This term is used for simplicity in certain contexts, such as research or policy documents, but is not a colloquial term.

People who self-identify as African, Caribbean and/or Black. This identification is informed by lived experiences, as well as family history and ancestral links. People use many different words to describe their identity and community. Not every member of a community will use the same words to describe themselves. 

There are many communities within the African, Caribbean and Black umbrella. Some ACB people have been in Canada for many generations, some are recent immigrants who have come to Canada to study or pursue professional opportunities, and others have come seeking refuge from situations of conflict or persecution. These communities are diverse in religious and spiritual affiliation, residency status, sexual orientation/identity, marital and relationship status, cultural norms and values, income and education levels, language, geographic location and level of participation with other members of ACB communities.

Racialization emphasizes how racial categories are socially and culturally constructed. It can happen at a social level, with a group being racialized through media coverage, political action and the production of a general consensus in the public about that group. Racialization can also happen at an interpersonal level, through the actions of individuals (e.g., avoiding eye contact, crossing the street, asking invasive questions) that designate the target individual or group as “other” or “not normal.” 

Most Canadians of African or Caribbean ancestry ¹ Government of Canada PHA of C. Chapter 13: HIV/AIDS in Canada among people from countries where HIV is endemic – HIV/AIDS Epi Updates – April 2012 – Public Health Agency of Canada [Internet]. 2014 [cited 2017 Jan 3]. Available from: http://www.phac-aspc.gc.ca/aids-sida/publication/epi/2010/chap13-eng.php have more recent ties to a home country or countries and ² Immigration and Ethnocultural Diversity in Canada [Internet]. [cited 2017 Jan 3]. Available from: http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-010-x/99-010-x2011001-eng.cfm may have come from a society in which they are the majority. There are Black Canadians who trace their heritage to the first slaves brought by British and French colonists to the North American mainland, as well as Black Loyalists or fugitive slaves who settled in Canada after the American Revolutionary War. It is also important to note that many Canadians of Caribbean background are not of African ancestry, such as people of Indo-Caribbean or Euro-Caribbean backgrounds. According to Statistics Canada’s 2011 census, Black Canadians make up 4.3% of the population in Ontario, 3.2% in Quebec, 2.3% in Nova Scotia, 2.1% in Alberta and 0.8% in British Columbia.³ Immigration and Ethnocultural Diversity in Canada [Internet]. [cited 2017 Jan 3]. Available from: http://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-010-x/99-010-x2011001-eng.cfm

Ontario and Quebec have the largest proportion of individuals who originate from African and Caribbean countries, followed by Alberta, British Columbia and Manitoba. The five cities with the largest numbers of people who originate from African and Caribbean countries are Toronto, Montreal, Vancouver, Ottawa and Calgary.⁴ Government of Canada PHA of C. Chapter 13: HIV/AIDS in Canada among people from countries where HIV is endemic – HIV/AIDS Epi Updates – April 2012 – Public Health Agency of Canada [Internet]. 2014 [cited 2017 Jan 3]. Available from: http://www.phac-aspc.gc.ca/aids-sida/publication/epi/2010/chap13-eng.phpIn contrast to the aforementioned provinces, the majority of Nova Scotia’s Black residents are third generation or more Canadians.

Though race is socially constructed, it has tangible effects. Experiences of anti-Black racism and other forms of oppression are often shared by ACB people living in Ontario and across Canada, to varying degrees, as is resistance and activism in different forms.

The deleterious impacts of racial discrimination on health are well documented. Systematic review findings highlight how experiences of racism lead to (or result in) poorer mental health and reduced health-promoting behaviours. Racial discrimination is a known determinant of poverty and housing insecurity, and shapes the demographic profile of different neighbourhoods and geographic areas. ACB people are often relegated to areas with reduced access to quality education and employment opportunities, thus diminishing their social capital.

For many ACB people, racism limits access to information and services and creates barriers (ex. underemployment, social and economic exclusion) to coping and protecting oneself from HIV transmission. Racism also plays a key role in ACB people denying HIV as a problem and distancing themselves from HIV prevention interventions. Many ACB people have experienced racism within Ontario and across Canadian society in general and with healthcare providers and service organizations in particular. This is one important reason many are reluctant to seek the assistance of service providers, reveal information during a risk assessment or seek support, treatment and/or care.

In the context of HIV, intersectionality refers to the ways that HIV-related stigma, racism, sexual and physical violence against women and children, heterosexism and homophobia, attitudes toward health and well-being, discomfort with discussing sex (sex as a taboo subject), sexual practices (e.g., having multiple sex partners), immigration and migration and cultural and personal hygiene practices all influence HIV prevention in ACB communities across Ontario and Canada.⁵ ICAD, ACCHO, WHIWH. Towards the Improvement of HIV Prevention Services for African, Caribbean and Black Communities in Canada: A Gap Analysis [Internet]. Ottawa; 2011. Available from: https://accho.ca/gap_analysis_eng_final/

People from ACB communities who are living with or at risk of contracting HIV encounter many forms of discrimination. ACB people experience HIV vulnerability in relation to other pressing issues facing their communities including: unemployment, racism, racial profiling, poverty, language barriers, family breakdown and intergenerational conflict. Experiences of discrimination based on race, gender and sexual orientation may all have a negative impact on an individual’s health and well-being, and more specifically may impact their access to and decision-making about HIV prevention methods.

Analyzing people’s lived realities through the lens of intersectionality reminds us that every ACB individual’s unique social status and position in Canadian society is influenced by a complex set of intersecting identities and circumstances. The resulting power hierarchies can lead to social exclusion and impact individual behaviours, which in turn are proximal risk factors for disease.⁶ Baidoobonso S, Bauer GR, Speechley KN, Lawson E. HIV risk perception and distribution of HIV risk among African, Caribbean and other Black people in a Canadian city: mixed methods results from the BLACCH study. BMC Public Health. 2013;13(1):1.

Anti-racism strategies work to identify and address individual racism and systemic racism (policies, procedures, lack of integration of diverse perspectives, and racialized attitudes embedded in routine operations).⁷ PASAN. PROS & CONS: A Guide to Creating Successful Community-Based HIV and HCV Programs for Prisoners. Prisoners with HIV/AIDS Support Action Network (PASAN); 2011.

An anti-oppression framework involves an analysis of the effects of class demarcation, power, privilege, the absence and presence of civil liberties, internalized and external classism, caste systems, gender oppression, heterosexism, homophobia and transphobia within society for the purpose of eradicating the associated burdens imposed upon oppressed and marginalized individuals and groups. An anti-oppression framework places responsibility with those who wield or influence power to enact change and facilitate equity and it simultaneously supports oppressed and marginalized individuals and groups to mobilize and build their capacity for self-determination.⁸ ICAD, ACCHO, WHIWH. Towards the Improvement of HIV Prevention Services for African, Caribbean and Black Communities in Canada: A Gap Analysis [Internet]. Ottawa; 2011. Available from: https://accho.ca/gap_analysis_eng_final/

GBMSM CASE STUDY
One study based in Toronto found that Black GBMSM must challenge, negotiate or resist racialization and oppression in their intimate relationships and in the public sphere. The power dynamic, often racially based, between Black GBMSM and their sexual partners has implications for HIV prevention and safer sex among GBMSM. Some men from variously marginalized communities may feel disadvantaged or disempowered in their ability to negotiate safer sex in encounters with men whose status appears more socially assured or desirable. This implies that HIV-prevention programs for Black GBMSM in Toronto should more forthrightly incorporate issues of race, racialization and the power dynamic into their safer sex and sexual health programming.⁹ Husbands W, Makoroka L, Walcott R, Adam BD, George C, Remis RS, et al. Black gay men as sexual subjects: race, racialisation and the social relations of sex among Black gay men in Toronto. Cult Health Sex. 2013 Apr 1;15(4):434–49.