12th Annual Conference of the British HIV Association 29 March–1 April 2006, Brighton, UK

BARRIERS TO VOLUNTARY CONFIDENTIAL HIV TESTING AMONG AFRICAN MEN AND WOMEN IN ENGLAND: RESULTS FROM THE MAYISHA II COMMUNITY-BASED SURVEY OF SEXUAL ATTITUDES AND LIFESTYLES AMONG AFRICANS IN ENGLAND

HIV Med 2006; 7(Suppl. 1):7 (abstract no. O28)

Gillian Elam¹, Katharine Sadler¹, Christine McGarrigle¹, John Parry¹, Oliver Davidson², Danielle Mercey³ and Kevin Fenton^1
1 Health Protection Agency Centre for Infections, London, ² Camden Primary Care Trust, ³ Royal Free and University College, London, UK

OBJECTIVES: In response to rising diagnoses of HIV infection in Africans in the UK, Mayisha II aimed to measure diagnosed and undiagnosed HIV infection among African communities and explore the socio-demographic and behavioural associations with HIV infection.

METHODS: A community-based survey was conducted among 1359 Africans in London, Luton and the West Midlands with in-depth follow-up interviews among 44 selected survey respondents during 2004–2005. Oral fluid samples were provided by 75% of respondents using an Orasure device for anonymous testing for HIV antibodies. Respondents were recruited from venues and social gatherings by community fieldworkers who also administered the Orasure tests.

RESULTS: Despite high levels of HIV testing in the survey sample, half of females and 43% of males reported never having a voluntary confidential HIV test (VCT); fear of reprisals following an HIV diagnosis continue to deter others from VCT and contribute to undiagnosed HIV in the sample. Analysis of narrative accounts indicates that HIV infection is associated with sexual 'misbehaviour' and 'immorality'. Consequently, there are expectations of retribution and rejection by partners and family members following diagnosis. However, respondents' accounts of outreach work and the uptake of the Orasure test during the survey suggest that interventions can have an impact on such beliefs.

CONCLUSION: Findings from Mayisha II confirm that the impact of discrimination and stigma is widespread within the lives of Africans in the UK and contributes to decisions to HIV test. Outreach work is having an impact on the acceptability of VCT in the community, but more action is needed to reduce HIV-related stigma and discrimination.

2006-03-29
O28

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