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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Determinants of HIV, viral hepatitis and STI prevention needs among African migrants in Germany; a cross-sectional survey on knowledge, attitudes, behaviors and practices

BMC Public Health > Ausgabe 1/2015
Claudia Santos-Hövener, Ulrich Marcus, Carmen Koschollek, Hapsatou Oudini, Mara Wiebe, Omer Idrissa Ouedraogo, Adama Thorlie, Viviane Bremer, Osamah Hamouda, Marie-Luise Dierks, Matthias an der Heiden, Gérard Krause
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12889-015-2098-2) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

CSH, UM, MW, HO planned the study design and were supported by VB and OH. CSH, MW, HO and OIO conducted the local study in Hamburg and trained peer researchers; they received support from CK and AT. Data analysis was mainly conducted by CSH and supported by CK and MaH. CSH, HO, OIO, AT and CK participated in the interpretation of results and were supported by VB, OH, MLD, UM and GK. The manuscript was drafted by CSH and critically revised by GK, UM, OH, AT, VB and CK. All authors read and approved the final manuscript.



Migrants from sub-Saharan Africa (MisSA) are a relevant sub-group for HIV-transmission in Germany. A total of 10-15 % of all newly diagnosed cases are MisSA, and approximately one third acquired HIV in Germany. There is limited information on knowledge, attitudes, behaviors and practices (KABP) regarding sexual health in African communities residing in Germany.


From October-December 2013 we conducted a cross-sectional survey on KABP regarding HIV, viral hepatitis (HEP), and sexually transmitted infections (STI) among MisSA in Hamburg as a community-based participatory research project to identify knowledge gaps, sexual risk behavior regarding HIV/HEP/STI, HIV/STI-testing history and attitudes toward people living with HIV (PLWH). Trained peer researchers recruited participants through outreach. Questionnaires in German, English or French were either administered face-to-face or self-completed. Questions on knowledge about HIV/HEP/STI presented true statements; participants were asked if they knew the information before. To detect differences in sub-groups, unadjusted odds ratios (OR) were calculated, and a multivariate analysis for knowledge on HIV/HEP/STI was performed.


The final sample included 569 participants of whom 57 % were men. Most participants originated from Western and Central sub-Saharan Africa. Median time living in Germany was 6 years. Overall, 28 % had a university degree and 54 % reported a good level of German language. Over 80 % knew the risks for HIV transmission. A total of 44 % of respondents wrongly assumed that an HIV-diagnosis might lead to deportation and 64 % were not aware of the free and anonymous local HIV/STI-testing service. The proportion of participants with knowledge of presented facts on HEP varied from 40-58 %. The respective proportion on STI was 28-68 % and better among women compared to men (44 % vs. 54 %; OR = 1.45; 95 % CI 1.22-1.74). Men reported more often casual sex partners than women (43 % vs. 23 %; OR = 2.6; 95 % CI 1.7-4.0), and more frequently a previous STI (58 % vs. 39 %; OR = 2.1; 95 % CI 1.1-4.1). Overall, 16 % of women reported a history of sexual violence. The majority of respondents (75 %) reported that they would treat PLWH like any other person.


Study participants demonstrated good knowledge on HIV-transmission but knowledge gaps regarding HIV/STI-testing services, HEP and STI. This calls for targeted interventions providing more information about these topics in African communities in Hamburg and possibly also elsewhere.
Additional file 1: Stratified analysis of items on knowledge about HIV, HEP and STI (participants who responded “I knew this already”) by basic demographic information, partnership status and mode of administration. Significant differences only (p<0.05). (DOCX 47 kb)
Additional file 2: Results of stratified analysis of sexual behavior by school education, age group and religion, HIV/STI-testing history by school education, age and religion and attitudes toward PLWH by age and religion. (DOCX 31 kb)
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