From: Biniam Tekle (biniamt@dehai.org)
Date: Tue Dec 22 2009 - 12:35:11 EST
http://www.guardian.co.uk/commentisfree/2009/dec/22/hiv-aids-black-african-immigrants-uk
The
hidden rise of HIV in the UK
Cultural barriers and lack of outreach services have sent rates of HIV/Aids
among black African immigrants soaring
- *Hazel Barrett*
Tuesday 22 December 2009 15.00 GMT
My research in the west Midlands with postgraduate student Betselot
Mulugeta, talking to groups of immigrant men and women from the Ethiopian
and Eritrean communities, has revealed serious misconceptions about the
nature of the HIV/Aids epidemic in the UK. Lack of information tailored for
different migrant groups, alongside lower awareness of HIV/Aids through
media coverage as a whole, is a problem with real consequences.
Newly reported cases of HIV in the UK are higher than ever before. Between
1995 and 2006, the rate of HIV
infection<http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1203084368853>among
black Africans in the west Midlands increased 100-fold, compared to a
two-fold increase among white people, a three-fold increase among black
Caribbeans and a six-fold increase among other mixed ethnic groups
(according to the region's strategic health authority figures).
Taking the Ethiopian and Eritrean population as one example: they are
predominantly young and single, tend to live alone and are often sexually
active. Their culture and language restrict the information available to
them. This group therefore represents a reservoir of HIV infection which is
both a concern for the immigrant community itself and the host population.
As social networks among the Ethiopian and Eritrean communities in the west
Midlands do not condone or tolerate the discussion of sexual issues,
external information networks are crucial in raising awareness of the HIV
situation in the west Midlands and reducing stigma and discrimination of
those who are HIV-positive.
The respondents in our study said they believed the UK was "civilised" and
therefore they could not contract HIV/Aids, that the problem had been left
behind in Africa. Some commented that they believed all migrants were
screened before being allowed entry, and that drugs were available in the UK
that would "cure" Aids. Perhaps most tellingly, interviewees said that Aids
wasn't talked about in the UK and no information or warnings were provided,
so they had assumed there wasn't a problem. Culturally, condoms are a
difficult issue. It is considered unacceptable for either partner in a
sexual relationship to ask for a condom to be used, because it's thought to
suggest the woman is promiscuous or a prostitute, or that there is a lack of
trust between them.
One of the main reasons for this lack of appreciation of the HIV risk
environment in the west Midlands appears to be a lack of communication and
understanding between HIV-related service providers and immigrant
communities. In particular there are very few culturally sensitive outreach
sexual health promotion programmes aimed at different immigrant groups from
high HIV-prevalence source regions in the west Midlands, with hidden groups
such as failed asylum seekers and irregular migrants often ignored.
The ruling by the UK court of appeal earlier this year that refused asylum
seekers and other "not ordinary UK residents" are not entitled to free NHS
treatment and care is creating a reservoir of HIV infection in the UK. It is
these marginalised and often hidden groups, who are highly vulnerable to HIV
infection due to their socio-economic situation, that are being denied free
medical treatment. Denying unrestricted NHS HIV treatment to this group is a
serious public health issue which may well fuel the epidemic in the UK.
There is a desperate need to understand the social context of the disease
both in terms of the migrants' region of origin as well as in their new UK
communities. The British government is yet to address the steep rise in
rates of the disease among heterosexuals and a new Aids awareness campaign
targeted at those most at risk of spreading it is imperative. It's a
campaign they are reluctant to undertake because of the sensitivities around
immigration, race and perceptions of neo-colonialism.
Sub-Saharan Africa is home to 67% of global cases of HIV/Aids, but it is
dangerous to think of the disease as just an African problem now that we can
travel easily between continents. Surely it is time we had another UK
national campaign to bring this deadly disease to everybody's attention and
to correct the misconceptions both the host and migrant communities have of
the HIV/Aids epidemic in the UK.