Africans HIV Prevention in England
posted: 23/06/2010
HIV prevention among black Africans in England describes the major prevention challenges and highlights the actions that are needed and details the sexual health needs of Africans in England. It’s a useful briefing paper with helpful information on where to find more information and guidance. It is one of a series of briefings from the Race Equality Foundation.
Its key messages are that
- Black Africans in England have the highest rates of heterosexually acquired HIV. Black Africans are about 1% of the population, but have nearly half of new HIV diagnoses. Many of these infections occurred abroad, but a rising proportion happen here.
- The majority of black Africans in England are tested for HIV very late; this makes onward HIV transmission much more likely. Most, particularly men, are diagnosed at such a late stage that treatment does not work as well as it should. This cuts the quality and length of life.
- There are many more same-sex relationships than reported among black Africans in England. Often men have relationships with both women and men.
- The sexual health of black African communities is worsened by many socio-economic factors.
- There are many unmet sexual health and social needs among black Africans living in England, making people far more vulnerable to HIV.
It concludes with a shopping list of the main unmet needs that require action. These include
- Late HIV testing and undiagnosed HIV are serious issues. All myths and misconceptions about testing and treatment need challenging to encourage testing. More information about the available services, and more support to encourage their use are needed, particularly to reach men and new migrants. There need to be good referral systems within and between organisations.
- Prevention interventions and information should target people with lower education, and young black Africans. People, including late teenagers, lack basic information concerning condom access and use and negotiating safer sex, for example. Interventions should target heterosexual men and men who may have sex with men.
- Educating men especially about consistent condom use is critical because many women are vulnerable to HIV infection due to socio-economic factors, lacking the power or authority to safely insist on condom use. Positive women often face the same problem with negotiating in safety for condom use to avoid onward transmission. Condom distribution, including of female condoms (femidoms), needs to be intensified to improve condom accessibility.
- People diagnosed with HIV should be involved in the development and implementation of interventions (sometimes called ‘positive prevention’), because people with HIV have a key part to play in halting onward transmission and reducing HIV-related stigma and discrimination. However, ‘positive prevention’ needs to respect human rights and dignity, incorporate shared responsibility and avoid reinforcing HIV stigma and discrimination.
- Service providers working with Africans should be aware of HIV trends in the countries of origin of their service users, and the local prevalence data in England, in order to plan and target their interventions appropriately. NW England annual district level detailed HIV statistics
- The majority of black Africans are involved in various religious faiths, making religious leaders key contacts for reaching wider audiences. Interventions should be sensitive to faith issues. Many religious leaders would benefit from training in HIV issues.
- Service providers should recognise that there are many more same-sex relationships among black Africans than reported, and tailor their services appropriately. Providers should not assume having same gender sexual relationships has much or any connection with the gay and bisexual sexual identities familiar in England. However services should also seek out Africans who do have gay or bisexual identities. Whatever the sexual identity a person has, it is same sex behaviour that gives rise to significantly higher HIV transmission risk and unmet sexual health needs than with exclusively heterosexual black Africans.
- There is a need for continuous information, education and communication on HIV and sexual health, targeting not just black Africans but also the general population, in order to reduce stigma and discrimination, which undermine the impact of current interventions. Tightly targeted interventions risk increasing HIV stigma among and directed towards black Africans.
- GPs (family doctors) can play a leading role in HIV diagnosis among black African communities. This needs handling with sensitivity.
HIV prevention among black Africans in England
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