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.
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