Migrant black Africans are disproportionately affected by HIV in Western Europe; we discuss the barriers to HIV testing for sub-Saharan migrants, with particular emphasis on the UK and the Netherlands. Cultural, social and structural barriers to testing, such as access to testing and care, fear of death and disease and fear of stigma and discrimination in the community, can be identified. Lack of political will, restrictive immigration policies and the absence of African representation in decision-making processes are also major factors preventing black Africans from testing. HIV testing strategies need to be grounded in outreach and community mobilisation, addressing fear of diagnosis, highlighting the success of treatment and tackling HIV-related stigma among black African migrant communities. © 2008 British HIV Association.

Barriers HIV testing Stigma Western Europe discrimination migrant

Netherlands cultural anthropology immigrant Negro HIV Infections Human immunodeficiency virus infection mass screening health care policy Europe sex ratio human priority journal Western Europe screening test attitude to AIDS Residence Characteristics Confidentiality Humans Cross-Cultural Comparison African Continental Ancestry Group male Truth Disclosure female AIDS Serodiagnosis pregnancy stigma Health Knowledge, Attitudes, Practice Article Risk-Taking HIV-1 Prejudice United Kingdom government regulation Patient Acceptance of Health Care Transients and Migrants social discrimination decision making