Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science




Dr. Luginaah, Isaac


Heterosexual African Caribbean and Black (ACB) men are overwhelmed with HIV infections in Canada relative to other racial groups. Epidemiological evidence suggests that heterosexual contact is the most common route of HIV transmission among ACB populations. Despite their heightened HIV vulnerabilities, evidence from community consultation and local research shows that heterosexual ACB men tend to face challenges accessing HIV related services. Moreover, there is a dearth of literature on how ACB men build resilience against their HIV vulnerabilities in the Canadian context. This dissertation is part of an Ontario wide HIV study across four cities—Windsor, Ottawa, Toronto and London in Southern Ontario called weSpeak with the overall aim of improving ACB men’s sexual health. As part of the larger study, the overarching objective of this dissertation therefore, was to identify from an intersectional theoretical lens, the interlocking factors that influence ACB men’s uptake of HIV testing services and how knowledge of their sexual partner’s HIV status informed their protective behaviours. A cross-sectional survey was administered to 156 individuals between March 2018 and February 2019. Negative log-log link function analytic techniques were employed in assessing access to HIV testing services and preventive behaviours among heterosexual ACB men. Findings show that about half of heterosexual ACB men did not know the HIV status of their regular female sexual partners. Importantly, those who did not know the HIV status of their regular female sexual partners were more likely to use condoms compared to those who had knowledge of their regular partner’s status. Results further show that having difficulty accessing healthcare constrained heterosexual ACB men’s uptake of HIV testing services. The constitutive effect of demographic, behavioural and structural factors better explained the difficulties associated with the uptake of HIV testing services than the disaggregated component parts. The overall lack of knowledge of heterosexual ACB men’s regular female sexual partner’s HIV status is a major concern and points to the need for programmes that encourage regular testing and disclosure of HIV status within intimate relationships. Similarly, heterosexual ACB men’s HIV vulnerabilities need to be understood as requiring a holistic solution rather than the frequent focus on behavioural explanations that are often ascribed to Black men’s heightened HIV vulnerabilities.