HIV prevention for Black women: structural barriers and opportunities

J Health Care Poor Underserved. 2008 Aug;19(3):829-41. doi: 10.1353/hpu.0.0043.


Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women's perspectives on HIV risk and prevention. Four 90-minute focus groups (n=26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Africa / ethnology
  • Aged
  • Attitude to Health / ethnology*
  • Black People / psychology*
  • Caribbean Region / ethnology
  • Demography
  • Female
  • Focus Groups
  • HIV Infections / ethnology*
  • HIV Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice
  • Healthcare Disparities*
  • Humans
  • Middle Aged
  • Ontario / epidemiology
  • Prejudice
  • Primary Prevention / organization & administration
  • Primary Prevention / statistics & numerical data*
  • Qualitative Research
  • Risk Factors
  • Social Class*
  • Socioeconomic Factors
  • Taboo
  • Women's Health Services / organization & administration
  • Women's Health Services / statistics & numerical data*