Marseille 2007
| Abstract #233 - Breaking the Cycle: Silence, Denial and HIV Stigma in African and Caribbean Communities in Toronto, Canada | ||||
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Session: 6.10: Posters A (Poster) on Monday in Chaired by Authors: Presenting Author: Dr Liviana Calzavara - University of Toronto, Canada |
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| Additional Authors: Dr Winston Husbands, Ms Wangari Tharao, Ms Fauzia Gardezi, | ||||
| Aim: Rates of HIV infection among African and Caribbean people living in the study region have increased by over 80% between 1999 and 2005 and approximately 13% of HIV+ are of African or Caribbean descent. Anecdotal information indicates lower rates of HIV screening, delayed diagnosis, and reduced uptake of treatment services. The HIV Stigma Project examined how these communities experience and respond to HIV. | ||||
| Method / Issue: 30 semi-structured interviews with HIV+ men and women and 12 focus groups discussions were conducted with 74 HIV- or status unknown men and women from 3 African (Ethiopia, Kenya, Somalia) and 3 Caribbean (Jamaica, Trinidad, Guyana) communities. Participants were recruited through AIDS service organizations, health centres and other community organizations, and word-of-mouth. Focus groups and interviews were audio-recorded, transcribed and analyzed for emerging themes. | ||||
| Results / Comments: Themes reflected a complex interaction between individual, cultural and structural factors that create and re-enforce a cycle of silence, denial, stigma, fear and discrimination. Since HIV is less visible than in their countries of origin, there is a perception among African and Caribbean people in Canada that HIV does not exist in their communities in Canada. Those infected are seen as having violated cultural and religious values. It is assumed they became infected by engaging in homosexuality, extra-marital sex, being promiscuous, or having sex with people of different cultural or religious background. And they are marked by their communities as immoral, bringing shame to their family and community. Gossip, verbal harassment and ostracism are frequent responses to those who are infected or assumed to be. As a result many of those infected or at risk do not disclose their status or situation to friends and families. Community ostracism and fear of HIV disclosure is further fueled by immigration concerns. There is a fear that addressing HIV will lead to further stigmatization and discrimination against these immigrant communities by white society and the media who perceive and portray HIV as a black / African disease. Individuals who disclose are afraid of the negative impact it will have on their communities and their lives. Recent immigrants fear that HIV disclosure will compromise their chances of securing residency or sponsoring family members, and risk being alienated by their communities in Canada. Recent immigrants face many social and structural challenges (including unemployment, poverty, lack of appropriate housing, stereotyping, racism, discrimination) which serve to further increase individual HIV risk while also reducing the visibility / importance of HIV relative to the other challenges faced. | ||||
| Discussion: Strategies to break the cycle of HIV silence, denial, stigma and discrimination in these communities must move beyond individual-level education and intervention. There is a need for a broader community response and mobilization. The results of this study have served to initiate community discussions and initiatives. As one respondent put it, HIV/AIDS is so controllable. And yet, because theres this huge silence around it, its just going to get largerand its killing our people and we wont own itwe dont even want to touch it, and thats going to be to the detriment of all of us. | ||||
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