HIV Risk in African, Caribbean and Black Youth: Perceptions of community leaders in the Windsor-Sussex Region

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Carlos Khalil
Robb Travers
Rachel Goldfarb
Todd Coleman

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Abstract

Disproportionately high rates of HIV in African, Caribbean and Black (ACB) communities are well documented; this is particularly true in youth. A quarter of new HIV cases between 2012 and 2017 occurred in those with Black ethnicity. Extensive research has been conducted on why this might be, and several factors have been identified, including poor education, stigma leading to misconceptions, risky sexual behaviours, etc. These risk factors can be grouped into individual level factors, and community level factors. Research has not been conducted on community leaders’ and elders’ understanding of why this troubling trend exists. Thus, this study aimed to assess community leaders’ perceptions on disproportionate rates of HIV in ACB youth in Windsor, Ontario. Windsor has a relatively high proportion of ACB communities and HIV cases. To accomplish this, 12 individual interviews and two focus groups were conducted with individuals who had deep connections to the Windsor ACB community and its youth. Interviews were transcribed, coded, and thematically analyzed using NVIVO by multiple raters to ensure inter-rater reliability. Ultimately, community leaders’ answers were organized into two groups of risk factors: direct and distal causes. Direct causes intuitively increased HIV risk and included cultural norms, lack of sexual health education and knowledge, and lack of community services. Distal causes were contextual factors that increased HIV risk; these included racism, low socioeconomic status, family breakdown, and immigration effects. Finally, interviewees identified three main solutions that were in line with previous literature. These included increasing community services, providing role models and peer connections, and increasing sexual health education. It is believed that these solutions will establish an understanding of both levels of HIV risk factors in community leaders and youth alike, and ultimately mitigate rates of HIV in ACB youth.