A qualitative analysis of multi-level barriers to HIV testing among women in Lebanon

While the number of HIV cases in the Middle East and North Africa region is low compared to other regions, recent studies show that incidence is increasing especially among high-risk populations; in particular, little is known about women and HIV in the region. Through semi-structured interviews wit...

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Bibliographic Details
Published in:Culture, health & sexuality health & sexuality, 2017-09, Vol.19 (9), p.996-1010
Main Authors: Clark, Kirsty A., Keene, Danya E., Pachankis, John E., Fattal, Omar, Rizk, Nesrine, Khoshnood, Kaveh
Format: Article
Language:English
Subjects:
Adult
AIDS Serodiagnosis
Attitude of Health Personnel
Barriers
Culture
Diagnostic tests
Ecological studies
Female
Grounded theory
Health care industry
Health education
Health insurance
Health services
High risk
HIV
HIV testing
Human immunodeficiency virus
Humans
Insurance policies
Interviews as Topic
Lebanon
Male
Medical diagnosis
Medical tests
NGOs
Nongovernmental organizations
Patient Acceptance of Health Care - ethnology
Patient Acceptance of Health Care - psychology
Physicians - psychology
Qualitative Research
Sex education
Sexual behavior
Sexual health
Snowball sampling
stigma
Taboos
Tests
Women
Womens health
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Summary:While the number of HIV cases in the Middle East and North Africa region is low compared to other regions, recent studies show that incidence is increasing especially among high-risk populations; in particular, little is known about women and HIV in the region. Through semi-structured interviews with sexual healthcare providers and staff at non-governmental organisations, we sought to understand barriers to HIV testing among women in Lebanon. Using snowball sampling, key informants were recruited from greater Beirut (12 physicians, 9 non-governmental organisation staff). Data were analysed using a grounded theory framework. Findings identified barriers to HIV testing among women at each level of an adapted social-ecological model (i.e. social-cultural barriers, policy barriers, interpersonal healthcare provider barriers and intrapersonal barriers). Primary findings include the culture of sex as taboo; lack of sexual health education among women; fear of disclosing HIV testing and diagnosis; financial barriers linked to stigmatising insurance policies; and provider attitudes towards women. Findings can be used to inform HIV-related sexual health interventions at multiple levels for women in Lebanon and the greater region.
ISSN:1369-1058
1464-5351
DOI:10.1080/13691058.2017.1282045