Both the NASAH and PADARE surveys showed that over one-half of participants had been diagnosed in the UK less than three years ago. Whilst there is evidence that black Africans present later with HIV, this may be attributable to their not being in the UK rather than to problems accessing healthcare in the UK. Diagnosis in the UK may not be their first diagnosis. Sigma Research found that 21% of respondents were probably first diagnosed with HIV prior to residence in the UK, although reports identify a lower figure of 7% among black African women. Reactions to diagnosis were largely similar to those reported for other groups of HIV-positive people, with an initial period of shock often followed by confusion, social withdrawal and depression.

However, the NASAH study found that major depression was more common among African than white people with HIV, a finding possibly related to the often-difficult socio-economic circumstances of the former. African women frequently reported anxiety and uncertainty. Despite major depression being more common among African than white people with HIV, black Africans were almost three times less likely to be referred to a specialist mental health unit in London. Individuals of African origin have also been shown to be less likely to be referred by health advisors for psychological assessment, in part because they do not discuss their HIV- related distress unless questions are asked.

There is evidence that an HIV diagnosis is particularly stressful for those African people in the UK who have uncertain immigration status. It is also clear from the research evidence that many had experienced AIDS in Africa where HAART is rarely available and HIV remains a terminal illness. For the many Africans who have experienced HIV in Africa, or indeed for those whose immigration status was not clear, positive test results represented a death sentence. As a result, they view their immigration status and continued residence in the UK as a matter of life and death. Respondents in all studies showed that they were active participants in the management of their health.

In all the above studies, between two-thirds and three-quarters had taken anti-HIV treatment at some point. Other methods used to manage health included nutrition, religion and use of complementary therapies.