2. HIV in the United Kingdom:
2013 Report
Public Health England
» At end 2012, men who have sex with men (MSM)
remain the group with highest prevalence of HIV with
47 per 1,000 living with the infection. New diagnoses
among MSM continued to rise and reached an all-time
high of 3,250 in 2012.
» Black-African men and women were the second largest
group with highest prevalence of HIV with 38 per 1,000
living with the infection. Over the past five years, an
estimated 1,000 Black-African men and women
probably acquired HIV in the UK annually.
3. » Within Europe, there are very significant differences between different
European countries with regard to sexual education, accepted practice,
sexuality-related legislation and mores, and so on. The same applies to
Africa – so why do sexual health practitioners and agencies continue to
subscribe to a monolithic understanding of ‘Africanness’?
» Many Black-Africans do not only identify as ‘African’, but as citizens of
their distinct country and culture of origin. For example: Ugandan,
South African, Nigerian, Kenyan, etc.
» Many Black-African (or, as above, Ugandan, South African, Nigerian,
Kenyan, etc.) men who have or have had sexual contact with other men
do not self-identify as “gay”, “bisexual” or even as “MSM” and may
predominately identify as heterosexual, thus further complicating the
traditional interpretations of MSM and Black-African HIV statistics.
» These issues highlight a lack of understanding of significantly distinct
sexual AND cultural self-definitions in HIV prevention and statistical
analysis.
» They also highlight a need for new non-monolithic frameworks for
analysis, outreach, and prevention work.
4. Some of the reasons for high
levels of HIV infection in
different UK-based African
communities
» HIV myths and misinformation
» Lack of education regarding risk behaviours, safer sex,
and testing centres/procedures
» Language barriers
» Poverty
» Sexual exploitation and abuse
» Concerns about stigma and fear of discrimination
» Fear of immigration and deportation
5. Some of the factors that affect
many African-identifying MSM
in their lives, and which may
encourage risk behaviours
» Multiple systems of oppression (racism and homophobia,
for example) acting upon them simultaneously
» Difficulty in identifying with and integrating into Western
gender/sexual constructs
» Fear of losing family and community support
» Feelings of isolation, depression, and anxiety
» Fear of outing
6. Some of the factors that may
inhibit successful HIV prevention
outreach for different African-
identifying MSM
» Lack of culturally-relevant/sensitive engagement practices
» Lack of culturally-sensitive and appropriate materials (leaflets,
flyers, etc.)
» Lack of ‘safe spaces’ in which to receive sexual health
information and testing
» Concerns regarding confidentiality
» Lack of resources and spaces in which lived experiences that
mirror their own are seen
» Lack of activities extending from an understanding of the
breadth of different African cultures, MSM experiences and
perspectives
7. Considering a focus on
identity,
representation, and
lived experiences,
how do sexual health professionals and
agencies better address the unique
concerns of (differently) African-identifying
MSM, defuse fears and preconceptions
around HIV and testing, and increase
testing and sexual health awareness
amongst African-identifying MSM
nationally?
8. Possible frameworks for more effective
interventions and outreach work
» Involvement: Involving African-identifying MSM from various African
countries and cultures in EVERY STEP of engagement/outreach design and
intervention development.
» Intersectionality: Understanding that HIV infection can be linked to different
experiences of oppression and developing holistic approaches to sexual
health in the lives of African-identifying MSM
» Dynamic Models: Rethinking ‘one size fits all’ design of online and printed
materials for MSM – e.g. bare white chests with ‘KNOW YOUR STATUS’
emblazoned across may not be acceptable materials for certain individuals
to access and/or carry around
» Social Networking: Moving with and influencing the use of evolving social
media platforms for interventions and education
» Sexual(ity) Diversity: Empowering by ‘seeing’ and dis-labelling – i.e.
recognizing the complexities of sexual self-identification and inserting
information regarding male-to-male sexual activity and risk behaviours into
broader sexual health messages
» Recognizing the Power of Personal Testimony: Seeking, commissioning and
utilizing the personal stories of African-identifying MSM across a spectrum
of lived experiences, backgrounds, politics, and HIV statuses
9. Questions to
consider…
» How do we better utilise social networking and mobile
technology to provide safe virtual spaces and
confidential access to HIV information?
» How can agencies work together to create national
physical and real spaces for African-identifying MSM
to connect and share experiences?
» How do we ensure that African-identifying MSM see
themselves and their experiences in the resources we
direct them to?
