| HIV is a pandemic affecting mainly poor minority populations in developed and the majority in developing countries. Sub-Saharan African countries are some of the most affected and are considered to be the epicenter of HIV/AIDS (UNAIDS, 2003). Currently, there is a large African immigrant population living in Philadelphia and other United States cities. Some of the new immigrants arrive HIV infected and are further compromised by co-infection with TB and other parasitic diseases such as malaria, filariasis, and helminths (Turrientes et al., 2003), diseases that are difficult to diagnose in the U.S. because most health care professionals are unfamiliar with the symptoms and appropriate screening tests (Lopez-Velez et al., 2003).; This formative study is the first in the United States and Europe to address factors related to use of health care services among sub groups of African immigrant populations. The sample consisted of 239 participants from Anglophone (AP) and Francophone (FP) African countries living in Philadelphia. There were 125 (AP) and 114 (FP) participants. The voluntary participants were students, businessmen, doctors, lawyers, preachers, hairdressers, teachers, preachers, imams, and those who were unemployed at the time of data collection. Questionnaires were completed in sites where meetings were held such as churches, mosques, community centers, and through the "snowball" method. Site visits were conducted in three area health delivery systems utilized by APs and FPs.; Both APs and FPs identified access to health care services as a problem. FPs identified documents, while APs identified transportation as major barriers to access. A majority of APs used primary care physicians compared to FPs. A majority of APs compared to FPs had good English proficiency. FPs primarily received their HIV information from the radio and newspapers, while APs obtained HIV information chiefly through the Internet, word of mouth, and professional journals. More FPs reported high risky sexual behavior while the APs reported more protective behavior. FPs had poorer knowledge about HIV compared to APs. APs had more social support, higher education, and were seemingly more acculturated than FPs.; During site-visit interviews, FP women revealed involvement of multiple and concurrent sexual relationships among FP men, their partners, and African American women. The site-visit interviews corroborated reports of more HIV stigma, less access due to language barriers, and more risky sexual behavior by FPs.; In conclusion, the psychosocial differences between the populations affected the consumption of HIV health care service delivery. The factors included language proficiency, educational attainment and access to services. Independent information acquisition was different between the APs and FPs, which impacted their perceived ability to utilize HIV services. |
