JMIR Publications

ABSTRACT

Background:

Black men and their communities are more affected by HIV. Although they constitute less than 5% of the Ontarian population, they accounted for 26% of new HIV diagnoses, nearly half of which (48.6%) were attributed to heterosexual contact in 2015. HIV stigma and discrimination reinforce ACB men’s HIV vulnerability by creating unsafe environments that deter them from testing and disclosure, resulting in isolation, depression, delayed diagnosis and linkage to treatment and care, and poor health outcomes. In response to these challenges, Intergenerational strategies were identified from previous community-based participatory study as best practices to reduce HIV vulnerabilities and promote resilience among heterosexual Black men and communities. The proposed intervention is premised on this recommendation of intergenerational intervention.

Objective:

The overall goal is to engage heterosexual Black men and communities in co-creating a community-centred, culturally safe intergenerational intervention to reduce HIV vulnerabilities and related health disparities. Specific objectives include: i) Advance critical HIV health literacy among heterosexual Black men and communities; ii) Engage heterosexual Black men, community leaders, and stakeholders in co-designing the HIV-Response Intergenerational Participation (HIP) Intervention to reduce HIV vulnerabilities and promote community resilience; iii) Pilot the HIP intervention with Black men of diverse ages and assess its acceptability, feasibility, and effectiveness; iv) Apply evidence gained from piloting HIP to improve the intervention and design a scale-up intervention study for use in Ontario and Canada.

Methods:

We will engage 12 diverse community stakeholders in Ontario, inclusive of Heterosexual Black men (HBM) in 8 weekly sessions to evaluate existing evidence of effective HIV health literacy interventions, identify essential and relevant aspects, and work collaboratively to co-design the HIV-Response Intergenerational Participation (HIP) Intervention for use with Black men and communities. Next, we will recruit 24 self-identified HBM of 3 age groups: 18 to 29; 29 to 49; and 50+ as participants in the study. We will pilot and evaluate the HIP intervention with 24 HBM of 3 age groups: 18 to 29; 29 to 49; and 50+ (split as two events: 12 participants in-person in Toronto and 12 participants online in Windsor, London, and Ottawa). We will use data obtained along with questionnaires from validated scales and focus groups to evaluate the effectiveness of HIP. The data will include HIV knowledge, perceived stigma towards people living with HIV, acceptance, and uptake of HIV testing, PrEP, PEP, and condom use. We will also collect data related to perceptions about system-level factors such as discrimination, socially misconstrued masculine identity, etc. Quantitative analysis will essentially be a univariate descriptive analysis. We will use thematic analysis to highlight the results of the Focus Group Discussions. Finally, we will disseminate the evaluation results and engage researchers, leaders, Black men, and communities to expand the project team to scale up the intervention in Ontario and across Canada.

Results:

We hope to commence implementation by May 2023 at the latest, and by September 2023 we should have produced amongst others, an evidence-informed HIP intervention that can be adapted for use by HBM and communities beyond Ontario.

Conclusions:

The pilot intervention will strengthen critical health literacy and build resilience against HIV through intergenerational dialogue among HBM of all ages. Clinical Trial: The study was reviewed and approved by the University of Toronto HIV Research Ethics Review Board (RIS Protocol # 44285) and by the Toronto Metropolitan University Research Ethics Board (REB 2023-099).