Projects per year
Abstract
Objectives
African and Caribbean heritage (ACH) communities in the UK face disproportionately high rates of HIV and often experience delayed diagnoses, worsening health inequities. Increasing HIV testing in these communities is essential to address these disparities and support the UK’s HIV reduction targets. This study examines barriers and facilitators to HIV testing among Bristol’s ACH community, a high-prevalence area with significant rates of late diagnoses, filling a critical gap in context-specific data.
Methods
Using a mixed-methods approach, this study combined 29 in-depth interviews and 41 online surveys, capturing ACH community members’ views on HIV stigma, healthcare trust and testing experiences. Data were thematically analysed and mapped to the Social Ecological Model (SEM) framework, with community researchers conducting data collection and analysis to enhance participants’ engagement and trust and contribute to a deeper contextual analytical understanding.
Results
Findings highlight significant barriers across SEM levels: individual-level knowledge gaps and stigma, interpersonal confidentiality concerns within tight knit communities, community-level taboos and distrust and organisational barriers, such as discriminatory healthcare experiences. Effective facilitators included culturally specific services, flexible testing options, community-driven outreach and increased healthcare representation, all of which fostered greater trust and engagement in testing.
Conclusion
The study underscores the importance of culturally aligned interventions, including representation within and training in cultural competence for healthcare providers and community co-production in service design. Implementing such strategies could reduce late diagnoses and support the normalisation of routine HIV testing in ACH communities, ultimately contributing to health equity. Future research should explore gender and age-specific barriers, while assessing the long-term impact of community-led interventions to inform national HIV policy and public health strategies for marginalised communities in the UK.
African and Caribbean heritage (ACH) communities in the UK face disproportionately high rates of HIV and often experience delayed diagnoses, worsening health inequities. Increasing HIV testing in these communities is essential to address these disparities and support the UK’s HIV reduction targets. This study examines barriers and facilitators to HIV testing among Bristol’s ACH community, a high-prevalence area with significant rates of late diagnoses, filling a critical gap in context-specific data.
Methods
Using a mixed-methods approach, this study combined 29 in-depth interviews and 41 online surveys, capturing ACH community members’ views on HIV stigma, healthcare trust and testing experiences. Data were thematically analysed and mapped to the Social Ecological Model (SEM) framework, with community researchers conducting data collection and analysis to enhance participants’ engagement and trust and contribute to a deeper contextual analytical understanding.
Results
Findings highlight significant barriers across SEM levels: individual-level knowledge gaps and stigma, interpersonal confidentiality concerns within tight knit communities, community-level taboos and distrust and organisational barriers, such as discriminatory healthcare experiences. Effective facilitators included culturally specific services, flexible testing options, community-driven outreach and increased healthcare representation, all of which fostered greater trust and engagement in testing.
Conclusion
The study underscores the importance of culturally aligned interventions, including representation within and training in cultural competence for healthcare providers and community co-production in service design. Implementing such strategies could reduce late diagnoses and support the normalisation of routine HIV testing in ACH communities, ultimately contributing to health equity. Future research should explore gender and age-specific barriers, while assessing the long-term impact of community-led interventions to inform national HIV policy and public health strategies for marginalised communities in the UK.
| Original language | English |
|---|---|
| Number of pages | 8 |
| Journal | Sexually Transmitted Infections |
| Early online date | 13 May 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 13 May 2025 |
Bibliographical note
Publisher Copyright:© Author(s) (or their employer(s)) 2025.
UN SDGs
This output contributes to the following UN Sustainable Development Goals (SDGs)
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SDG 3 Good Health and Well-being
Research Groups and Themes
- NIHR ARC West
Keywords
- HIV Testing, African and Caribbean heritage (ACH) communities, Health disparities, Stigma, Cultural competence, Social Ecological Model, Community-based interventions, Late diagnosis, Healthcare access, UK HIV policy
Fingerprint
Dive into the research topics of 'Barriers and facilitators to HIV testing among African and Caribbean heritage communities: a mixed methods study'. Together they form a unique fingerprint.Projects
- 1 Active
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Common Ambition Bristol: Addressing HIV stigma and testing in partnership with African and Caribbean communities
Horwood, J. (Principal Investigator), Fox, F. E. (Co-Investigator), Eyles, E. C. (Co-Investigator), Adeniyi, T. R. (Co-Investigator), Sillero Rejon, C. (Co-Investigator) & de Vocht , F. (Co-Investigator)
31/01/21 → 31/12/27
Project: Research
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