Structural and Social Disadvantage and Post-Migration HIV Vulnerability among African, Caribbean, and Black Communities in Ontario
- 1School of Social Work, Faculty of Health, Dalhousie University, Halifax, NS, Canada
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
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BibTeX
@misc{tharao2026structural,
title = {{Structural and Social Disadvantage and Post-Migration HIV Vulnerability among African, Caribbean, and Black Communities in Ontario}},
author = {W. Tharao and T. Nyoni and E. Amoako and D. N. T. Fombang and A. Perryman and A. Daftary and M. Ndungu and J. MacNeily and S. Bullock and S. Blot and V. Pierre-Pierre and M. Loutfy and R. Kaul and D. Tan and A. Rachlis and C. Cooper and I. Salit and H. Luyombya and S. T. Ryan and L. Calzavara and M. S. Team},
howpublished = {medRxiv},
year = {2026},
month = nov,
doi = {10.64898/2026.11.03.26364040},
url = {https://www.medrxiv.org/content/10.64898/2026.11.03.26364040v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Structural and Social Disadvantage and Post-Migration HIV Vulnerability among African, Caribbean, and Black Communities in Ontario
AU - W. Tharao
AU - T. Nyoni
AU - E. Amoako
AU - D. N. T. Fombang
AU - A. Perryman
AU - A. Daftary
AU - M. Ndungu
AU - J. MacNeily
AU - S. Bullock
AU - S. Blot
AU - V. Pierre-Pierre
AU - M. Loutfy
AU - R. Kaul
AU - D. Tan
AU - A. Rachlis
AU - C. Cooper
AU - I. Salit
AU - H. Luyombya
AU - S. T. Ryan
AU - L. Calzavara
AU - M. S. Team
PY - 2026
DA - 2026/11/03
PB - medRxiv
DO - 10.64898/2026.11.03.26364040
UR - https://www.medrxiv.org/content/10.64898/2026.11.03.26364040v1
AB - 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
ER -