Sexuality and HIV Prevention: Perspectives from Somali Women Living in Minnesota

Background:  Minnesota has become home to the largest concentration of Somalis in the United States.  Little information is available outlining how Somali culture defines sexuality for resettled female Somali refugees living in the U.S.  This is the first known study to collect pilot information regarding sensitive sexual information related to HIV transmission, testing, and knowledge among Somali women residing in the United States.  Method:  We used a community based participatory research (CBPR) approach to conduct 30 semi-structured interviews with local Somali women aged 18-40.  In order to holistically understand the HIV risk, a full range of sexual behaviors and attitudes were assessed.  Interview transcripts were analyzed for themes using standard qualitative analysis protocols.  Descriptive statistics were utilized to describe frequency of attitudes or behaviors, as well as scores on an HIV Transmission Knowledge Scale.   Results:  Findings indicate high rates of HIV testing, low engagement in risky behaviors, acceptance of condom use, and moderate knowledge of HIV transmission.  Negative community response to our study was an unexpected result.  We found that our successful research strategies were using a CBPR approach and utilizing a community advisory board, whereas our barriers included introduction of controversial topics (sexual orientation and handing out condoms) and our interviewer’s age (late 20’s).  There was a high value placed on HIV education.  Conclusions:  Findings highlight both risk and protective factors for Somali women in regards to HIV transmission.  Although Somali women may value privacy regarding topics of sexuality and HIV, they express openness to HIV prevention education.