Marseille 2007
| Abstract #69 - Testing times for UK African communities? Understanding the reasons for late presentation of HIV. | ||||
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Session: 45.4: Prevention in the new millenium (Parallel) on Tuesday @ 16.30-18.30 in PR Chaired by Yolande Obadia, Araceli Rousaud Authors: Presenting Author: Dr Caroline Yandell - University of Bristol, United Kingdom |
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| Additional Authors: Prof Chris Salisbury, Dr Ali Heawood, Dr Nicola Low, | ||||
| Aim: The UK African population is disproportionately affected by HIV infection, presentation is often late in the disease, and over 40% of African people living with HIV remain undiagnosed. Antiretroviral treatment may be less effective in more advanced disease, and undiagnosed infection may be contributing to the increase in HIV infection acquired by African people within the UK. Much remains unknown about the cultural practices, beliefs, experiences and attitudes of African people, with or at risk of HIV, against a background of economic deprivation, uncertain immigration status and dispersal which forces many new and vulnerable people out of the capital. This study explores the barriers to timely HIV testing in UK African communities from the perspectives of professionals and African people, and considers how to improve the uptake of testing. | ||||
| Method / Issue: A qualitative study of professional and African views of HIV testing was undertaken. Interviews with key informants from a range of professional backgrounds explored their views, experiences and attitudes relating to HIV testing in Africans. In-depth interviews with a purposive sample of African participants, of known and unknown HIV status, explored cultural norms and beliefs, perceptions of risk, knowledge and experience of HIV, access to services and issues relating to immigration and racism. Data were analysed using the constant comparative method derived from grounded theory approaches. | ||||
| Results / Comments: Complex influences and beliefs act as barriers to HIV testing amongst Africans in the UK. Key themes emerging from the data included competing priorities, fear, stigma and perceptions of risk. Cultural norms, spiritual beliefs, and negative experiences of HIV in Africa all strongly influenced attitudes to HIV testing. There was limited awareness both of asymptomatic disease and disease modifying drugs and this impacted detrimentally upon the likelihood of testing for HIV prior to the development of illness. Professionals were often profoundly affected by their engagement with African patients, expressed strongly held personal and political views, and felt keenly the emotional burden and frustrations of their work. Abhorrence of racism was particularly prominent and many professionals expressed anxiety about targeted voluntary HIV testing based on country of origin, whilst African people regarded it as broadly acceptable. | ||||
| Discussion: This study identifies complex influences which may act as barriers to HIV testing and highlights a number of cultural and social factors, beliefs and perceptions amongst African communities, which professionals should be aware of in order to be culturally competent. Many African people living with HIV do not perceive their risk of infection and are unlikely to seek testing until they develop symptoms late in the disease. Being made aware of the benefits of early diagnosis of HIV, especially the modifying effect of treatment, appears to transform attitudes to HIV. Primary Care may have a particularly important part to play in increasing the uptake of timely HIV testing; many African people would respond positively to being offered HIV testing in a generalist health care setting if they were aware of the benefits of early diagnosis. | ||||
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