Reaching out, building up Adapting approaches to engagement of minority communities and services 13 March 2013

Reaching out, building up Case studyPart twoPart one  A tale of two halves  One size never fits all  Naz Latina  BAME Sexual Health Overview  Counting the costs  Our beginnings  Last year  NPL rational  Service offer  User profile 2

Part One

Sexual Health Overview UK 4 STIs and HIV London overview HIV positive people seen in care Source: HPA 2011 report

Counting the costs In London PCTs spent £ million in on HIV related treatments Africans most likely of all groups to be diagnosed late Rates of late diagnosis among African women are not especially high. This is due to screening for HIV in pregnancy. High rate of late diagnosis among Africans is largely due to high numbers of African men who test late and TB rates highest among those diagnosed with HIV late. Around 460 people with HIV/AIDS died during the same period, the majority had been diagnosed at the late stage of the disease. 60% of those who died were Black/African. Counting the cost

Our Beginnings In 1991, Nazir was diagnosed with HIV. He was a married with two children, a Muslim and gay. When his status became public, he was ostracised by his community, rejected by his mosque and failed to access social support which could recognise that he had more than one identity. Sadly, he died from an AIDS related disease. Naz Project London (NPL) was set up in his memory, to support Black Asian and Minority Ethnic (BAME) communities, to understand more about HIV using an approach that respects cultural heritage, acknowledges the role faith in the community and challenges homophobia. Today, we provide a broad range of services to enable BAME communities to enjoy better Sexual Health. 6

Last Year 1113 one to one advice sessions 40,834 condoms distributed 14,334 reached through outreach £539,000 income raised 113 one to one sessions 608 HIV Tests 232 Counselling sessions 130 Volunteers

NPL Rationale To mobilise BAME communities to face up to challenges of Sexual Health and foster self reliance in addressing the challenges of sexual Health and HIV Reduce the number of BAME HIV/ STI infections Inform national strategy and local service provision ++ Leverage sexual health equality for BAME people 8 Vision Objectives Implementation Sexual Health Promotion HIV support services ResearchPolicy

HIV Client Services Profile Spanish Speaking 78% M 21% F 65% LBGT 27% H 96% Roman Catholic Portuguese Speaking 76% M 23% F 41% LGBT 35% H 89% Roman Catholic Muslim 63% M 37% F 25% GB 58% H 96% Muslim African 37% M 63% F 3% LGBT 94% H 54% Christian 19% Muslim South Asian 53% M 47% F 4% H 91% LGBT 45% Hindu 28% Sikh

Part Two

A tale of two halves Public approach Proactive Accessible Reproductive health The Thinking Private discussion Reactive Paid for service Issue based The Thinking

One size never fits all Under-utilization of health services could be attributed to Cultural stigma of sexual health programmes Linguistic barriers Lack of knowledge about services Seeking help from family and friends and Maintaining family honour by not sharing personal problems with outsiders

Part Three

Naz Latina Latin American Community grown four fold since 2000 – UK English not first language Undocumented migration issues Poor take up of statutory healthcare services Historical marginalisation of LGBT communities Strong faith background NPL Outreach worker from the community MSM CLUBS MARKETS WORKSHOPS TO CBOS SUPPORT FOR PLWHIV PATHWAYS INTO SH SERVICES