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Title: Developing a model of Sub-Saharan Africans' experience of receiving a positive HIV test result in primary care
Author: Follows, Camilla
ISNI:       0000 0004 8500 4472
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2018
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Human Immunodeficiency Virus (HIV) is a blood borne virus that impairs or destroys immune system cells. Over time this weakens people's immune system making them more susceptible to infections and individuals gradually become immune-deficient (World Health Organization (WHO) 2017). Immune function is typically measured by CD4 cell count (white blood cells that protect the body from infection); the higher the CD4 count, the better able an individual is to fight HIV and other infections. The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which is defined by a significantly weakened immune system and the development of certain infections. HIV can either be transmitted through unprotected sexual contact, sharing intravenous drug equipment or mother to child transmission during pregnancy, birth or through breast-milk (, 2015). Whilst there is currently no cure for HIV, antiretroviral therapy (ART), are drugs that are used to prevent HIV from making more copies of itself and can help people with HIV live longer, healthier lives. ART has also been shown to reduce sexual transmission of HIV by 96%. (Hull, Wu, & Montaner, 2012). HIV remains a major public health concern, with 36.7 million people living with HIV and 1.8 million new diagnoses in 2016 worldwide. Between 2000 and 2016, new HIV infections fell by 39%, and HIV-related deaths fell by one third with 13.1 million lives saved due to the expansion in the availability of ART (WHO, 2017). It is estimated that in 2016, 25.6 million people were living with HIV in sub-Saharan African regions (AVERT, 2017). HIV in the UK disproportionally affects sub-Saharan Africans; they comprise 1.8% of the population but represent 29% of all people living with HIV. In 2016, black African men and women comprised 39% of heterosexual adults with a new HIV-diagnosis (PHE, 2017a). Migration patterns suggest that the number of sub-Saharan Africans migrating to high-income countries is rapidly increasing. Several potential stressors can accompany HIV such as the diagnosis experience itself, taking medication, engaging with on-going care, disclosure decisions and management of possible changes in relationships. Comorbidities such as anxiety and depression are also seen in this population. Sub-Saharan Africans living in high-income countries potentially face exacerbated and additional challenges in adjusting to living with HIV including increased HIV-stigma, challenges around HIV-disclosure and social care needs (e.g. poverty, housing, education and employment). Understanding how the challenges of being HIV-positive living in a high-income country impact on sub-Saharan Africans is crucial. The aim of the systematic review was to consider the wellbeing and mental health of individuals of sub-Saharan African origin who are currently living in high-income countries with a diagnosis of HIV.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available