OBJECTIVES The increase in people with HIV infection from outside the European Union (EU), particularly from sub-Saharan Africa, has mirrored the increase in migrants to Ireland. The aim of this study was to inform the work of the social work team in the HIV clinic, Department of Genito-Urinary Medicine, St. James's Hospital, Dublin. Conscious of the low take up of HIV support services by users from outside the EU, this study set out to explore what they knew of Irish support services, what supports they were currently receiving, and what they might need from Irish social workers

METHOD Over the first six months of 2003, service users attending the HIV Clinic in St. James's Hospital were asked to take part in a survey that involved completing a questionnaire. Purposive random sampling was employed, whereby only HIV positive service users from outside the EU were targeted. Most of those approached agreed to take part. Information sought included demographic information; when, where and how they found out about their HIV diagnosis; what their knowledge of HIV was; whether they had been pre or post test counselled, some aspects of their social network, including their level of disclosure of HIV, what they knew of Irish support services and whether their support needs were currently been met.

RESULTS The majority of the 57 study participants came from Zimbabwe, South Africa or the Congo, and were asylum seekers. They spoke a total of 26 languages, from Amaharic to Zulu. Most were diagnosed HIV positive while in Ireland and had left their country of origin for other reasons. They were largely informed about HIV, modes of transmission and safer sex, but sought more information about the long-term impact of HIV treatments. They were not aware of the range of HIV support organisations and only a small number were accessing support. The majority did not want a peer supporter from their country of origin. The most positive aspect of living in Ireland was access to HIV treatment. The most negative was living away from family and feelings of isolation.

DISCUSSION Fear of loss of confidentiality, stigma and discrimination inhibited study participants linking in with their own communities for support. They felt socially isolated and were missing families in countries of origin. This study highlights the impact of migration on Irish HIV services and the role that social work can play in the development of essential supportive social networks with migrant groups affected by HIV. It argues for the need to develop a culturally competent practice as Ireland moves towards a more intercultural society, to ensure service users from outside EU are fully aware of the information and supports they may need to cope with HIV. The authors suggest that immigration policies that promote integration should be an essential component of a national HIV prevention strategy.