Winston Husbands, Senior Scientist, Ontario HIV Treatment Network, Toronto, ON, Canada
Desmond Miller, Research Coordinator, Ryerson University, Toronto, ON, Canada
Lance McCready, Associate Professor, University of Toronto, Toronto, ON, Canada
Josephine Wong, RN, PhD, Professor, Ryerson University, Toronto, ON, Canada
Leondre Guy, Researcher, Ryerson University, Toronto, ON, Canada
Andre Harriot, Research Assistant, Ryerson University, Toronto, ON, Canada
Carl James, Professor, York University, Toronto, ON, Canada
Henry Luyombya, Coordinator, Ontario HIV Treatment Network, Toronto, ON, Canada
Omima Mohidin, Connected for Care Coordinator, Africans in Partnership Against AIDS, Toronto, ON, Canada
Charles Ozzoude, Researcher, Ryerson University, Toronto, ON, Canada
Maurice Poon, Associate Professor, York University, Toronto, ON, Canada
Emmanuel Tabi, Researcher, University of Toronto, Toronto, ON, Canada
Background and purpose: Black people in Canada experience disproportionately high risks for HIV infection. Unfortunately, HIV prevention discourses directed at heterosexual Black men have been over-determined by racist stereotypes and assumptions that HIV infection is a consequence of flawed sexualities and problematic sexual practices. These discourses disregard the positioning of Black men in Canada as economically, politically, and socially marginalized and a person-in-environment perspective requires understanding how systems and structures intersect with individual and community experiences to create contexts of health promotion and health risk. The study explores vulnerability and resilience to HIV among self-identified heterosexual Black men in Ontario, Canada with attention to these important social and structural issues.
Methods: This paper reports on focus group and individual interviews conducted with 69 self-identified heterosexual Black men in Toronto (7 groups, =53; individual interviews, n=16). Three of the seven focus groups were configured to focus on perspectives from youth (age <24 years, =12), HIV-positive men (n=10), and Francophone men (n=6). Semi-structured interview guides explored issues of race, masculinity and heterosexuality in relation to HIV vulnerability and resilience. Interviews were audio-recorded and transcribed verbatim (with translation for the French-language interview) and research team members transcripts generating codes and categories based on principles of constructivist grounded theory, with multiple team members reviewing individual transcripts and coded data.
Findings: Analysis revealed that definitions of masculinity, love, sexuality and sexual agency have cultural are constrained by an economic context in which Black men are disempowered, and a social context in which Black men are stigmatized. Participants described the loss of paths to idealized masculine roles associated with work and family, and the need to defend against ideologies and practices that label them as dangerous and deficient. They suggested to find positive images of manhood that are attainable and, in response, assert masculinity based on troubled stereotypes about and sexual viability that leave little room for discourses about sexual health. At the same time, participants were hopeful about emerging group dialogues asserting self and community defined masculinities for Black men, and saw them as key to shifting unhealthy sexual practices and developing effective interventions for sexual health.
Conclusions and Implications: Conventional HIV Prevention dialogues focused on the sexual behaviour of heterosexual Black men may be failing because they echo existing discourses that denigrate and disempower them. These participants compel social work to consider the damage of these approaches and align HIV prevention research and practice for heterosexual Black men with the growing movement to promote culturally-syntonic ideals of manhood.
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