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Are black people being left behind?

MAKING A DIFFERENCE: The Mamohato Welcome Centre was designed and opened by Sentebale charity co-founder and patron Prince Harry in Thaba Bosiu, Lesotho. It’s a purposebuilt home to work with disadvantaged children living with HIV

WITH NEW infection rates and AIDS related deaths on a decline globally, it seems we are finally gaining ground in the fight to end the epidemic.

However, an alarming world trend in new HIV infections suggests that black people have been left by the wayside.

As an HIV-prevention campaigner, I know the struggle of addressing the wants and needs of people who are most likely to get HIV.

Sometimes healthcare workers are guilty of making broad assumptions about their daily lives, a consequence of the shoestring budgets.

“Black African men and women are advised to have a HIV test and a regular HIV and STI screen if having unprotected sex with new or casual partners,” suggests HIV in UK – Situation Report 2015 for targeted HIV-prevention messaging. This report found that in the UK, where white people make up the larger population of people living with HIV, black people were more likely to contract HIV, because it was much more prevalent in that minority population.

Making sweeping assumptions about black sexuality is counterproductive and it feeds into the social stigma that is attached to the virus, a major driver of HIV, deterring people from seeking healthcare and family planning, because of what others might say.

Growing up in what has been dubbed the world’s HIV capital, South Africa, I am familiar with false, racist rhetoric blaming high HIV prevalence in black people on wayward sexual behaviours. Brazilian researcher Kia Caldwell points out that HIV is spread due to socio-economic circumstance and not bad sex habits.

In a 2016 report on how HIV affects Afro-Brazilian females, she stressed the need for an intersectional approach to HIV research and health policy in her home country, which saw a decline in new HIV infections in all population groups except for black females. She blames the Afro-Brazilian experience of HIV on widespread poverty and violence, and a lack of access to healthcare and employment, perpetuated by structural bias based on skin colour.

The South African Studies in Poverty and Inequality Institute noted this exact experience in their 2013 study of access to healthcare in South Africa. It found while healthcare services are available, poor black people were less likely to visit local clinics as it often meant a day of unpaid leave, a precarious proposition for a casual employee.

A researcher friend working in rural South Africa told me that for a lot of men who sleep with men in these more remote communities, access to a safe setting for sex was hard to come by, let alone condoms or the time to find them. They struggle to have sex safely, even if they wanted to.

The inclusion of local voices in HIV research, messaging and advocacy is essential.

UNAIDS states in its 2016 global HIV update: “Beneath this global figure lies multiple disparities – across regions, within countries, between men and women and young and old, and among specific populations being left behind. These disparities must be addressed in order to achieve the reductions required to end the AIDS epidemic as a public health threat by 2030.”

Angelo C Louw is the former editor-in-chief of South Africa’s largest youth magazine, UNCUT

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