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This report presents results from iSpeak, which was a research study implemented in 2011 to understand the HIV-related needs, challenges and priorities of heterosexual Black men (i.e., African, Caribbean and Black) in Ontario. The study was developed and implemented by a team of individuals and organizations affiliated with the African and Caribbean Council on HIV/AIDS in Ontario (ACCHO). The team conducted two focus groups with HIV-positive and HIV-negative heterosexual Black men in Toronto and London, a focus group with service providers who deliver HIV-related services to Black communities throughout Ontario, and interviews with four Toronto-based researchers interested in health among Black communities.


In the focus groups, heterosexual Black men understood  their ‘heterosexual’  identity in a very traditional way, while acknowledging the complexity of sexual identities.  They understood health holistically, including the importance of emotional wellbeing and the surrounding environment. They acknowledged the many health and HIV services that may be available, but stressed that services were  insufficiently  available  or accessible to  heterosexual Black  men.    Though  participants were disposed to discussing health issues with wives and girlfriends, they admitted being reluctant to engage people who are not healthcare providers.  HIV-positive participants also spoke approvingly of constituting themselves as an informal support group.


Service providers were concerned that AIDS service organizations were somewhat disconnected from heterosexual Black men, even though Black men also appeared reluctant to access services. Service providers understood that Black men wanted to be involved in community responses to HIV, even at a leadership level. Service providers suggested that Black men were challenged establishing a livelihood, which was not conducive to prioritizing HIV.


Researchers noted  a serious lack  of  research and paucity  of  researchers focussing  on Black men’s health   and   wellbeing,   even   though Black  communities are  sometimes conflicted about researchers. They agreed that concerted efforts are needed to build the relevant knowledge base, and recommended more attention to structural approaches and issues (oppression, poverty, etc.) rather than the current preoccupation with individual behaviour.  One researcher also stressed that researchers need to disseminate information and knowledge in a form that people can understand and support.


The research team identified a number of possible ‘next steps’. Research is needed to understand the issue of service access/inaccessibility among heterosexual Black men.  AIDS service organizations may also develop and monitor initiatives to engage Black men at various levels in community responses to HIV.   HIV prevention efforts may be strengthened by research to understand HIV transmission in Canada versus prior infection in Africa or the Caribbean, and the main drivers of HIV transmission among those infected in Canada. These efforts may be complemented by the development of a resource to apprise new immigrants about all aspects of HIV in Ontario. Research may also examine how the climate of criminal prosecution for non-disclosure of HIV-status in sexual encounters affects Black men.   This research may be accompanied by interventions to support informed decision-making related to disclosure.