Understanding HIV Transmission Among Persons From Africa and the Caribbean Following Their Arrival in Canada

Project Name:

MSAFIRI

Funding Dates:

2014

Status:

Completed

Principal Investigators:

Robert Remis* (U of T, ACCHO), Liviana Calzavara* (U of T), Wangari Tharao* (WHIWH/ACCHO), Shamara Baidoobonso*, Rupert Kaul* (U of T), Ann Burchell (OHTN), Amrita Dafraty, Tola Mbulaheni (ACCHO)

Description:

This research uses data from the OHTN Cohort Study to compare the health and demographic characteristics of HIV-positive immigrants from sub-Saharan Africa and the Caribbean who contracted HIV in their homelands compared to those that are infected in Canada. In addition, the research team will conduct interviews with persons known or suspected to have been infected with HIV since arriving in Canada in order to understand the circumstances surrounding their infection and also the contextual factors that may have influenced their vulnerability to HIV infection.

Purpose and Objectives:

To characterize HIV acquisition in persons from Africa and the Caribbean after their arrival in Canada. Specific objectives 1. To identify the sub-population of the Ontario ACB community at the greatest risk for acquiring HIV since arriving in Canada 2. To characterize the patterns of HIV acquisition among ACB populations infected following their arrival. 3. To identify and understand the contextual factors associated with becoming newly infected with HIV after arriving in Canada.

Method:

Mixed methods

Population:

African and Caribbean persons known to be HIV-infected who are not known to be in care at any of the six selected OCS clinics

Region:

Toronto; London & Ottawa

Start and End Date:

2014 - 2017

Results:

The vast majority of pre-migration infections were among heterosexuals (87%); whereas the highest rate of infections among post-migration/ Canadian-born were among MSM (44%), followed by heterosexuals (41%). 4 in 5 heterosexual women could identify the partner who was the likely source of their infection. 96% of women were unaware of partners status. Women top 5 reasons for not using condoms: (75%) Partner doesn’t like using condoms, (35%) Thought relationship was mutually faithful, (30%) Heat of the moment, (20%) Participant doesn’t like using condoms, (10%) Participant feared they would lose relationship. (91%) acquired HIV from a regular partner. 9% acquired HIV from a casual partner. For heterosexual men, half the men could identify the partner who was the likely source of their infection:, Most were unaware of their partner’s status. Men's top 5 reasons for not using condoms: (58%) Participant doesn’t like using condoms, (58%) Thought the partner was low risk for HIV, (41%) Heat of he moment (33%) Thought relationship was mutually faithful, (20%) Partner doesn’t like using condoms. For Men who have sex with men, 2 in 3 men could identify partner who was the likely source of their infection:. Most were unaware of their partner’s status: For MSM, top 5 reasons for not using condoms: (41%) Heat of the moment (35%) Thought partner was low risk for HIV, (34%) Partner doesn’t like using condoms, (21%) Thought relationship was mutually faithful, (21%) Participant doesn’t like using condoms

Project Indicators and Outcomes:

Funding Sources:

OHTN

Keywords: