Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs : challenges and strategies from England

Objective: HIV infection is a sensitive issue in black communities [1]. Statistics show black sub-Saharan African (BSSA) communities disproportionately constitute two-thirds of people with HIV [2]. African communities constitute 30% of people accessing HIV treatment in the United Kingdom yet represent less than 1% of the population [3, 4]. This article explores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement. Methods: Ten focus group discussions and 21 semistructured interviews were conducted in a 2-year period with participants from the BSSA communities and sexual health services in the West Midlands, England. The research was supported by the Ubuntu scheme, a sexual health initiative working with African communities in Birmingham, England. Results: Ineffective engagement with African communities can hinder the effectiveness of HIV prevention programs. Skills and strategies sensitive to BSSA culture are important for successful implementation of prevention programs. HIV prevention programs face challenges including stigma, denial, and marginalized views within BSSA communities. Conclusion: Networking, coordination, and cultural sensitivity training for health professionals are key strategies for engaging BSSA communities in HIV prevention programs.