Social determinants of health and long‐term conditions in people of Black African and Black Caribbean ethnicity living with HIV in London: A qualitative study

• Published in: Health expectations : an international journal of public participation in health care and health policy Vol. 27; no. 3; pp. e14055 - n/a
• Main Authors: Kolodin, Vlad, Barbini, Birgit, Onyango, Denis, Musomba, Rachel, Liu, Jia, Hung, Rachel K. Y., Nikiphorou, Elena, Campbell, Lucy, Post, Frank A., Tariq, Shema, Lempp, Heidi
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.06.2024
• Subjects: Adult; Africa - ethnology; Black African; Black people; Black People - psychology; Caribbean Region - ethnology; Chronic Disease - ethnology; Chronic illnesses; Cisgender; Community; Comorbidity; Cultural competence; Data analysis; Economic deprivation; Ethnicity; Female; Focus Groups; Gender; Health care access; Health services; Health Services Accessibility; HIV; HIV infection; HIV Infections - ethnology; HIV Infections - psychology; Human immunodeficiency virus; Humans; Interviews; London; Long term; long‐term conditions; Male; Middle Aged; Minority & ethnic groups; Patients; Psychosocial factors; Qualitative analysis; Qualitative Research; Quality of life; Race; Selfmanagement; Side effects; social determinants of health; Social Determinants of Health - ethnology; Social factors; Sociodemographics; London; Africa; Caribbean Region; United Kingdom > UK; Black African; social determinants of health; long‐term conditions; qualitative research; HIV infection
• ISSN: 1369-6513; 1369-7625; 1369-7625
• DOI: 10.1111/hex.14055

Background People living with human immunodeficiency virus (HIV) are disproportionately impacted by socioeconomic deprivation and are at increased risk of developing other long‐term conditions (LTCs). These illnesses require transformative action to tackle the adverse effects on their health. Data on lived experiences of LTCs among people living with HIV of Black African and Black Caribbean ethnicities are sparse, and how people with LTCs are impacted by social determinants of health (SDoH). Methods Through a phenomenological study design this qualitative study, conducted in 2022, comprised four focus group discussions (FGDs) with 20 people of Black ethnicities living with HIV were purposively invited from a community organisation (CO) in London, including four semistructured interviews with CO staff. Following transcription, qualitative data were analysed thematically and measures to validate the findings were implemented. Results The findings are presented in terms of the following four levels of SDoH: (1) individual determinants (such as the impact of SDoH on lifestyle modification and self‐management); (2) interpersonal determinants (such as positive experiences of accessing healthcare for LTCs); (3) clinical determinants (such as care pathway barriers) and (4) systemic determinants (such as systemic barriers related to race/ethnicity). Conclusions It is necessary to provide ongoing and interactive education to community members who live with HIV, focusing on risks and management of LTCs. Additionally, individuals would benefit from support to navigate increasingly complex and fragmented health services. Health Service staff require cultural competence when caring for patients of Black African and Black Caribbean ethnicities with complex health and psychosocial needs. Patient or Public Contribution The research team collaborated with an HIV CO in South London from the very start of the project to agree the study design and learn about the realities of their daily lived experiences. Community collaborators helped to develop the semistructured interview and FGD topic guides, and were directly involved in the data gathering, analysis and validation.