{
  "abstract": "Background. African, Caribbean, and Black (ACB) communities in Canada experience a disproportionate burden of HIV, and a considerable share of infections among ACB immigrants is acquired after arrival in Canada. Yet how ACB people themselves understand the structural circumstances surrounding post-migration acquisition remains underexamined. This study asked how intersecting structural and social disadvantages shape post-migration HIV vulnerability among ACB communities in Ontario. Methods. We conducted an interpretive secondary thematic analysis of 44 in-depth interviews from the MSAFIRI Study, read through intersectionality and structural-vulnerability lenses. Interviews were coded inductively and deductively by two analysts, with consensus adjudication and community review of the thematic structure. Results. Five structural conditions organized participants accounts: racism as a structural condition of settlement; immigration precarity and the work of settling alone; economic precarity, including insecure work, poverty, and unstable housing; ruptured kin networks and isolation under migration; and gendered violence and homophobia. These conditions compounded one another, so that disadvantage in one domain deepened vulnerability in another. Conclusion. Post-migration HIV vulnerability among ACB communities is produced by intersecting structural disadvantages encountered in the receiving country context. Equitable HIV prevention requires structural and community-led responses that address immigration precarity, economic and housing insecurity, gendered violence, homophobia, and anti-Black racism, alongside biomedical and individual-level prevention. Keywords: HIV; African, Caribbean, and Black communities; migration; structural vulnerability; intersectionality; social determinants of health; Canada",
  "abstract_shown": true,
  "affiliations": [
    "School of Social Work, Faculty of Health, Dalhousie University, Halifax, NS, Canada"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 21,
  "authors": [
    {
      "name": "W. Tharao"
    },
    {
      "affs": [
        0
      ],
      "name": "T. Nyoni"
    },
    {
      "name": "E. Amoako"
    },
    {
      "name": "D. N. T. Fombang"
    },
    {
      "name": "A. Perryman"
    },
    {
      "name": "A. Daftary"
    },
    {
      "name": "M. Ndungu"
    },
    {
      "name": "J. MacNeily"
    },
    {
      "name": "S. Bullock"
    },
    {
      "name": "S. Blot"
    },
    {
      "name": "V. Pierre-Pierre"
    },
    {
      "name": "M. Loutfy"
    },
    {
      "name": "R. Kaul"
    },
    {
      "name": "D. Tan"
    },
    {
      "name": "A. Rachlis"
    },
    {
      "name": "C. Cooper"
    },
    {
      "name": "I. Salit"
    },
    {
      "name": "H. Luyombya"
    },
    {
      "name": "S. T. Ryan"
    },
    {
      "name": "L. Calzavara"
    },
    {
      "name": "M. S. Team"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5qnfbawpy88x4.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.03.26364040",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26364040v1.full",
  "id": "5qnfbawpy88x4",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26364040v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "hiv aids"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26364040v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5qnfbawpy88x4.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T00:21:05Z",
      "native_id": "10.64898/2026.11.03.26364040",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.03.26364040v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:hiv aids",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Structural and Social Disadvantage and Post-Migration HIV Vulnerability among African, Caribbean, and Black Communities in Ontario",
  "title_text": "Structural and Social Disadvantage and Post-Migration HIV Vulnerability among African, Caribbean, and Black Communities in Ontario",
  "type": "preprint",
  "updated_at": "2026-11-05T00:20:37Z",
  "url": "https://research.draconitic.com/paper/5qnfbawpy88x4",
  "venue": "medRxiv",
  "versions": []
}