Increasing the uptake of HIV testing to reduce undiagnosed infection and prevent transmission among black African communities living in England: Barriers to HIV testing

Abstract

Globally, the HIV epidemic continues to have an impact on the lives of millions of people. In 2008, there were an estimated 83,000 people living with HIV (both diagnosed and undiagnosed), equivalent to 1.3 per 1000 population in the UK. In that same year, 7,798 people were newly diagnosed with HIV. The global epidemic is reflected in the UK; around 38% (2,790) of these newly diagnosed infections were among black Africans who acquired their HIV through heterosexual contact. It is thought that most (87%) of these infections among black Africans in the UK were acquired abroad, mainly in sub-Saharan Africa (Health Protection Agency 2009). Late diagnosis of HIV is defined as diagnosis taking place after anti-retroviral treatment would normally have begun, or when the person has an illness which defines them as having AIDS. It is the most important factor associated with HIVrelated disease and death in the UK and is a particular problem among black Africans. In 2007, over 40% of new diagnoses among black Africans were classified as ‘late’. HIV testing can help reduce transmission of the virus. People who find out they have HIV may change their sexual behaviour as a result of the diagnosis. A negative HIV test provides an opportunity for preventive education and advice and may also lead to changes in behaviour. Increasing the frequency of testing may result in earlier detection of HIV following infection - when it is most virulent - providing greater opportunity to reduce transmissio