Experiences of and responses to HIV among African and Caribbean communities in Toronto, Canada

Abstract African and Caribbean communities in Canada and other developed countries are disproportionately affected by HIV/AIDS. This qualitative study of African and Caribbean communities in Toronto sought to understand HIV-related stigma, discrimination, denial and fear, and the effects of multiple intersecting factors that influence responses to the disease, prevention practices and access to treatment and support services. Semi-structured interviews were conducted with 30 HIV-positive men and women and focus groups were conducted with 74 men and women whose HIV status was negative or unknown. We identified a range of issues faced by African and Caribbean people that may increase the risk for HIV infection, create obstacles to testing and treatment and lead to isolation of HIV-positive people. Our findings suggest the need for greater sensitivity and knowledge on the part of healthcare providers; more culturally specific support services; community development; greater community awareness; and expanded efforts to tackle housing, poverty, racism and settlement issues.

[1]  Anne M Johnson,et al.  Why the(y) wait? Key informant understandings of factors contributing to late presentation and poor utilization of HIV health and social care services by African migrants in Britain , 2007, AIDS care.

[2]  P. Caulford,et al.  Providing health care to medically uninsured immigrants and refugees , 2006, Canadian Medical Association Journal.

[3]  K. Fenton,et al.  Access to HIV care among migrant Africans in Britain. What are the issues? , 2006, Psychology, health & medicine.

[4]  Ellen E. Foley,et al.  HIV/AIDS and African immigrant women in Philadelphia: Structural and cultural barriers to care , 2005, AIDS care.

[5]  S. Houston.  Social Determinants of Health: Canadian Perspectives , 2005 .

[6]  G. Reid,et al.  Sex and secrecy: A focus on African sexualities , 2005, Culture, health & sexuality.

[7]  W. Sseruma,et al.  Outsider status: stigma and discrimination experienced by gay men and African people with HIV , 2004 .

[8]  J. Anderson,et al.  Women from Africa living with HIV in London: a descriptive study , 2004, AIDS care.

[9]  K. Widaman,et al.  Stigma, social risk, and health policy: public attitudes toward HIV surveillance policies and the social construction of illness. , 2003, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[10]  B. Evans,et al.  Impact of the HIV epidemic in sub-Saharan Africa on the pattern of HIV in the UK , 2003, AIDS.

[11]  A. Copas,et al.  HIV testing and high risk sexual behaviour among London’s migrant African communities: a participatory research study , 2002, Sexually transmitted infections.

[12]  N. Britten,et al.  Pathways to HIV testing and care by black African and white patients in London , 2002, Sexually transmitted infections.

[13]  A. Copas,et al.  Africans in London continue to present with advanced HIV disease in the era of highly active antiretroviral therapy. , 2001, AIDS.

[14]  Rosaline S Barbour,et al.  Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? , 2001, BMJ : British Medical Journal.

[15]  B. Peters,et al.  Treatment issues for HIV+ Africans in London. , 1999, Social science & medicine.

[16]  Margaret A. Chesney,et al.  Critical Delays in HIV Testing and Care , 1999 .

[17]  K. Melia.  Producing ‘Plausible Stories’: Interviewing Student Nurses , 1997 .