HIV infection in black Caribbeans in the United Kingdom
- Correspondence to: N Low Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK; nicola.lowbristol.ac.uk
An untold story?
“...We know that there are black people dying of HIV. But...at a personal level, at an institutional level, at a political level...we’ve kind of colluded not to tell this story.” (Michael Hamilton).1
The rate of AIDS among black Caribbeans in the United Kingdom was known to be three times higher than in the majority white population nearly 10 years ago.2 The potential for heterosexual spread of HIV within Britain’s black Caribbean community is well recognised because of the high risk of gonorrhoea and chlamydia in people from black Caribbean backgrounds3–7 and the facilitating effect of bacterial sexually transmitted infections on HIV transmission.8 It is, however, the absence of an HIV epidemic that has been remarked upon because of the paradox whereby black Caribbeans have the highest rates of bacterial sexually transmitted infections but black Africans in the United Kingdom bear the highest burden of HIV of any ethnic group with much lower rates of other sexually transmitted infections.9 The apparent lack of spread of HIV to black Caribbeans has been attributed to assortative (like with like) sexual mixing within ethnic groups.9
The extensive HIV epidemic among Britain’s black African communities distracts attention from HIV in black Caribbeans. New HIV diagnoses in black Africans now exceed those in white people,10 although black Africans …
