A/C study protocol: a cross-sectional study of HIV epidemiology among African, Caribbean and Black people in Ontario

Abstract

<jats:sec><jats:title>Introduction</jats:title><jats:p>African, Caribbean and Black (ACB) communities are disproportionately infected by HIV in Ontario, Canada. They constitute only 5% of the population of Ontario yet account for 25% of new diagnoses of HIV. The aim of this study is to understand underlying factors that augment the HIV risk in ACB communities and to inform policy and practice in Ontario.</jats:p></jats:sec><jats:sec><jats:title>Methods and analysis</jats:title><jats:p>We will conduct a cross-sectional study of first-generation and second-generation ACB adults aged 15–64 in Toronto (n=1000) and Ottawa (n=500) and collect data on sociodemographic information, sexual behaviours, substance use, blood donation, access and use of health services and HIV-related care. We will use dried blood spot testing to determine the incidence and prevalence of HIV infection among ACB people, and link participant data to administrative databases to investigate health service access and use. Factors associated with key outcomes (HIV infection, testing behaviours, knowledge about HIV transmission and acquisition, HIV vulnerability, access and use of health services) will be evaluated using generalised linear mixed models, adjusted for relevant covariates.</jats:p></jats:sec><jats:sec><jats:title>Ethics and dissemination</jats:title><jats:p>This study has been reviewed and approved by the following Research Ethics Boards: Toronto Public Health, Ottawa Public Health, Laurentian University; the University of Ottawa and the University of Toronto. Our findings will be disseminated as community reports, fact sheets, digital stories, oral and poster presentations, peer-reviewed manuscripts and social media.</jats:p></jats:sec>

Legislatively Excluded, Medically Uninsured and Structurally Violated: The Social Organization of HIV Healthcare for African, Caribbean and Black Immigrants with Precarious Immigration Status in Toronto, Canada

“…In 2016, Black people also represented 7.5% of Toronto’s total population, the highest proportion compared to other census metropolitan areas such as Montréal and Ottawa-Gatineau. In Ontario, Black immigrants account for 30% of HIV prevalence and 25% of new infections while representing only 4.7 of the general population ( Mbuagbaw et al, 2020b ).…”

“…Canada has one of the highest rates of immigration in the world, with a steady stream of Black immigrants from sub-Saharan African and the Caribbean countries ( Statistics Canada, 2019 ). HIV disproportionately impacts African, Caribbean, and Black (ACB) communities in Canada ( Mbuagbaw et al, 2020b ). Although Black immigrants represent only 3.8% of the general Canadian population, they account for approximately 14.9% of people living with HIV ( Haddad et al., 2019 ; PHAC, 2020 ).…”

“…This scientific evidence informed the development of the UNAIDS 90-90-90 targets, which stated that by 2020, 90% of all people living with HIV will know their HIV status, 90% of people with an HIV diagnosis will receive ART, and 90% of people receiving ART will achieve viral suppression, and the Fast Track strategy which aimed to reduce incidences of HIV infection and end the epidemic by 2030 ( Cohen, 2011 ; UNAIDS, 2014a ). Despite biomedical advances and global initiatives aimed towards ‘ending HIV’, ACB immigrants in Ontario are being left behind in the HIV response due to inequities that restrict their right to health, including access to HIV healthcare and health-related services, leading to poor health outcomes ( Etowa et al, 2020 ; Mbuagbaw et al, 2020b ).…”

Community perspectives on addressing and responding to HIV-testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) among African, Caribbean and Black (ACB) people in Ontario, Canada

“…The study included both quantitative and qualitative components. The quantitative component was designed to estimate HIV prevalence and facilitate an improved understanding of associated behaviors, knowledge, individual-, community- and structural- factors, and health care access and utilization among ACB people in Ontario (see Mbuagbaw et al [ 29 ] for more details). The qualitative component was designed to provide ACB community members with an opportunity to participate in the interpretation of quantitative study findings, contribute to data collection and be involved in the formulation of recommendations.…”

Pan-Africanism in Canada: Anti-Blackness and Black Consciousness in Canada's Capital

“…Much of the existing research on Afro-Canadian leaders is concentrated in Toronto, Montreal, and Halifax (Arthur et al 2012, Austin 2007, Johnson 2016, Kitossa 2019, McDuffie 2016. Of the research on African Canadian populations in Ottawa, a majority are related to health issues such as HIV (e.g., Omorodion et al 2021, Mbuagbaw et al 2020 or specific ethnic groups such as Somali (e.g., Lagace et al 2012) including work by graduate students (Abdulle 2000, Farah 2011, Mohamed 2007, Kenny 2008.…”