Africans comprise up to 70 percent of all new heterosexual HIV cases in the United Kingdom each year, but they struggle to access prevention information and services, advocacy groups have said.
A 2007 report by the UK parliamentary office for science and technology found that of all ethnic groups, black Africans represented the largest number of new HIV diagnoses. "Almost 25,000 people born in sub-Saharan Africa were estimated to be living with HIV in the UK in 2006, a proportion 50 times that of whites," it noted.
Despite such figures, knowledge about how to prevent HIV remains low among this group, according to a recently released assessment of the HIV prevention needs of African people in England by research group, Sigma.
"Sixteen percent [of people surveyed] did not know it is possible to have HIV without knowing it, and a similar proportion did not know that someone with HIV is not obviously positive simply by looking at them."
The study, which surveyed more than 4,100 African men and women, found that 48 percent of Africans living in England had never been tested for HIV, yet more than one in 10 of the respondents wanted to test for HIV but did not know where to go, highlighting the need for more information about the availability of testing services.
Male respondents were more likely to have had more than one sexual partner in the last year than women, and one in eight men reported having had five or more partners in the last year. Bisexual and homosexual men had higher numbers of partners than exclusively heterosexual men, while bisexual men were least likely to know all the facts about AIDS.
Condom use among the respondents was inconsistent, with 25 percent of people who reported having had sex in the past year saying they had not used a condom, and fewer women than men reporting condom use. One in 10 respondents said they had definitely or probably had sex without a condom with someone who had a different HIV status to themselves in the last year.
An estimated 30 percent of those who did use condoms reported that it had broken or come off during intercourse, highlighting a need for more education on condom use. A quarter of respondents were unaware that condoms were freely available from clinics and other service providers.
The report recommended that "interventions to increase condom use should address confidence in negotiating their use, and should aim to increase the social acceptability of carrying and using them."
The researchers noted that access to health services was particularly difficult for illegal immigrants, who were often too afraid of being arrested and deported to seek medical help; many had fled conflicts in which they might have been subjected to sexual violence, or forced into sex work that could have made them vulnerable to HIV infection.
The African HIV Policy Network (AHPN), a UK-based coalition of NGOs that collaborated with Sigma in the research, has estimated that twice as many African women as men are diagnosed with HIV in the UK annually, mirroring the epidemic on the African continent, where HIV infections among women outstrip infections among men.
AHPN's recommendations for reducing the number of new HIV cases among Africans living in England included directing more public funding to prevention programmes targeted at this group, providing better sex education in schools with large numbers of African students, and making prevention interventions accessible and appropriate for African audiences.