HIV risk perception and distribution of HIV risk among African, Caribbean and other Black people in a Canadian city: Mixed methods results from the BLACCH study
Authors: Shamara Baidoobonso, Greta R. Bauer, Kathy N. Speechley, and Erica Lawson
African, Caribbean and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about the epidemiology of HIV risk in this population. This paper helps fill the knowledge gap by: presenting service providers’ and ACB people’s perceptions about HIV risk in ACB populations; describing the distribution of HIV risk behaviours among ACB people according to markers of social status and position; and comparing results from these two analyses. Methods The Black, African and Caribbean Canadian Health (BLACCH) Study is a mixed methods study that used semi-structured interviews and a cross-sectional quantitative questionnaire to collect information about HIV and health from 188 ACB people in London, ON, Canada. Qualitative content analysis was used to identify interview themes, and weighted bivariate statistical analyses were performed on the quantitative data. Behaviours related to HIV risk were stratified by sex, poverty status, immigration experience and employment status. Results Community members perceived that they were at low risk for HIV and mainly focused on sexual risks. They called for more information about HIV in Canada and culturally appropriate HIV services. Service providers cited marital infidelity and cultural and religious attitudes about condoms as barriers to women protecting themselves. They mentioned cultural norms, beliefs about masculinity and underrepresentation of heterosexual ACB men at AIDS service organizations as barriers to men protecting themselves. There were few statistically significant differences in risk behaviours reported by men and women. Those living in poverty were more likely to abstain from sex (p=0.006) and use condoms (p=0.027) in the past year. Those living in Canada longer reported higher prevalences of forced sex (p<0.001), mixing alcohol or drugs with sex (p=0.001) and past STI diagnoses (p=0.032). Stable employment was associated with higher prevalences of not using condoms in the past year (p=0.005) and past STI diagnoses (p=0.018). Conclusions The results show that perceptions about ACB people's HIV risk differ from actual risk, and those with higher social standing might be at greater risk. Furthermore, the social determinants of health are important factors in the epidemiology of HIV among ACB people.
Please note that abstracts only appear in the language of the publication and might not have a translation.
Brodie M. Sakakibara, Adebimpe O. Obembe, and Janice J. Eng (2019).
The prevalence of cardiometabolic multimorbidity and its association with physical activity, diet, and stress in Canada: Evidence from a population-based cross sectional study
BMC Public Health , 9-Jan
Arsham Alamian and Gilles Paradis (2012).
Individual and social determinants of multiple chronic disease behavioural risk factors among youth
BMC Public Health , 224
Natalie D. Riediger, Andrea E. Bombak, and Adriana N. Mudryj (2019).
Health-related behaviours and their relationship with self-rated health among Canadian adults
BMC Public Health , 8-Jan
Adriana Angarita Fonseca, Catherine Trask, Tayyab Shah, and Brenna Bath (2019).
Stable prevalence of chronic back disorders across gender, age, residence, and physical activity in Canadian adults from 2007 to 2014
BMC Public Health
Peter Kitchen, Allison Williams, and James Chowhan (2011).
Walking to work in Canada: Health benefits, socio-economic characteristics and urban-regional variations
BMC Public Health
Beth K. Potter, K. N. Speechley, I. A. Gutmanis, M. K. Campbell, D. Manuel, and J. J. Koval (2005).
Socioeconomic status and non-fatal injuries among Canadian adolescents: variations across SES and injury measures
BMC Public Health
Ashley McAllister, Lee Bentley, Henrik Brønnum-Hansen, Natasja Koitzsch Jensen, Lotta Nylen, Ingelise Andersen, Qing Liao, Theo Bodin, Cameron Mustard, and Bo Burström (2019).
Inequalities in employment rates among older men and women in Canada, Denmark, Sweden and the UK
BMC Public Health , 11-Jan