‘There is no love here anyway.’ Sexuality, identity and HIV prevention in an African sub-culture in Amsterdam, The Netherlands

Abstract

Background: Undocumented African immigrants in The Netherlands are persons perceived to be at high-risk for HIV infection and yet are also a group that health care providers find difficult to access. The present study explores the experiences of a sample of undocumented African immigrants living in Amsterdam and offers recommendations aimed at providing more effective prevention interventions. Methods: Data collection occurred through interviews and focus groups with men and women aged 20–35 of both African and Dutch descent, using their interactions to explore possible communication challenges. Field notes of interviews were transcribed and analysed to identify emergent themes and patterns. A conceptual framework related to power and identity construction was adopted. Results: The findings of the present study show how identity is shaped and constrained by discourses around sexuality and health, as well as what participants perceived to be conflicting belief systems, as well as the Dutch socioeconomic context. The data were divided into two broad categories: challenges around Dutch prevention interventions and challenges around peer-support. Each category is structured around sub-themes, such as ‘concepts used in prevention messages’, ‘inter-cultural tension’, ‘identification with the educator’ and ‘stigma: roots and implications’. Conclusions: These findings indicate that issues of power and identity construction have great implications for the uptake of HIV prevention strategies by African immigrant groups and reveal important opportunities on which to focus prevention efforts.