European grass not always greener for HIV-positive Africans

On paper France treats its 20,000 HIV-positive immigrants well - they are entitled to free healthcare, and even those whose residence status is still to be determined get free treatment after three months if they cannot afford to pay.

But immigrants increasingly face a cold shoulder in Europe, indicating that the spirit of the law is being interpreted more conservatively. For people like Patricia, 32, from the Central African Republic (CAR), that has meant two years of fear and uncertainty.

Unlike most other HIV-positive migrants in France, she knew she was infected before she arrived. Only a tiny proportion of the 42,000 people in crisis-prone CAR who need antiretroviral treatment (ART) are enrolled in drug programmes, so she took a chance and fled to Paris.

"When I learned in 1995 that my husband had infected me with the HI virus I wanted to kill myself," said Patricia, who was aged 21 at the time. "Thankfully, a doctor counselled me and guided me towards some support groups. It took me two years to understand my sickness, to accept it and to live with it."

She lived nine years with the virus but without ART. "Treatment was expensive, and there were always shortages. Regular medical check-ups weren't possible - you had to go into [neighbouring] Cameroon."

In 2001 she founded the National Congress of HIV Positive Young Women in the CAR. "The idea was to get together, share our experiences, and explain to young people that life isn't over when you are HIV positive, to do fundraising activities and to fight against stigma."

Just as her health began to deteriorate seriously, she was invited to an AIDS conference in Toulon, in the South of France, and jumped at the chance. The price was that she had to leave her son behind: "it tore my heart out".

Patricia moved to Paris and stayed temporarily with a cousin. Her visa expired and she contacted the African Positive Association (APA), a nongovernmental organisation (NGO) that helps HIV-positive African migrants.

"My only recourse was the APA, which made sure I didn't end up on the street," she recalled. "I was afraid to be arrested by the police - it had happened once before in the metro [underground railway]. I was caught without a ticket because I didn't have the money to buy one. From then on, I was always fleeing the police."

It was a tough period "because, without a visa it's difficult to find housing. I had to go to the hospital with a file from social services to obtain my medication. It was complicated to get treated, but also to keep up my morale when I didn't even know where I was going to sleep at night. Some medications need to be refrigerated, so I had to keep them at the APA."

In December 2004 the Department of Health and Social Affairs granted Patricia a temporary six-month visa, and then one for a year. After another three-month extension, she finally received a one-year residence permit last month, allowing her to work legally.

"It's reassuring to be able to look for work. Up until now, I was just doing odd jobs - cleaning and looking after the elderly - but I stopped because it didn't pay well. I worked Monday to Sunday and I would make between 400 and 500 euros (US$500 to $635) per month."

Today she is enrolled in a training course for AIDS prevention motivators, run by the APA. The NGO often runs sensitisation campaigns in the Chateau Rouge district of Paris, where many African immigrants live.

"I would like to have the strength to take care of other HIV-positive patients, especially in Africa," said Patricia. "I hope to have a house of my own and bring my son over, who I haven't seen in almost three years. It's for him that I'm holding on. I want a home and a partner and another child."

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