THE SILENT VOICES OF THE HIV/AIDS EPIDEMIC: AFRICAN AND CARIBBEAN WOMEN

E Tharao, N Massaquoi, M Brown
Women's Health in Women's Hands, Toronto, Ontario

Background: Prevalence of HIV infection among African and Caribbean communities residing in Ontario has increased by 85% since 1996, with a 13% annual increase. The majority of HIV infected infants are born to women from these communities. However African and Caribbean women play a limited role in HIV/AIDS services and programs.
Study Objectives: 1. Determine knowledge and awareness of HIV/AIDS and related services, service utilization and factors influencing access to HIV/AIDS information and services
2. Identify and document HIV/AIDS services available and the role(s) played by target population in identified services
3. Identify and document major issues/challenges/barriers faced by service providers
Method(s): Data were collected through 2 focus groups with 21 women, including HIV+ women, 45 interviews with key African and Caribbean women and their service providers. Focus groups and interviews were audiotaped, transcribed, analyzed thematically.
Results: Results indicate that:
1. Basic knowledge about HIV/AIDS and available services varied and was dependent on awareness of HIV status.
2. Gender issues including lack of communication between partners, women's dependence on men, lack of power to negotiate condom use, disrespect for women, and changing gender roles were key in maintaining women's silence.
3. Cultural and religious values, beliefs and practices, and language barriers influence women's access to information and services, limiting their ability to cope with or protect themselves from infection.
Other factors included: Unemployment/underemployment, immigration, fear of HIV, quality of care, myths/stereotypes, racism, gender discrimination, confidentiality/disclosure issues, exclusion from decision making, development or delivery of services.
Conclusions: Most African and Caribbean women learn about HIV and related services after diagnosis. To mount effective responses, factors limiting access to information and services must be understood within the context of culture, gender, religion, political and socio-economic dimensions. A clear understanding of the above factors is essential to facilitate women';s participation in HIV/AIDS initiatives.

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