Anti-HIV treatment

HIV and Africans in the UK

Africans are one of the groups most affected by HIV in the UK. Some recent reports have looked at the impact of HIV in this community and they are analysed by Jabulani Chwaula in the article below.

HIV has been with us for a quarter of a century, but despite knowing more than ever about how to prevent its transmission, and the availability of effective treatment, it’s still surrounded by stigma and discrimination.

Fear, worry, misconceptions and lack of personal awareness about the risk of infection still continue to be the basis on which a lot of people are making their decisions about their own health and that of others, or choices about safer sex.

Stigma and discrimination within African communities are so strong that they often prevent people from testing for HIV. There are high levels of undiagnosed HIV amongst Africans in the UK, and Africans are the group to have their HIV diagnosed late, when HIV-related illness has already developed. About 200 people a year die in the UK, many of them Africans, because their HIV is diagnosed so late they cannot benefit from anti-HIV treatment.

HIV i-Base recently released a report on the treatment information needs of the UK’s Africans. The report shows that Africans often have multiple issues that prevent them from benefiting from anti-HIV treatment. Such issues include not understanding the importance of taking medication properly, fears about immigration status and entitlement to NHS treatment and care, and language barriers.

The report also suggests that some patients don’t understand medical terms commonly used in routine HIV care, such as undetectable viral load or combination therapy. But the longer a person had been living with HIV, the more likely they were to understand such terms.

Myths and misconceptions are also barriers to treatment:

“I am sorry I need to bring up something. There are people who still believe that they have been cured through their faith and others who believe that because they are undetectable that HIV has been eradicated from their bodies. Many people still believe that”

Female participant (East London).

The HIV i-base report makes some suggestions about how HIV treatment information could be made more accessible to Africans.  For example making sure information is in ‘plain’ everyday non-technical language, running workshops to encourage communities to actively participate in the issues that concern them, and train advocates who can deliver treatment support.

The media can have a stigmatising attitude towards HIV and the African HIV Policy Network (AHPN) and Panos London recently released a guide with suggestions about how the African community can challenge this. It’s called Start the Press and it shows that the UK media often presents HIV as a disease of Africa that Africans are bringing to the UK. This stigmatises HIV and makes Africans reluctant to access HIV treatment and care.  

“Stigma to me means to be regarded (as) an alien…in the community I live in. You are not treated the same as others…As an African woman living with HIV I feel I am stigmatised more for where I come [from].”

African person living with HIV

The impact of stigma and discrimination cannot be underestimated. The AHPN and Panos report suggests: “To confront HIV stigma in the UK effectively, media coverage must be factually accurate and balanced, and draw on the voices and perspectives of those who are most affected – including African communities”.

But many Africans with HIV are living with multiple layers of stigma and HIV in the UK is often perceived as being purely a heterosexual epidemic.  This is far from the case, and the needs of African men who have sex with men are often overlooked.

“That is my only fear because if I go back to my country, as a gay person I cannot live comfortably at all. The HIV is a worry…but that has a solution, which is having a good job, having money to get the medication. But being gay has no solution, because you are just surrounded by people that don’t like you...that is the main problem I have as a black African living in the UK.“

African Man living with HIV (Homerton report).

Homerton University Hospital has released a report; I count myself as being in a different world: African gay and bisexual men living with HIV in London . This report looks at the needs and experiences of bisexual and gay African men living with HIV in London.

“Because of the stigma…I don’t want to bump into a lot of other African people who are going to know me and then they’ll start talking about it. Then your life is in the cycle.”

African Man living with HIV (Homerton report).

Many Africans, particularly African men, cannot speak English and this can mean that they do not access HIV care.

There are currently 70,000 people living with HIV in the UK, and as many as a third of these infections are undiagnosed. HIV isn’t just a problem for Africa, it’s very much an issue for the UK. It can only be addressed by looking at the reality of multi-ethnic Britain and developing prevention and treatment strategies that address the needs of all the communities affected by HIV.