A new study highlights the need for more awareness among health professionals of the experiences of HIV-positive black African migrants and refugees living in New Zealand who feel stigmatized.
The study, by social work researchers from Massey, Auckland and Fordham universities, provides insights into the lives of a migrant group often wary of seeking treatment because of the stigma about HIV in their own communities and fear of discrimination generally.
Titled Standing in the Fire in reference to how HIV infection was described by one participant, the study of 13 HIV-positive black African migrants and refugees reveals remarkable strengths and resilience among participants who had already suffered terribly before coming to this country, Massey University social work lecturer and study author Dr. Mark Henrickson says.
While most participants reported favorably on treatment they have received from GPs and specialist medical staff, some experienced discrimination at work and in access to health and dental care.
A better understanding is needed among New Zealands wider health and social services about black Africans, for whom a diagnosis of HIV can mean they may feel, or are seen as, already dead. This reflects beliefs about the nature of boundaries between life and death, as well as notions of being punished for alleged misdeeds, the study reveals.
We need to get the message through that HIV is a manageable chronic condition, not a death sentence, Dr. Henrickson says.
Fear of being gossiped about and rejected by their communities led to secrecy and a sense of isolation for some participants, the study says. African migrants come from a collective context, where membership in a community is part of ones identity. Being infected with HIV can separate the individual from the collective.
As one participant says of her HIV diagnosis; People will judge you; if you are a woman they think you are a prostitute, because it is a condition for prostitutes. But if you are married and then you get it, still you lose your status in the community. People start looking down at you. You are already dead to them
A hopeful finding was that participants connected to support groups such as the Positive Women, Body Positive and the New Zealand AIDS Foundation had formed a new sense of identity and community with others in similar situations.
The qualitative study involved interviews with nine women and four men. Almost all reported finding out their HIV-positive status either upon entry into New Zealand or in refugee camps prior to coming here.
The researchers, including Associate Professors Christa Fouché from Auckland University, and Fulbright Fellow Cynthia Poindexter, of Fordham University, United States, were all deeply affected by the literally unspeakable suffering of the participants, of whom five are United Nations quota refugees. So palpable was the participants experiences of suffering that each of the researchers noted that in their years of social work experience they had never encountered a group that had suffered more.
Traumatic experiences included arrest and imprisonment, rape, torture, seeing family members murdered, multiple losses of family, friends and communities, and leaving their country and culture forever.
The research, funded by Massey, Auckland and Fordham universities, reflects a growing interest in the experiences and wellbeing of black African migrants in New Zealand, says Dr. Henrickson. While the latest census from 2006 puts the number of African migrants at 10,647, the actual figure is thought to be a lot higher, he says.
Concern over health services has also been prompted by a sharp rise in new HIV cases, following a levelling off in 1995. This increase included more heterosexual transmissions, with more overseas-acquired infections predominantly among African and Asian migrants, according to the study.
New Zealand, it notes, has a relatively low incidence, with a cumulative total of 3,374 people diagnosed with HIV at the end of 2010.
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www.massey.ac.nz/massey/fms//Massey News/2011/8/docs/HIV-BAM_Research Report_web.pdf