Ethical Issues in Targeted HIV Prevention Work among ‘Black African’ Migrants in London

Abstract

‘Black Africans’ in England are disproportionately and highly affected by the heterosexually contracted HIV epidemic. Policy and practice frameworks have advocated ethnic matching in HIV prevention. We explore how self‐identifying ‘black African’ workers in London were co‐producers of ‘black African’ identities to target in preventative HIV interventions. Drawing on a focused literature review and 12 in‐depth interviews with workers, the paper identifies themes associated with co‐production of an African identify by workers. The historical inclusion of the category ‘black African’ in the 1991 census coincided with the emergence of Africans as at higher HIV ‘risk’. In co‐producing an African public, the workers projected their heterosexual and Christian affiliations on to the targeted population, perceiving themselves as ‘insiders’ knowledgeable about rumours that had historically co‐produced African identities. Fear of those in authority galvanised the formation of African‐led agencies, offering entry points for HIV prevention to Africans. By projecting aspects of their complex ‘selves’ on to the ‘other’, encounters in public spaces were deemed ‘opportunities’ for outreach interventions. The ethics of ‘cold calling’, confidentiality and informed consent were taken as ‘given’ in these socially produced ‘private’ spaces located in ‘public’ venues. In following HIV prevention frameworks as advocated by Pulle et al (2004), the workers endorsed yet problematised the notion of ethnic matching.