go about breaking down those myths through the training provided through BEAT IT?
Ijeoma Otigbuo: The challenges we face include a lack of trust that prevents these issues from being discussed openly in a provider setting, and trying to educate clients to change their minds about these longstanding cultural beliefs. They hold on so hard to the beliefs that when you are trying to get them to see it another view, they resist and they may not come back. One way we can change that – and this is very important to remember – is not to treat them as if they are stupid in regards to these beliefs. Say, "Ok, that is interesting but let's see the other side of the coin, and let's negotiate." It helps to break the ice.
The goal of the BEATIT is to provide tools that enhance the provider-patient relationship in a way that builds that trust and creates open dialogue. We want to encourage individuals to know their status and as a result be an active part of their care.
Ijeoma Otigbuo is a researcher with more than 10 years of experience in public health research. Her experience spans Senegal, Nigeria, Gambia, South Africa and the United States. In addition to initiating and directing of the AIDS Awareness Resource Center at Montgomery College, Dr. Otigbuo conducts HIV global trainings for health care providers, clinicians, physicians, nurses and community members. She has a deep interest in access to quality care for vulnerable populations, specifically African immigrant populations in the U.S. Dr. Otigbuo acts as a consultant and resource person to various organizations and has served on HIV/AIDS Immigrants and Refugees Advisory Board of Maryland.