Late diagnosis increase risk of HIV progression for black Africans.

The recently published Better Health briefing paper on HIV and African communities emphasise the need for better collaboration between health and support providers in order to deliver effective preventative services to black Africans affected by HIV.

Black Africans make up one percent of the UK population but account for almost half of all new HIV diagnoses in the UK. They are disproportionately affected by HIV compared to other minority ethnic groups. Key issues:
• HIV prevalence amongst black Africans in England. African heterosexuals are the most affected group in the UK. The majority of those diagnosed are between 20 – 49 years. More women are tested than men through antenatal care.
• The majority of black Africans are diagnosed late and this will impact on treatment and increases the risk of the disease progression. Reasons for late diagnosis vary but include: stigma associated with HIV affecting disclosure; misconception that testing positive will lead to deportation and not knowing where to get tested, amongst others.
• There are more same sex relationships than reported among black Africans in England. However, discrimination and stigmatism often affect disclosure of these relationships, as men still rely on communal networks for social support.
• The sexual health of the black African communities is dependent on diverse socioeconomic factors. Securing housing, confirming immigration status and finding work are priorities often before health needs. The uncertainty of residency status in particular can lead to sexual risks being taken, such as prostitution, which will increase the risk of HIV infection. Faith and religion can provide emotional support, but at the same time denouncing homosexuality in religious teachings will affect sexual behaviour and attitudes.
• There are many unmet sexual and social needs of black Africans. Service and policy responses include a Department of Health funded NAHIP programme where partnership with community based African organisations delivers appropriate health support. But there are a number of issues still to address, such as myths and misconceptions about testing and treatment (particularly to men and new migrants) to reduce late testing.

These are some of the key messages from the Better Health Briefing paper on HIV prevention among black Africans in England: a complex challenge by John Owuor.
The paper outlines the social and economic factors that impact on Africans sexual health. It highlights the challenges in providing appropriate HIV health treatment and support by primary care services. To download the paper go to www.raceequalityfoundation.org.uk