Roger Antabe1, Irenius Konkor2, Martin McIntosh3, Erica Lawson4, Winston Husbands5, Josephine Wong6, Godwin Arku2, Isaac Luginaah2. 1. The Department of Geography, University of Western Ontario, Social Science Centre, 1151 Richmond Street, London, Ontario, N6A 5C2, Canada. rantabe@uwo.ca. 2. The Department of Geography, University of Western Ontario, Social Science Centre, 1151 Richmond Street, London, Ontario, N6A 5C2, Canada. 3. Regional HIV/AIDS Connections (RHAC), 30-186 King Street, London, Ontario, N6A 1C7, Canada. 4. The Department of Women's Studies and Feminist Research, University of Western Ontario, Social Science Centre, 1151 Richmond Street, London, Ontario, N6A 5C2, Canada. 5. Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, Ontario, M4T 1X3, Canada. 6. Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Podium Building, Room POD-481, 350 Victoria St., Toronto, Ontario, M5B 2K3, Canada.
Abstract
BACKGROUND: In Canada, heterosexual African, Caribbean, and Black (ACB) men's heightened risk of HIV infection has been linked to behavioral characteristics, including practices of hegemonic masculinity that discourage the use of HIV preventive services. However, this framing is bereft of the role of structural factors that may be contributing to new HIV infections. This paper examined the underlying factors limiting access to health services among heterosexual ACB men in London, Ontario Canada. METHODS: A convenient sampling technique was used to recruit thirty-seven (n = 37) self-identified heterosexual ACB men and service providers. Four focus groups (FG) were conducted; three with ACB participants of similar age category (i.e., 16-24; 25-38; 39+), and one with service providers. The FGs focused on the barriers to using health services and interrogated the ease of access to HIV intervention programs by ACB men respectively. Recurring themes from the FGs were probed further using in-depth interviews (n = 13). FGs and in-depth interviews complemented each other in reducing uneven power dynamics, fact checking, and allowing for detail discussion of the topic under study. Data analyses were done in NVivo using a mixed inductive-deductive thematic analyses approach. RESULTS: Most ACB men lacked information on HIV and were unaware of their increased risk of infection. Contrary to the notion that behavioral characteristics keep ACB men away from health services, we found that most ACB men were unaware of the availability of these services. Those that had some knowledge about the services reported that they were not appropriately tailored to their needs. In addition, stereotypes and stigma about the etiology of HIV among Blacks, and systemic neglect served as significant barriers to ACB men's use of services. CONCLUSION: The findings suggest that, to enhance preventive health service use among heterosexual ACB men, there is the need to remove structural barriers. Engaging ACB men in the design and implementation of policies may be useful at improving access to HIV information, testing, and treatment services. Increased information dissemination to ACB men would create awareness of the availability of HIV services. Finally, service providers should be conscious of ACB men's concern about experiences of discrimination and racism at service centers.
BACKGROUND: In Canada, heterosexual African, Caribbean, and Black (ACB) men's heightened risk of HIV infection has been linked to behavioral characteristics, including practices of hegemonic masculinity that discourage the use of HIV preventive services. However, this framing is bereft of the role of structural factors that may be contributing to new HIV infections. This paper examined the underlying factors limiting access to health services among heterosexual ACBmen in London, Ontario Canada. METHODS: A convenient sampling technique was used to recruit thirty-seven (n = 37) self-identified heterosexual ACBmen and service providers. Four focus groups (FG) were conducted; three with ACBparticipants of similar age category (i.e., 16-24; 25-38; 39+), and one with service providers. The FGs focused on the barriers to using health services and interrogated the ease of access to HIV intervention programs by ACBmen respectively. Recurring themes from the FGs were probed further using in-depth interviews (n = 13). FGs and in-depth interviews complemented each other in reducing uneven power dynamics, fact checking, and allowing for detail discussion of the topic under study. Data analyses were done in NVivo using a mixed inductive-deductive thematic analyses approach. RESULTS: Most ACBmen lacked information on HIV and were unaware of their increased risk of infection. Contrary to the notion that behavioral characteristics keep ACBmen away from health services, we found that most ACBmen were unaware of the availability of these services. Those that had some knowledge about the services reported that they were not appropriately tailored to their needs. In addition, stereotypes and stigma about the etiology of HIV among Blacks, and systemic neglect served as significant barriers to ACBmen's use of services. CONCLUSION: The findings suggest that, to enhance preventive health service use among heterosexual ACBmen, there is the need to remove structural barriers. Engaging ACBmen in the design and implementation of policies may be useful at improving access to HIV information, testing, and treatment services. Increased information dissemination to ACBmen would create awareness of the availability of HIV services. Finally, service providers should be conscious of ACBmen's concern about experiences of discrimination and racism at service centers.
Entities:
Keywords:
African; Black; Caribbean; HIV; Heterosexual; Men; Ontario; Preventive health
Authors: Fiona M Burns; Anne M Johnson; James Nazroo; Jonathan Ainsworth; Jane Anderson; Ade Fakoya; Ibidun Fakoya; Andy Hughes; Eva Jungmann; S Tariq Sadiq; Ann K Sullivan; Kevin A Fenton Journal: AIDS Date: 2008-01-02 Impact factor: 4.177
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