Social and Proximate Determinants of the Frequency of Condom Use Among African, Caribbean, and Other Black People in a Canadian City: Results from the BLACCH Study.
African, Caribbean, and other Black (ACB) people are a priority group for HIV prevention in Canada, but little is known about condom use in this population. This exploratory community-based research project addresses this gap in knowledge. 125 sexually active ACB people completed a questionnaire covering condom use and social determinants of health. The data were analyzed using ordinal logistic regression and mediation analyses. 20.5 % of sexually active ACB adults used condoms consistently. Male gender, wealth, unstable immigration classes, and unsecure employment statuses were independently associated with more frequent condom use. Proximate determinants mediating these relationships included: not having a cohabiting regular partner, not disliking condoms, and having a history of unwanted sex. The proximate determinants mediated 85.7-97.6 % of the effects of the social determinants. These results link social context and proximate factors with condom use. They can be used to design evidence-informed interventions for ACB people.
Epidemiology and Biostatistics, The University of Western Ontario, London, Canada. sbaidoob@outlook.com.
Shamara
S
Baidoobonso
Epidemiology and Biostatistics, The University of Western Ontario, London, Canada.|Women's Studies and Feminist Research, The University of Western Ontario, London, Canada.
Greta R
GR
Bauer
Epidemiology and Biostatistics, The University of Western Ontario, London, Canada.
Kathy Nixon
KN
Speechley
Women's Studies and Feminist Research, The University of Western Ontario, London, Canada.
Erica
E
Lawson
D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D002170:Canada / Q000453:epidemiology; D017691:Caribbean Region / Q000208:ethnology; D055812:Community-Based Participatory Research; D017280:Condoms / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D012309:Risk-Taking; D012737:Sex Factors; D012725:Sexual Behavior / Q000208:ethnology; D064890:Social Determinants of Health; D012959:Socioeconomic Factors; D055815:Young Adult
African descent; Black people; HIV/AIDS; Sexually transmitted infections; Social determinants of health