Syeda Zakia Hossain

Perceived stigma and social risk of HIV testing and disclosure among Iranian-Australians living in the Sydney metropolitan area

BACKGROUND Fear of being stigmatised is a major social risk for seeking help in the HIV/AIDS arena. However, little is known about the social perceptions that people hold about the disease. This study explores the level of perceived stigma and its effect on the social risk of HIV testing and disclosure among Iranian-Australians immigrants living in the Sydney metropolitan area. METHODS A total of 236 Iranian-Australians immigrants aged 20-65 years participated in this cross-sectional study. RESULTS The majority of respondents (73.3%) perceived that HIV-infected people face a great deal of or some stigma. Participants were concerned about being stigmatised if they tested positive or were known to be HIV-positive in the future. A significant majority expressed that such concerns would affect their decision-making related to HIV testing and disclosure. Females were more likely to perceive HIV/AIDS stigma. Multiple regression analyses showed that perceived HIV/AIDS stigma could explain 28.6% of the variance in social risk of HIV testing and disclosure (B=0.89, β=0.53, P<0.0001) and 24.6% of the variance in decision-making related to HIV testing and disclosure (B=0.62, β=0.49, P<0.0001) after controlling for sociodemographic factors. Time since migration (predictive power of 4.8-6.78%) strongly influenced the associations. CONCLUSIONS If social stigma is left unaddressed, individuals would be reluctant to undertake HIV testing or disclose their HIV status if tested positive. Further attempts are needed to change the current social construction of HIV/AIDS among Iranians-Australians living in Sydney.

Decision making, use of contraception and fertility in Bangladesh: a path analysis

Draws on data from the 1989 Bangladesh Fertility Survey to explore whether or not socio‐demographic factors such as woman’s age, education, occupation, income and residence affect fertility because of different attitudes towards decision making and the use of contraception. Describes the methodology used and forms of data analysis – path modelling via LISREL. Analyses the findings – that as the woman’s age increases so does the number of children ever born, women who have not completed primary education have more children than women who have completed secondary or higher education, urban women have fewer children than rural women, and women with more education and a higher income have more autonomy in decision making, consequently are more likely to use contraception and have fewer children. Reports that when men make the decisions, families are larger and infers that there are policy implications in that finding. Concludes that the determining factors affecting fertility and use of contraception in Bangladesh are the woman’s level of education, residence in urban or rural areas, and the extent of inter‐spouse communication.

Functional Analysis of HIV/AIDS Stigma: Consensus or Divergence?

Functional theory proposes that attitudes may serve a variety of purposes for individuals. This study aimed to determine whether stigmatized attitudes toward HIV/AIDS serve the same function for all (consensus function) or serve different functions for different individuals (divergence function) by assessing various aspects of HIV/AIDS stigma using a sample of 236 adults aged 20 to 65 years from the Iranian community living in Sydney, Australia in 2007. Respondents were classified as evaluatives or expressives based on their responses to attitude function inventory scale. HIV/AIDS-related attitudes in the study group were found to have more of an expressive (58.5%) than an evaluative function (32.2%). Multiple regression analyses revealed that various aspects of HIV/AIDS stigma were functionally divergent within the study group and could serve evaluative and expressive function. The study’s findings suggest that different messages should be presented to different audiences depending on whether the stigma performs an expressive or evaluative function.

Elder Abuse: Risk Factors of Abuse in Elderly Community-Dwelling Iranians

Elder abuse is currently recognized internationally as a common problem with serious consequences for the health and wellbeing of old people. This study sought to produce an estimate of the prevalence of, and risk factors for, elder mistreatment and types of abuse in an urban Iranian population. A cross-sectional, population-based, descriptive study was conducted on 300 elderly, aged 60+ years, utilizing two health centers in Ahvaz, a province in central Iran in 2012. The participants were interviewed in their homes to collect data on risk factors and mistreatment, elder mistreatment being defined as abuse belonging to any of the four major forms: psychological, financial, physical or neglect by an immediate family member, in-laws, or relatives. Elder mistreatment was reported by 14.7% of the participants. Physical (70.4%) and neglect (61.4%) were the most common subtypes of total mistreatments. Univariate analysis showed the most consistent associations of abuse types to be with being female (OR = 2.34, CI 1.17–4.69), with education (OR = 0.36, CI 0.17–0.71), and with dependency on children for an income to live (OR = 3.18, CI 1.57–6.41). A multivariable logistic model indicated income dependency to be the only predictor of mistreatment (OR = 2.30, CI 1.10–4.81). Our data shows abuse of the elderly to be prevalent. That income dependency is the most important predictor of mistreatment of Iranian elderly suggests that addressing their income status with preventive intervention by establishing a social security system in Iran that provides for the elderly would have significant social welfare benefits.

Breast Cancer Epidemiology in Gulf Cooperation Council Countries: A Regional and International Comparison

Abstract Breast cancer is the most frequently diagnosed noncutaneous malignancy in women living in Gulf Cooperation Council countries. The present report aimed to highlight the similarities and variations in breast cancer incidence, age at diagnosis, clinicopathologic features, molecular characteristics, and lifestyle factors that contribute to an increasing incidence of breast cancer compared with neighboring Arab and westernized countries. The data presented, although having important implications for policy makers, also highlights the need for further research. Such research would ensure that effective prevention and detection strategies are tailored to the specific needs of the Gulf women such that the management of breast cancer is optimized.

Levels and functions of HIV/AIDS stigma within the Iranian community living in the Sydney metropolitan area

Objective: This study examines the levels of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) related stigma among the Iranian population and the factors that contribute to the formation of stigma within the study population. Design: A quantitative research design was used in this research whereby participants completed a self-administrated questionnaire. A sample of 236 adults aged 20–65 were collected using non-probability sampling techniques. Setting: The study was carried out in the Sydney (Australia) metropolitan area and data were collected in 2007. Method: To obtain a desirable sample size, multivariate techniques including snowball were used. Herek’s (1986) functional approach to attitudes was used to analyze HIV/AIDS stigma in the study population. Results: The findings illustrate that HIV/AIDS-related stigma was dominant among the study population. Overall, participants had negative feelings toward people with HIV/AIDS (PWHA); they were in favour of punitive policies against them and were more likely to avoid having contact with people who had contracted HIV/AIDS. Multiple regression analysis revealed that both instrumental (fear of contamination) and symbolic factors (attitudes towards homosexuals and injecting drug user) independently contributed to HIV/AIDS stigma. Conclusion: The findings suggest that HIV/AIDS stigma has instrumental and symbolic function, and concentrating solely on instrumental (HIV/AIDS transmission routes) factors is less likely to address it properly. Therefore, educational campaigns to reduce HIV/AIDS stigma should also focus on symbolic factors. The findings contribute to the knowledge area of better understanding of HIV/AIDS stigma among ethnic minorities of similar characteristics. The results are valuable for the Iranian community, health service providers, health educators and policy makers.

An exploratory study of acculturation among Muslims in Australia

ABSTRACT Muslims constitute 2.2% of the Australian population. Given the current socio-political climate and the limited research, the present exploratory study explores the relationship between acculturation, ethnic identity, self-identity, generational status, religiosity, and demographics among adult Australian Muslims. A cross-sectional convenience sample of 324 adult Australian Muslims completed either online or paper-based questionnaires in either English or Arabic. Recruitment was via convenience sampling and social media advertisements. Acculturation, ethnic identity (MEIM), religiosity, and demographic variables were measured. The study sample was young and mostly female, with high religiosity levels. Acculturation was negatively correlated with ethnic identity. From multiple regression analysis, acculturation was predicted independently by religiosity (low), age (young), gender (male) and ethnic identity (low). First generation Australian Muslims were older, had stronger ethnic identity and religiosity, and more commonly self-identified as non-Australian. By contrast second- and third-generation were more likely to self-identify as bicultural or Australian. In summary, acculturation of Australian Muslims is influenced by multiple variables, particularly ethnic identity, religiosity, and generation; hence all these variables need to be included in policy regarding successful integration of migrants.

Identity construction of second-generation Iranians in Australia: influences and perspectives

ABSTRACT Understanding the complexity of identity in the children of immigrants has become important with the growing rates of global migration. A new theoretical construct refers to an individual’s subjective representation of the interrelationships among his or her multiple group identities and how their subjective identity could be explained. The aim of this study was to examine the impact of their Iranian background and the social characteristics of their host society, Australia, on the second generation’s understanding of their national and ethnic identity. This cross-sectional study is based on a quantitative method. Participants in the study were second-generation Iranians aged 18–40, living in Australia. Data were collected on how these second-generation Iranians identified themselves with Iranian society and/or with the wider society, and how their chosen identity was influenced by their background, their national beliefs, their perspectives towards the host country and the host country’s perspective towards specific ethnic groups. Overall, 137 people participated in this study, and the results show patterns of biculturalism; the majority claimed hyphenated identity wherein the second identity was shown to be the weaker identity. The main contextual factors influencing their identity formation were birth place, acculturation and attitudes towards the host.

Detection, management and impact of diabetes among the Lebanese Community of Sydney: A qualitative study

Background: Diabetes is a serious global health issue which is known to be more prevalent among certain cultural and ethnic groups. While genetics may be a contributing factor, the higher incidence or difficulties in managing the disease may be attributable to cultural habits over generations. Studies have found the prevalence of diabetes among the Middle Eastern community is unusually high; however there is lack of information on prevalence of diabetes among Lebanese community in Australia. The aim of this study is to explore this group’s experience of diabetes. Methods: A qualitative study with in-depth interviews was conducted on Lebanese migrants living in Sydney metropolitan area (SMA) who had been diagnosed with diabetes mellitus at least six months prior to the study. Participants were purposively selected from SMA surgeries serving the primary Lebanese residential communities. Results: The findings show that lack of communication and education due to the language barrier combined with cultural differences create a difficult environment in which to treat diabetes among this ethnic minority group. It appears that the time taken by doctors and dieticians to explain the causes and effects of the disease to their patients is insufficient, that their understanding of the social and dietary customs of the community is inadequate, the usability of current treatment options is thus limited for this group, and that more appropriate treatment should be given. Conclusion: Information on diabetes needs to be available to patients and family members in a language they understand and must extend to disease management and control in the context of their daily lives. Only when doctors, educators and public health servants diagnose, treat and teach about the disease in a social and cultural context that is relevant to their specific target group can they work in conjunction with their patients to achieve effective management and control of diabetes.