Although African immigration to American cities is increasing, there is little published demographic or epidemiological data on this population. As growing numbers of HIV-positive Africans seek care at public health centres in the city of Philadelphia, medical personnel are confronted with the challenges of serving this population. This qualitative study explores the perspectives of HIV service providers who are treating this new patient group, and it examines the cultural and structural barriers African women face in the area of HIV prevention, testing, and treatment in the city of Philadelphia. These barriers include legal status, linguistic problems, fear of the American health system, misunderstandings about modes of transmission of HIV, and lack of awareness about antiretroviral treatment. Culturally appropriate education about HIV prevention and treatment needs to be developed for African immigrants, and medical personnel need to understand the experiences, fears, and concerns of this population. © 2005 Taylor & Francis.

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immigrant HIV Infections Human immunodeficiency virus infection human social isolation middle aged medical personnel priority journal housing language Urban Health Services social worker interview Attitude of Health Personnel United States Humans Philadelphia sociology male female Africa qualitative analysis clinical article cultural factor patient education Article adult legal aspect virus transmission Emigration and Immigration Patient Acceptance of Health Care Fear acquired immune deficiency syndrome attitude to health hostility Health Services Accessibility finance