No 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.

In this study of Black gay and bisexual men in Toronto, sexually active survey participants reported on their sexual behaviours with male partners of different ethnoracial backgrounds, and interview participants reflected on how their sexual relationships emerged in the context of race and interracial desire. Most survey participants reported sexual relationships with other Black men. Participants were more likely to be insertive with White and other ethnoracial men than with Black men. A significant number of participants who were receptive or versatile with Black partners switched to the insertive role when their sexual partners were not Black. Interview participants ascribed a sense of fulfilment to their sexual relationships with other Black men, but avoided relationships with White men or interpreted such relationships as either purely sexual and/or inflected by their racialised objectification. Others avoided sexual relationships with other Black men or preferred relationships with White men, sometimes in opposition to experiences of oppressive masculinity from some Black partners but mindful of the possibility of racialised encounters with their White partners. Study participants emerge as informed sexual subjects, self-conscious about their sexual relationships and variously inclined to negotiate or resist racialisation and oppression in the private and public spheres.

In Canada, there is a paucity of research aimed at understanding Black gay men and the antecedents to risk factors for HIV. This study is an attempt to move beyond risk factor analysis and explore the role of sexual and ethnic communities in the lives of these men. The study utilized a community-based research and critical race theory approach. Semi-structured interviews were conducted with eight key informants to augment our understanding of Black gay men and to facilitate recruitment of participants. In-depth interviews were done with 24 Black gay men. Our data showed that the construction of community for Black gay men is challenged by their social and cultural environment. However, these men use their resilience to navigate gay social networks. Black gay men expressed a sense of abjuration from both gay and Black communities because of homophobia and racism. It is essential for health and social programmers to understand how Black gay men interact with Black and gay communities and the complexities of their interactions in creating outreach educational, preventive and support services.

Health professionals should consider the role of racial discrimination and sexual objectification within the context of risk and treatment for alcohol use disorders, harm reduction, and HIV prevention for gay and bisexual men of colour.

Previous research has highlighted the association between HIV sexual risk behaviors, muscularity concerns, and masculinity among gay and bisexual men (GBM). A few studies that explored these issues, however, have used relatively small sample sizes and predominantly White GBM samples. In addition, little is known about whether a drive for muscularity and perceptions of masculinity are associated with HIV sexual risk behaviors among GBM of color. This community-based study examined the association between drive for muscularity, masculinity, and HIV sexual risk among a sample of 389 GBM of color in Toronto. In multivariable analyses, drive for muscularity and masculinity were significantly associated with HIV sexual risk, after controlling for sociodemographic variables and internalized homophobia. Findings suggest that a desire to be more muscular or a disappointment with one’s musculature, as well as an endorsement of body image and penis size as indicators of masculinity may play a role in HIV sexual risk behaviors. This study is among the first to examine the role of drive for muscularity and notions of masculinity in relation to HIV sexual risk exclusively among an ethnoracially diverse sample of GBM. Further research is needed to better understand the link between body image and masculinity to reduce HIV risk among GBM of color.

The 6-month incidence of clinically significant low back pain is high in Saskatchewan. It is important to prevent this condition because of the high economic and social costs associated with it.

The Greater Involvement of People Living with HIV/AIDS Principle (GIPA) has been a core commitment for many people involved in the community-based HIV/AIDS movement. GIPA refers to the inclusion of people living with HIV/AIDS in service delivery and decision-making processes that affect their lives. Despite its central importance to the movement, it has received little attention in the academic literature. Drawing on focus group discussions among staff members and volunteers of AIDS service organizations, activists, and community members, we explore challenges to the implementation of the GIPA principle in community-based HIV/AIDS organizations in Ontario, Canada. Our findings reveal ways in which implementing GIPA has become more complicated over recent years. Challenges relating to health, stigma and disclosure, evolving HIV/AIDS organizations, and GIPA-related tensions are identified. This paper considers our findings in light of previous research, and suggests some implications for practice.