HIV in African people in StocktononTees

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HIV in African people in Stockton-on-Tees

• Dr Paul Williams GP
• paul.williams2_at_nhs.net

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County of origin of Arrival patients 8/11/04
(n558)
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Africans at Arrival

• 229 African people
• 203 adults
• Eritrea
• Ethiopia
• Zimbabwe
• Sudan
• DR Congo
• Angola
• Cote DIvoire
• Liberia

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HIV Status of African adults

• 203 adult patients born in Africa

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Diagnosed HIV

• 116 people know their HIV status

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Undiagnosed HIV

• HIV status of 43 is unknown

?
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Rape

• In a study of 350 consecutive newly arrived
  refugees in Stockton on Tees in 2003/4
• 43.2 of African women disclosed rape
• 4.4 of African men disclosed rape or sexual
  assault

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Reasons for not having HIV test

• Fear of positive result
• Association between HIV and death
• Worries about immigration status
• Myths about HIV
• Prejudice
• Lack of knowledge
• Lack of awareness

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Stockton HIV Strategy group
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Aims of HIV health promotion strategy

• Increase the uptake and availability of voluntary
  counselling and testing
• Improve knowledge and awareness of HIV
• Encourage safer sex
• For the community to take over the project

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Tools

• Involving African people in planning
• Word of mouth communication
• Talking with community groups
• Posters and information in targeted areas
• Football team
• VCT in the community
• Evaluation

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Evaluation?

• Comparison of testing before and after
  implementation
• Evaluation of community knowledge through
  questionnaire
• Measures of harm?
• Case studies qualitative measures

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Difficulty with evaluation

• Difficult to measure a complex intervention is
  it the intervention that does/doesnt work or
  its implementation?
• Transient population but some people remain for
  long time
• Different African communities arriving
  different religions, cultures, values

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Problems with the intervention

• Stigma
• Community priorities change (immigration,
  assimilation)
• Evidence from developing countries and areas of
  UK with established African populations -
  ?transferability
• Many people have opinionsdifficulties with
  working with community

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Successes

• Being approached formally by unhappy members of
  the community
• Approaches to the Community nurse offering
  information and testing - ?unmet need
• Requests to speak at events
• Football team engagement

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Future

• Continues presence at community events
• Try to take the long-term view to change
  attitudes and build trust to facilitate behaviour
  change
• Encourage key individuals to take over project