A culturally sensitive approach to HIV research and education in rural Ghana

The goal of public health is to decrease morbidity and mortality in a population through effective research and evidence-based behavior change programs. Cultural sensitivity to certain topics can impede the success of public health research and education programs if not adequately taken into account. The community-based participatory research (CBPR) model provides a context in which public health practitioners and population members can collaborate to produce data and interventions that are meaningful to both parties. We conducted a pilot study within the CBPR model to begin defining an approach to HIV research and education in rural Ghana that accounts for the cultural identity of the population. The research population was in the village of Barakuma, in the Barakese District near Kumasi, Ghana. We interviewed individuals at various levels within the Ghanaian health-care system, asking three basic questions: (1) How should an outsider study HIV in villages in rural Ghana? (2) What cultural barriers exist when talking about HIV and sexuality? (3) What are the nature and impact of HIV in this area? We concluded that refinements exist that can improve the effectiveness of government health care efforts to promote behavior change. Despite significant efforts to disseminate knowledge about HIV, there is still confusion among rural Ghanaians concerning the nature and treatment of the disease. Future programs must address the social stigma attached to the disease and increase the perceived value of getting tested and seeking treatment through the medical system. This can only be accomplished by creating programs that maintain the attention of the population and are viewed as culturally relevant. We have compiled many themes that should be considered when preparing future research or education programs within the CBPR methods that aim to achieve these goals. If outside researchers are to play any role in the control of HIV in rural Ghana, it is imperative that they work within the culture, in full collaboration with local health experts and residents, to ensure that their efforts will translate into meaningful behavior change.