Perceptions of HIV risk amongst heterosexually identifying migrants from Southeast Asia, Northeast Asia, and sub-Saharan Africa living in Australia: implications for virtual elimination of HIV.

Heterosexually identifying migrants in Australia are among populations experiencing increasing HIV notifications, highlighting concerns about low rates of sexual health testing and awareness of Pre-Exposure Prophylaxis (PrEP). Utilising in-depth interviews, we explored perceptions of HIV risk among 16 heterosexually identifying migrants from Southeast Asia, Northeast Asia, and sub-Saharan Africa. Domains of inquiry were HIV risk assessment and management, knowledge and attitudes. Participants were majority female, aged 35 years and above, living in Australia for at least three years. Constructed themes were stigma and personal responsibility, access and awareness, proximity and distance, and differing socio-cultural attitudes. Cultural or community-based stigma influenced participants' perceptions of HIV or their reluctance to use PrEP, linked to morality and safety concerns. Limited uptake of PrEP was contrasted by generally high knowledge of HIV transmission, prevention, and treatment. Attitudes and perceptions were commonly influenced by access to sexual health education, exposure to and visibility of HIV information, social proximity to people living with HIV, and sociocultural norms. Participant insights highlight the need for culturally responsive public health education outside dedicated sexual health spaces, particularly regarding PrEP, and reinforce the need for targeted, peer and community-led health promotion responses to support virtual elimination of HIV.