Socioeconomic and psychosocial needs

Black African people living with HIV in the UK report a range of concerns, the experience of which may be influenced by physical and mental health, relationships, financial wellbeing, social mobility and cultural background.

In one study, a sample of 256 HIV-positive black African people were asked if they had experienced problems related to 20 ‘needs’ in the previous year. The five most commonly reported problems related to skills and training opportunities (82% of respondents), anxiety and depression (65%), money (65%), self-confidence (64%) and sleep (60%). More than one-in-five respondents had experienced between 13 and 19 of the 20 problems in the past year.¹

Those individuals who reported problems in relation to immigration frequently reported problems with money (82%) as well as housing and living conditions (73%).

As for people from other communities who test positive, diagnosis can be a shock and may trigger a period of social withdrawal or depression. However for some black African people, expectations of the impact of HIV are shaped by experiences in African countries where infection may lead to considerably shortened life expectancy and a disabling death.²

Research involving black African men found HIV had dealt a blow to their self-image, in that they were no longer able to live up to the strong masculine identity expected by others and by themselves. Most saw having a job and a solid income as an important part of who they are, but many of those who were unable to work for health or other reasons found it hard to put on a brave face while suffering inside. The pressure on men with familial ties to Africa to succeed financially is exacerbated by the restrictions imposed by HIV. For example, one respondent felt that living with the virus had so debilitated his male identity that he was akin to a woman back home.^3,4

Black African women too have to contend with the perceived challenges to identity and expectations, particularly with regards to motherhood. In one study, many described child rearing as an important source of identity and legitimacy. However, these women expressed competing anxieties over not wanting to bring an HIV-positive child into the world, or putting a potential father at risk of infection.^5,6

Isolation and loneliness were found to be common for both African men and women living with HIV. Many were doubtful they would find a partner and many, especially recent arrivals, lacked the dense familial networks that they had had in Africa. HIV-related stigma (or the fear of it) compounded this.

While being unemployed and receiving benefits was seen as demeaning for some, others found a sense of purpose working voluntarily with HIV service providers and being inspired and empowered by the people they worked with. For many religion was a key component of their coping strategy.