Late HIV Diagnosis in African Communities - Research Proposal Example

For decades now researchers have been curious about the high prevalence of late HIV diagnosis in African communities in both the United Kingdom and Sub-Saharan Africa. Recent reports show that 42% of Africans in the UK are diagnosed late, thereby missing out on the many benefits of being treated following early detection. This is especially shocking when compared with data from Sub-Saharan Africa which shows a similar level of late detection. Clearly, this is a major public health challenge that authorities must seize on. What accounts for the high level of late detection in the African community in the UK? What can be done to reduce these numbers, improve and speed up diagnoses? And how do we reconcile the fact that in some cases AIDS policy in sub-Saharan Africa is more advanced than in the United Kingdom? All these questions will be addressed in this thesis.
There are approximately 450,000 African living in the UK. According to the Health Protection Agency, one in twenty is infected with HIV. These figures on their own, while certainly cause for concern, are manageable. What makes the situation direr however is that many of these people do not know they have HIV and will not find out until the later stages of the virus. This means that they will be more likely to transmit it. It also means their quality of life will be much lower had they sought treatment during the early stages of the virus. A survey in 2008 by the University of Portsmouth of 4,000 Africans in the UK, showed that as many as a third of them said: “they had no reason to suspect they had HIV said they had no control over whether or not they became infected, and among those with diagnosed HIV, a quarter said they lacked the ability to make sure they did not pass it to their partners.” The study also showed that cultural factors and beliefs may in part play a role in these perceptions. Fear of being deported for having HIV often contributed to an individual’s reticence.
As the most heavily infected region in the world, Sub-Saharan Africa is ground zero for HIV detection. The lessons coming out of this calamitous situation are very important not only to prolonging and improving the lives of HIV-infected people in Africa but for others around the world. Those countries in Africa that have managed to control their epidemics—for example, Senegal and Uganda—have done this through intensive prevention campaigns. Public education has gone hand in hand with Voluntary Counselling & Testing (VCT). The rise of rapid testing and the ease of the provision of such testing has increased the rate of early testing from abysmal numbers only a few years ago. By making HIV everyone’s problem through public education, successful African governments have been able to increase their rates of early detection and begin to reduce the social stigma which can attach to HIV-testing or even public discussion of the issues. Fear and discrimination in both the UK and Africa contribute to a reticence towards early testing. Also, American aid has gone a long way to improve things. A recent documentary features Senator Barack Obama (as he then was) traveling in Kenya and urging people to get tested as soon and as frequently as possible. Ever the role model, he and his wife then submitted themselves to a test.
METHODOLOGY
For my thesis, I will take a sociological rather than a clinical approach to this important issue. One of the main questions I will be investigating is why is the rate of early detection so low in African populations in the UK? Another important question I will consider is what can we in the UK learn about early detection methods used in Africa?
In order to answer these questions, I will need to obtain a large quantity of data. This will primarily be done with surveys and field interviews. I intend to look at what sort of anxieties and fears the African population in the UK currently has and whether these fears are activated by the possibility a person may be infected by HIV. These sorts of issues can be addressed via surveys and interviews. Of course, a potential pitfall of this method is the possibility that those who choose to respond would be self-selected, but a large sample can reduce this concern.
A second aspect of the issue is stigma. How is the HIV stigma socially constructed and maintained? How is it different for people of different races? These questions will be investigated via interviews but also a large amount of secondary literature has been written on this issue. One of the most famous, of course, is Susan Sontag’s AIDS and its Metaphors. This too will be a starting point to this investigation.
I plan to travel to Africa—in particular to countries like South Africa and Botswana—in order to interview those on the front lines of this terrible battle. Read More