Language problems

Service users may have a working knowledge of English, but they may require translation and interpretation services to deal with complex issues or difficult language. Some voluntary agencies are able to provide interpreting services.

In situations where there are few people who speak the required language, care needs to be taken to maintain confidentiality for the service user. Some African families may be wary of interpretation services because of a fear of identification.

Recognising specific problems

On top of the range of difficulties which arise for all families living with HIV, African families are likely to experience additional problems which may include poverty, racism, language and cultural barriers and uncertainty over immigration status. Many of the families have come to the UK, mainly from sub–Saharan Africa, and can be cut off from relatives and isolated from the usual community support systems.

For most families who have come to the UK seeking asylum, the National Asylum Support Service will be involved. It is important to encourage families to fully disclose health issues including HIV in order to ensure the families are not dispersed inappropriately.

Medical issues

Because of the language barrier, past experiences and the insecurity of their present situation, many African people find it difficult to press for information or to assert their wishes in regard to treatment for themselves or their children.

Social factors

Information about how voluntary and statutory agencies operate in the UK and an accurate and sensitive needs assessment should be carried out.

Service provision needs to adjust to the needs of African families with children, for example through provision of acceptable diet, crèche facilities, appropriate decor, reading materials, videos etc. to reflect and enhance the positive identity of service users, especially children.

Empowerment and advocacy for African families will be promoted by recruiting workers and volunteers of relevant backgrounds and by encouraging user participation in developing and running services.

Specific groups who may be particularly isolated and vulnerable,  includethose newly arrived in the UK, prisoners and detainees.