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[Serrant-Green L.Black Caribbean men,sexual health decisions and silences.Doctoral thesis.Nottingham School of Nurs-ing,University of Nottingham;2004].Statistics show black sub-Saharan African(BSSA)com-munities disproportionately constitute two-thirds of people with HIV[Heath Protection Agency.Health protection report:latest infection reports-GOV.UK;2013].African communities constitute 30%of people accessing HIV treatment in the United Kingdom yet represent less than 1%of the population[Health Protection Agency.HIV in the United Kingdom:2012 report;2012],[Depart-ment of Health.DVD about FGM.2012.Available from fgm@dh.gsi.gov.uk.].This article ex-plores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement.Methods:Twelve focus group discussions and 24 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 initia-tive 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 success-ful 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 profession-als are key strategies for engaging BSSA communities in HIV prevention programs.