HIV majority neglected

nytimesBy Sylvia Rowley and Ciaran McCauley

The health of black Africans living in Lewisham could be compromised because of a lack of HIV prevention services from health authorities, The Platform can reveal.

Black Africans have the highest HIV rates of any group in Lewisham – they make up 9% of the borough’s population but 70% of people diagnosed with HIV last year, according to Lewisham Primary Care Trust (PCT).

Despite the high incidence of HIV among black Africans in the borough, they are not being targeted by the health authority’s HIV services. Alison Davies, a sexual health community outreach nurse on the team responsible for raising HIV awareness in Lewisham, said “we don’t do any work specifically with this group.” The PCT does not have any targets for HIV testing among the black African community.

According to Shaka Services, a sexual health organization covering south east London, members of the black African community can be reluctant to attend mainstream services. Constantia Pennie from Shaka Services said: “The PCT has set up rapid HIV testing sites at clinics but African community members just aren’t going. Many of them don’t feel comfortable walking into a government clinic.”

Shaka is putting in a bid with the PCT to run mobile clinics, testing people in community centres “where they can be more relaxed,” but at the moment this is not available.

Late diagnosis of HIV is damaging to a person’s health. National figures released last week show that 42% of black Africans were diagnosed when they should already have begun treatment, more than in any other group.

Southwark, Lewisham and Lambeth together have the highest rates of HIV in London. There are 1158 people living with HIV in Lewisham, 534 of whom are black African.

There is a lot of stigma and misinformation about HIV in African communities, says Harriet Kyalimpa, a health promotion specialist at African Health for Empowerment and Development (AHEAD). “Awareness raising with this community is crucial. Their level of information can be worrying. Some people think that they can control whether or not they pass on their HIV, or they think they’ll die sooner if they get tested.” A forthcoming report from the Terrance Higgins Trust shows that 33% of black African immigrants in Lewisham think they will be deported if they test positive for HIV.

260% increase in HIV cases since 2000

Without targeted awareness raising, myths about HIV persist and opportunities to reduce the transmission of HIV are being missed. Figures released by the Health Protection Agency show that there are now 2,440 black Africans living with HIV in south-east London, an increase of 260% since 2000.

The task of informing and testing members of the black African community is often placed on voluntary organizations, says a spokesperson from the South London HIV Partnership.

However, many small African community organizations are struggling financially and are at risk of closing, says Denis Onyango from the Southwark-based African Advocacy Foundation.

Dr Josephine Ruwende, Consultant in Public Health at Lewisham PCT said: “The PCT does HIV prevention work with a variety of voluntary groups, targeting high-risk groups such as men who have sex with men. The PCT funds a condom distribution scheme and offers rapid HIV testing in its four sexual health clinics.”

Lewisham PCT, along with Lambeth and Southwark, also funds a group of five community organizations to provide HIV awareness and prevention services to African communities. The ‘safer partnership’ began a year ago and it too early to say what difference it has made.

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