HIV risk in African, Caribbean and Black youth: perceptions of community leaders in the Windsor-Sussex Region

Disproportionately high rates of HIV in African, Caribbean and Black (ACB) communities are well documented; this is particularly true in youth. A quarter of new HIV cases between 2012 and 2017 occurred in those with Black ethnicity and several factors have been identified, including poor education, stigma leading to misconceptions, risky sexual behaviours, etc. These risk factors can be grouped into individual level factors and community level factors. Research has not been conducted on community leaders' and elders' perceptions of risk. Thus, this study aimed to assess community leaders' perceptions of HIV risk in ACB youth in Windsor, Ontario. Twelve individual interviews and two focus groups were conducted with individuals who had deep connections to the Windsor ACB community and its youth. Interviews were transcribed, coded, and thematically analyzed using NVIVO by multiple raters to ensure inter-rater reliability. Ultimately, community leaders' answers were organized into two groups of risk factors: direct and distal factors. Direct factors were regarded as increasing HIV risk and included beliefs and conventions, poor sexual health education and knowledge, and lack of community services. Distal causes were contextual factors that increased HIV risk; these included racism, poverty, family breakdown, and immigration challenges. Finally, interviewees identified three main solutions that were in line with previous literature. These included increasing community services, providing role models and peer connections, and increasing sexual health education.