The importance of HIV testing in Black communities cannot be underestimated and Naz, the sexual health charity serving Black Asian Minority Ethnic (BAME) communities across London has launched a new campaign to call attention to the ongoing disparities. Late diagnosis, for example, remains a persisting inequality in Black African heterosexual communities and the implications of a late HIV diagnosis are grave: people diagnosed late are sixteen-times more likely to die within one year of diagnosis. In a country like England, which offers free HIV care no matter your residency status, deaths from HIV-related illnesses are completely preventable. Why, then, are Black African communities suffering?
Margaret Sentamu, president of Mildmay International, a charity working across England and east Africa to deliver HIV treatment and care to predominantly Black service users, thinks stigma and shame have a big part to play in the reluctance to test for HIV. She says, “The stigma still lingers and I can really only compare it to mental health. A disproportionate number of people from minority ethnic backgrounds end up in intensive secure units, in mental health crisis, and the same is true with HIV/AIDS. There is stigma with mental health and there continues to be stigma with HIV/AIDS.”
Naz is concerned that despite biomedical advances of the past decade, making HIV a manageable long term condition, HIV-related stigma continues to plague BAME communities. The charity, one of the only sexual health charities in the UK led by a Black woman, is launching a new campaign to tackle HIV-related stigma and encourage HIV testing in BAME communities.
The events-led campaign, Countdown to Zero, “prioritises the needs of BAME communities in the fight to end all new HIV diagnoses by 2030”, in line with the UNAIDS and World Health Organisation’s 90-90-90 strategy. 90-90-90, which is described as an “ambitious treatment target”, aims to ensure that 90% of people living with HIV know their status, are on effective treatment and cannot pass the virus on. Marion Wadibia, chief executive of Naz, thinks the focus on biomedical metrics means the daily discrimination, racism and systemic disparities faced by BAME communities is not meaningfully accounted for.
Wadibia, who’s been leading the charity for six years, says, “We fully support the 90-90-90 targets and think they’re an ambitious but reachable goal to end all new HIV diagnoses by 2030. We are concerned, though, that funding cuts to BAME-led services have been slashed by 50% over the past year in London alone, meaning there isn’t sufficient funding in place to tackle late diagnosis rates. It is unclear to us how BAME communities will be brought along on this journey to end all new HIV diagnoses if we do not have the resources to intervene, educate and test.”
In the face of funding cuts and what Wadibia calls “an alarmingly small pool of private funding”, Naz and its partners are innovating. On Monday, 15 July, Naz hosted The Gospel According to HIV, an event bringing together faith leaders, people of faith and sexual health practitioners to encourage regular HIV testing and improve HIV literacy in faith communities. The charity, established 27 years ago, has long applied an “interventions at our intersections” strategy, which has allowed the team to deliver targeted and highly-effective interventions. Josh Rivers, director of communications at Naz, says, “We receive lots of information about disparities impacting our communities and seldom any solutions for how to meaningfully address those disparities. That’s where Naz comes in. We do the proverbial math. With the insights, cultural fluency and legitimacy that comes from working within our own communities, it becomes clear that BAME-led charities should be considered key stakeholders in ending HIV. We have access, ideas and efficacy.”
The Gospel According to HIV is an example of how the team at Naz deliver culturally-specific interventions. In 2017, Public Health England reported that of the heterosexual Black Africans who tested positive for HIV, 69% of men and 52% of women received a late diagnosis. According to the latest (2013) report from the Evangelical Alliance, 48% of churchgoers in London are Black; and from 2005 to 2012, church attendance across Southwark, Lambeth and Newham (London boroughs with considerable BAME communities) grew by 50%. Data from the 2016 HIV Stigma Index revealed that 59% of BAME people living with HIV felt supported when they told someone in their faith community about their status. “There is,” says Wadibia, “a clear and present opportunity to work closely with faith leaders and people of faith to ensure HIV advocacy, testing and care is incorporated more widely into ministries.”
In the spirit of progress, four faith leaders stepped forward at The Gospel According to HIV to take HIV tests in front of a packed church, including Reverend Rose Hudson-Wilkin, Chaplain to Her Majesty the Queen. On her support of Naz, Reverend Hudson-Wilkin says, “The Gospel According to HIV is such an important intervention which recognises the impact and influence of the church as a space for important social change. BAME communities continue to be disproportionately impacted by poor sexual health and HIV and it is of the utmost importance that faith leaders answer the call to incorporate HIV advocacy, testing and care into their ministries. If we’re to end all new HIV diagnoses by 2030, we cannot do it without faith leaders and faith communities.”
Naz, through its Countdown to Zero campaign, is calling on the government and funding bodies to allocate appropriate resources to BAME-led organisations delivering interventions in BAME communities. Wadibia believes the government is not doing it’s part. “Charities like Naz, movements like Decolonising Contraception, are best placed to do this work and we should be supported to do it. We will continue to innovate, but we need the government and funding bodies to meet us halfway. Our communities will continue to suffer unless the government steps up.”
Sign The Declaration, which calls on the government and funding bodies to fund BAME-led organisations to design and deliver HIV interventions in BAME communities.