HIV/AIDS and African immigrant women in Philadelphia: Structural and cultural barriers to care

Abstract

Although African immigration to American cities is increasing, there is little published demographic or epidemiological data on this population. As growing numbers of HIV-positive Africans seek care at public health centres in the city of Philadelphia, medical personnel are confronted with the challenges of serving this population. This qualitative study explores the perspectives of HIV service providers who are treating this new patient group, and it examines the cultural and structural barriers African women face in the area of HIV prevention, testing, and treatment in the city of Philadelphia. These barriers include legal status, linguistic problems, fear of the American health system, misunderstandings about modes of transmission of HIV, and lack of awareness about antiretroviral treatment. Culturally appropriate education about HIV prevention and treatment needs to be developed for African immigrants, and medical personnel need to understand the experiences, fears, and concerns of this population.

Acknowledgments

Circle of Care Philadelphia, an organization that receives Ryan White Title IV funds from the U.S. government to provide services for HIV positive women, adolescents, children, and their families, and to prevent perinatal transmission of HIV, commissioned this study. The author carried out the research in collaboration with Tiguida Kaba and Alphonso Kawah of the Africa Family Health Organization (AFAHO), an advocacy organization that serves the African immigrant community in Philadelphia. Among other contributions, Kaba and Kawah organized and helped facilitate the focus group discussions. Special thanks to Chidinma Ibe, who introduced the author to Kaba and Kawah. Many thanks to the focus group participants, the patients living with HIV, and the service providers who agreed to participate in the research. Thanks also to the anonymous reviewers whose comments improved the strength and clarity of the arguments.