More should be done to reduce burden of HIV on Africans living in the UK, says Health Protection Agency

The government needs to do more to address the unmet needs of Africans in the United Kingdom when it comes to HIV prevention, diagnosis and care, according to a report by Gillian Elam and her colleagues at the Health Protection Agency (HPA) in the January 26^th edition of the Eurosurveillance Weekly Surveillance Report . Although the Department of Health has recently funded several strategies, including producing a guidelines document which outlines a roadmap for reducing the burden of HIV on Africans in the UK, more needs to be done to make these guidelines a reality.

HIV/AIDS is disproportionately affecting African communities in the United Kingdom, and in England in particular. They are the second largest group affected by HIV in the UK after gay men and since 1999 new HIV diagnoses in Africans have overtaken new diagnoses in other groups.

In 2004, there were 3136 newly-diagnosed HIV infections in heterosexual men and women born in sub-Saharan Africa, accounting for more than 90% of all heterosexually-acquired HIV in the UK.

In addition, 2004 saw a rise in the numbers of people living with undiagnosed HIV infection, highest levels of which were seen amongst those born in sub-Saharan Africa, which can be partially explained by the recent dispersal of migrant populations from countries with high levels of HIV infection to areas outside London. According to the report, "many of these places do not have as many HIV-related services as London, new migrant populations may have poor access to local health services and HIV is not given a high priority for service development in many provincial areas."

Even in London, Africans have their HIV diagnosed at a later stage than either white or Caribbean patients. A 2004 HPA-led community-based survey found that "fear of HIV and associated stigma and discrimination [that] continues to deter African men and women from seeking HIV tests," and recommended that African community HIV organisations should do outreach work in order to motivate people to come forward for voluntary counselling and testing.

In January 2005, the Department of Health collaborated with the National Aids Trust, the African HIV Policy Network and other stakeholders on a strategy that aimed to "ensure that those involved with the prevention, detection and treatment of HIV receive support and guidance that is appropriate and relevant to the needs of African communities, and to focus the minds of policy makers on the importance of continuing HIV prevention and other work with African communities."

The strategy focusses on the myriad aspects of HIV prevention, diagnosis and care amongst heterogenous African communities living in the UK, including reducing the onward transmission of HIV, reducing the number of Africans with undiagnosed HIV infection, and improving the health of Africans living with HIV.

Although this strategy is one of several government-funded measures that address HIV and AIDS in African communities, and "is a useful demonstration of collaborative working, showing the importance of involving community groups in policy development", the report argues that the government needs to go much further "to reduce the burden of infection in African communities."

In particular, more needs to be done to make sure that this roadmap is actually followed, the report concludes. "It is disappointing," Ms Elam and colleagues write, "that no financial commitments were made and local health authorities and government are not obliged to adopt the guidelines."

A copy of the 2005 Department of Health report, HIV and AIDS in African communities: A framework for better prevention and care can downloaded here.