Situating HIV risk in barbershops: accounts of knowledge and practices from barbers in Nigeria

Abstract

This study explores the contextual factors mediating HIV transmission risk in barbershops using qualitative data from in-depth interviews with barbers (n = 16) in Nigeria. Barbers were aware of individual-level risk factors for HIV transmission. Accounts highlighted individualisation of risk responsibility, wherein the decisions and actions of individual barbers were seen as primary determinants of risk, while overlooking the role of factors beyond the individual in the production of risk. The implementation of HIV prevention measures (such as sterilisation of barbering equipment) was impeded by social and structural factors such as income insecurity and pressure and demands from clients. These exogenous factors interacted with individual-behavioural ones (fatigue, delay in restocking disinfectants) to create a risk environment for HIV transmission in barbershops. Barbers chose between competing risks when making decisions about HIV prevention. Concerns about maximising income by serving more clients often trumped HIV prevention through sterilisation of equipment. These findings contribute further insights and nuances to an existing literature which shows that risk is a highly contextualised phenomenon that reflects the different impacts of structural forces on lived experiences. The findings highlight a need for models that bridge cognitive and lived dimensions of risk understanding to optimise HIV prevention in barbershops.