AIDS in Africans living in London.

Abstract

either the AIDS-defining diagnosis or was detected within three months of this event. Sixty-two per cent of TB cases were diagnosed within twelve months of entry to the UK compared to 34% of all other AIDS cases. The prevalence of STD was very low; genital herpes was the commonest STD: 17% of the women, 9% men; 28% of the men and 11% of the women tested had a positive TPHA test. In cases known to be HIV-positive prior to an AIDS diagnosis, 41% took prophylaxis for PCP and 45% had taken zidovudine (ZDV). Forty two of the study participants had 89 children: 59 of these children had mothers in the study. Overall, 37 (42%) of the children had lost at least one parent at the time of data assessment. Conclusions-PCP and TB were the most common initial AIDS-defining diagnoses.The majority of TB cases were diagnosed within 12 months of entry to the UK. An AIDS-defining diagnosis was the first manifestation of HIV-related illness in the majority of patients. Because of late presentation to medical services, access to treatments for HIV infection and prophylaxis against opportunistic infections was limited. Extending the role of clinics and staff into the community might facilitate both earlier presentation and access to services. Future provision of local services will need to be sensitive to the requirements of individuals from different cultures and backgrounds. (Genitourin Med 1995;71:358-362)

HIV/AIDS and African immigrant women in Philadelphia: Structural and cultural barriers to care

“…In contrast to London, where the unmet needs of Africans became evident in the 1990s (Low et al, 1995;O'Farrell et al, 1995;Del Amo et al, 1996;McMunn et al, 1997;Erwin & Peters, 1999), HIV service providers and public health personnel in American cities have only recently become aware of this new patient group. The findings presented here confirm the conclusions of the Nasah study, which suggest that health interventions must focus on income-generation and other basic needs, and improving access to health information for African immigrants (Weatherburn et al, 2003).…”

“…African immigrants in the US represent a small portion of the HIV-affected population, but they may exhibit patterns similar to Africans living in London, such as having low selfperceived risk of HIV/AIDS (Erwin et al, 2002;Fenton et al, 2002) being diagnosed later than Americans (O'Farrell et al, 1995;Low et al, 1996) being slower to accept antiretroviral treatment (Del Amo et al, 1996), and having less knowledge of HIV treatment than Americans (Weatherburn et al, 2003). One study of Africans in London living with HIV reported social anxiety about disclosing their status and a high degree of mistrust of medical personnel (Erwin & Peters, 1999).…”

Uptake of medical interventions in women with HIV infection in Britain and Ireland. Study Group for the MRC Collaborative Study of HIV Infection in Women.

“…Although late diagnosis may be related to ethnicity6 9 we did not find evidence that uptake of medical interventions after diagnosis was significantly associated with presumed mode of acquisition of the virus or ethnicity.…”

Health systems’ responses to 25 years of HIV in Europe: Inequities persist and challenges remain

“…The majority of heterosexually acquired HIV infections in Europe are now in immigrants from high prevalence countries, who, like persons from ethnic minorities, present late to health services [116][117][118]. For example, in the UK, black Africans with HIV/AIDS, were more likely to present to outpatient clinics at an advanced stage of disease, but once diagnosed with HIV, their use of services was similar to that of the PLWHA who were not of black African origin [119][120][121][122][123][124][125]. Similarly, Italian IDUs in the UK experienced difficulties in accessing services [126].…”