title: HIV prevention for Black women: structural barriers and opportunities.
abstract: Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women's perspectives on HIV risk and prevention. Four 90-minute focus groups (n=26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.
authors.affiliation: Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario, Canada M5S 1A1. p.newman@utoronto.ca
authors.forename: Peter A
authors.initials: PA
authors.lastname: Newman
authors.forename: Charmaine C
authors.initials: CC
authors.lastname: Williams
authors.forename: Notisha
authors.initials: N
authors.lastname: Massaquoi
authors.forename: Marsha
authors.initials: M
authors.lastname: Brown
authors.forename: Carmen
authors.initials: C
authors.lastname: Logie
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D044383:Black People / Q000523:psychology*; D017691:Caribbean Region / Q000208:ethnology; D003710:Demography; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000208:ethnology* / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D054625:Healthcare Disparities; D006801:Humans; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011287:Prejudice; D011322:Primary Prevention / Q000458:organization & administration / Q000706:statistics & numerical data*; D036301:Qualitative Research; D012307:Risk Factors; D012923:Social Class; D012959:Socioeconomic Factors; D013609:Taboo; D014932:Women's Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*