Our society, often quick to categorize and generalize members of minority groups, rarely separates the “African” from the “American” when discussing the black epidemic. Prevention and treatment strategies often fail utterly to distinguish between exploding infection rates in the African-American community and African immigrant communities. This springs partly from the difficulty of the task—and from the lack of funding to implement it. Indeed, there’s a fundamental lack of awareness that these distinctions are even important. And this may be hurting both groups.
In Massachusetts, for instance, half of the black individuals who contracted HIV between 2003 and 2005 were non-U.S.-born, according to the Multicultural AIDS Coalition (MAC). The state is hardly atypical. That’s why MAC and other prevention experts are saying that more emphasis must be placed on targeting immigrant awareness. “Among immigrants of color, African immigrants are the leading immigrant population being affected [by HIV] in Massachusetts, in terms of newly diagnosed and prevalence rates,” says Chioma Nnaji, program manager for the Africans for Improved Access program at MAC. “And it’s steadily increasing.”
African immigrants, who hail from each of the continent’s 53 countries, face a variety of prevention concerns, Nnaji and other experts say. “You have to go beyond the prevention message and learn about [an individual’s] culture,” says Alpha Kassogue, a health educator at African Services Committee, a New York-based organization that provides health and social services to African immigrants. Kassogue, born in Mali, adds, “Dealing with someone from Mali is different than dealing with someone from Uganda.”
Nnaji agrees, saying that the extent to which a person’s homeland has or has not addressed the AIDS epidemic can affect the success of certain targeted prevention initiatives in the United States. “Some countries have done more work in HIV/AIDS than others,” she says. “You have individuals from Uganda who will be very conscious of HIV … and then you have those from Liberia, a country that has undergone civil war for the last ten years. Understanding those different dynamics [is important].”
For newly arrived African immigrants, the language barrier can be devastating: AIDS service organizations often don’t have translators fluent in the wide breadth of African dialects. This, coupled with undocumented immigrants’ fear of coming forward for health care, can endanger HIV-positive African immigrants and put those who are HIV negative at higher risk. The MAC program recently received funding specifically to target African immigrants; Nnaji and her staff are using it to work with various African communities around the Boston metropolitan area. Her staff holds “safety net parties,” where groups of African women gather to eat, relax and talk about safety and prevention.
Various immigrant communities can even stereotype and misperceive one another: A client from Ethiopia once told Nnaji that she would not have sex with anyone from that country because she felt that everyone there had HIV, a belief Nnaji says is common in many African nations. She stresses the importance of challenging myths and establishing a solid framework for prevention efforts: “There hasn’t been a history of HIV prevention work in the African immigrant population compared to other communities,” she says. “We need to take two or three steps back and look at awareness, issues around stigma, issues around disability and some of [the things] other communities have already gone through.”
Meanwhile, the Bush administration continues to fuel the misperception that AIDS is primarily a foreign—i.e., African—problem. The numbers there are indeed dire: An estimated 24.5 million people were living with HIV in sub-Saharan Africa at the end of 2005. But the growing presence of the African immigrant HIV-positive population in this country may provide the strongest argument yet that when it comes to fighting AIDS, there’s no geographical divide.