Introduction
The black population in Canada has experienced substantial growth over the past half century. As of 2006, the black community was approximately 2.5 % of the Canadian population with most of these being from HIV-endemic nations mainly in the Caribbean and Africa (Shimeles, Husbands, Tharao, Adrien, & Pierre-Pierre, 2011). The immigration of these communities in Canada has led to an increased HIV infection, with 57% of infected infants and 16 % of new infections being attributed to the African and Black community. The statistics on new infections as well as those on people living with HIV show that the black community in Canada has some of the highest rates of HIV infections (Shimeles, Husbands, Tharao, Adrien, & Pierre-Pierre, 2011). Social demographics play a crucial role in driving these high rates of infections among the ACB communities. Some of the interventions strategies previously employed include research. Research is however not a sustainable intervention response. To ensure that research achieves its full potential, there is a need for community engagement, as well as a supportive and enabling environment. Community engagement would result in more outreach; therefore, the most effective intervention strategy.
Rational
The Canadian black population makes up 2.5 % of the total population. Some of these communities have been in the country since the 1600s, with other having immigrated to Canada from Africa and Caribbean countries. These individuals account for the highest HIV infections reported in Canada with 57% of the infected infant and 16% of the new HIV infections being attributed to the African, Caribbean, and Black community. Studies have reported that 60% of these new infections mainly occur after moving to Canada; therefore, social demographics greatly influence the new HIV infections among the ACB community (Shimeles, Husbands, Tharao, Adrien, & Pierre-Pierre, 2011).
Purpose of the Intervention
The study aims at explaining the benefits of a community intervention strategy for addressing the issues related to HIV infection among the Black and African communities in Canada. Community intervention allows for shared learning as well as coordination among different organizations and communities; therefore, strengthening the HIV prevention response. The use of community interventions would thus result in widespread learning, and help to lower the high rates of infection among the ACB community
Annotated Bibliography
Catalani, C., Philbrick, W., Fraser, H., Mechael, P., & Israelski, D. M. (2013). mHealth for HIV Treatment & Prevention: A Systematic Review of the Literature. The Open Aids Journal, 12-41. Retrieved from http://bentham-open.com/contents/pdf/TOAIDJ/TOAIDJ-7-41.pdf
Catalani, Philbrick, Fraser, Mechael, and Israelski (2013) reviewed literature on mobile health technologies and their impact on HIV/AIDS prevention and management. The study conducted a review of articles on the application of mobile technology in HIV prevention. Data used in the study was retrieved from different databases, including health, engineering and science databases. Catalani, Philbrick, Fraser, Mechael, and Israelski (2013) reviewed a total of sixty-three articles. Data analysis revealed community participation, communication, and educational messaging as the key factors influencing the success of mobile phone interventions. Catalani, Philbrick, Fraser, Mechael, and Israelski (2013) explained that community participation promoted more sharing of educational messages; therefore, better communication on matters of preventing new infections. Community participation also results in faster rates of information delivery; therefore, reaching a higher demographic. Developments in information technology have also promoted more community participation as people can share information quickly; therefore, better learning and prevention opportunities (Catalani, Philbrick, Fraser, Mechael, & Israelski, 2013).
Charania, M. R., Marshall, K. J., Lyles, C. M., Crepaz, N., Kay, L. S., Koenig, L. J., . Purcell, D. W. (2014). Identification of Evidence-Based Interventions for Promoting HIV Medication Adherence: Findings from a Systematic Review of U.S.-Based Studies, 1996–2011. Aids Behaviour, 646-660. doi:10.1007/s10461-013-0594-x
Charania et al. (2014) study aimed at identifying and understanding the various evidence-based intervention strategies used to promote HIV prevention as well as promote healthy living among people infected with HIV. The study involved a review of studies conducted between 1996-2011 to identify the different evidence-based intervention strategies. Data analysis identified 65 main interventions with only ten of them being evidence-based strategies. Charania et al. (2014) also employed findings from a CDC HIV prevention project which explained community interventions as important intervention strategies for preventing new HIV infections. Charania et al. (2014) also explained community-based intervention strategies as important in promoting healthy living among individuals diagnosed with HIV.
Cornish, F., Priego-Hernandez, J., Campbell, C., Mburu, G., & McLean, S. (2014). The impact of Community Mobilisation on HIV Prevention in Middle and Low-Income Countries: A Systematic Review and Critique. AIDS Behaviour, 2110-2134.
Campbell, Cornish, Priego-Hernandez, Mburu, and McLean (2014) studied the effect of community mobilization on interventions programs meant for HIV prevention in low and middle-income countries. Campbell, Cornish, Priego-Hernandez, Mburu, and McLean (2014) employed a study of past literature on issues of community mobilization and HIV prevention. Data analysis revealed that community mobilization was an effective interventions strategy for preventing rates of HIV infection. Community mobilization was noted to be more effective in communities that share an identity. Cornish, Priego-Hernandez, Campbell, Mburu, and McLean (2014) concluded that community interventions strategies should focus on both the general population and on specific population groups. Community-based interventions involving specific groups should focus on populations that are at a higher risk of contracting HIV. Focussing on these communities from a group level would result in higher prevention rates (Cornish, Priego-Hernandez, Campbell, Mburu, & McLean, 2014).
Earnshaw, V. A., Bogart, L. M., Dovidio, J. F., & Williams, D. R. (2013). Stigma and Racial/Ethnic HIV Disparities: Moving Toward Resilience. Americal Psychology, 225-236. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3740715/
Earnshaw, Bogart, Dovidio, and Williams (2013) explored a HIV disparity and stigma model with the aim of understanding if racial stigma results in the high HIV racial disparity.The study reviewed different statistics on HIV infection to determine the impact of racial stigma on infections rates. Earnshaw, Bogart, Dovidio, and Williams (2013) identified community strategies to have an impact on stigma rates. Community interventions aimed at empowering individuals at a community level have promoted a reduction in HIV infection rates among racial minority groups . Some community interventions strategies explained in the study include community education nd empowerment, which may result in ethnic pride as well as racial socialization. Community interventions also include a sharing of information with younger members of the community.
Mugavero, M. J., Amico, K. R., Horn, T., & Thompson, M. A. (2013). The State of Engagement in HIV Care in the United States: From Cascade to Continuum to Control. Clinical Infectious Diseases, 1164-1171. doi:10.1093/cid/cit420
Mugavero, Amico, Horn, and Thompson (2013) study aimed at understanding the state of HIV care engagement in the US. The study aimed at understanding the evidence-based intervention practices as well the various challenges facing the intervention strategies. The study mainly identified community and individual engagement as factors promoting positive HIV care. Mugavero, Amico, Horn, and Thompson (2013) identified the need for different individuals within a community to promote care and preventions of HIV. According to Mugavero, Amico, Horn, and Thompson (2013), community engagement may involve educational efforts aimed at teaching community members about the various ways of preventing and caring for HIV patients. Community engagement may also involve monitoring and case management (Mugavero, Amico, Horn, & Thompson, 2013).
Rhodes, S. D., Kelley, C., Simán, F., Cashman, R., Alonzo, J., McGuire, J., . Martínez, O. (2013). Using Community-Based Participatory Research (CBPR) to Develop a Community-Level HIV Prevention Intervention for Latinas: A Local Response to a Global Challenge. Womens Health Issues, 293-301. doi:10.1016/j.whi.2012.02.002
Rhodes et al. (2013) studied the impact of Community-based research methodology on the creation of a prevention intervention for the Latin American community. Rhodes et al. (2013) explored a community-based participatory research model to create a multi-step intercession strategy. The study aimed at increasing the participation of Latino’s in community interventions. Dara analysis revealed that community-based interventions allowed all individuals to participate; therefore, higher HIV prevention rates. The use of community-based participatory research also allowed the researchers to understand different community demographics. The study also identified community participation to promote informal support among Latinos living with HIV (Rhodes et al., 2013).
Suthar, A. B., Ford, N., Bachanas, P. J., Wong, V. J., Rajan, J. S., Saltzman, A. K., . . Baggaley, R. C. (2013). Towards Universal Voluntary HIV Testing and Counselling: A Systematic Review and Meta-Analysis of Community-Based Approaches. doi:10.1371/journal.pmed.1001496
Suthar et al. (2013) conducted meta-analysis aimed at understanding the impact of community-based interventions on the universal HIV testing rates. Suthar, et al. (2013) conducted a review of 117 studies involving 867651 participants. The study findings revealed that community-based interventions promoted an increased rate of HIV testing and counselling. According to Suthar et al. (2013), community-based approaches help to reduce the instances of stigma; therefore, promote more people to get tested. Suthar et al. (2013) also identified community interventions to have resulted in augmented contact to HIV prevention, treatment and care information. Based on the findings provided by Suthar et al. (2013), community-based approaches play an important role in promoting HIV prevention among members of the same population.
Methodology
Data Description
The African, Carribean and Black community in Canada accounts for the majority of the new HIV infections. Although most of these individuals come from HIV-endemic countries, the majority of the new infections occur after immigrating into Canada (Shimeles, Husbands, Tharao, Adrien, & Pierre-Pierre, 2011). Ahari, Habibzadeh, Yousefi, Amani, and Abdi (2012) explained social demographics to be the main reason towards the high HIV prevalence rates among ACB communities. Intervention strategies aimed at preventing and reducing the rates of HIV infections should focus on the community as a whole rather than individual groups.
Proposed Intervention
This study aims at introducing an intervention strategy aimed at preventing new HIV infections among the ACB community. The study proposes the use of community-based intervention techniques to increase HIV prevention rates. Rhodes et al. (2013) explained community participation in playing an important role in promoting early testing and counselling. Community participation also reduces the level of stigma associated with HIV; therefore, improve prevention and care efforts (Earnshaw, Bogart, Dovidio, & Williams, 2013). The proposed intervention strategy will involve three main activities which are community engagement, capacity building and community-based research.
Community participation through engagement involves the creation of different community groups in Edmonton. These community groups would mainly include members who share several characteristics including race, or even the type of work conducted. The introduction of community groups would allow the sharing of information between the different groups; therefore, an engagement of some sort (Cornish, Priego-Hernandez, Campbell, Mburu, & McLean, 2014). The community groups can also organize events meant to promote HIV awareness. Collaborations between the different groups may allow interactions and overall community engagement.Community mobilization and engagement would also result in a reduced stigma, especially among African, Carribean and Black communities.
Capacity building as a form of community-based intervention would also work in promoting prevention of HIV infections. Community intervention may also involve educational activities teaching on HV prevention strategies. Community intervention groups may organise HIV awareness rallies; therefore, educate community members of the various risk factors. Collaboration between the different community groups would also promote the sharing of skills; therefore, improve the capacity to provide care for the African, Carribean and Black communities.
Research plays an important role in understanding the various HIV infection demographics. However, research without incorporating the views of the community may not provide conclusive information. Community-based research involves the creation of different groups to research issues affecting specific communities. In Canada, groups such as the East African Health Study play an important role in researching the beliefs, attitudes and health-related behaviors of the ACB communities. Community-based research allows a deeper understanding of the different issues that may exist in different communities in different cities. Understanding the various social demographics affecting the different communities would help in creating interventions strategies that address the community needs. Since most of these immigrants come from HIV-endemic countries, community research would ensure an understanding of the home country demographics; therefore, determine some of the reasons behind the high infection rates in the ACB community.
Conclusion
The proposed community-based intervention proposed for the study will address different public health services. The first service addressed by the intervention strategy is that of monitoring and solving health problems affecting the community. Community-based interventions including community-based research aim at monitoring and identifying the different health problems affecting the community. Community-based research also involves the proposing of strategies and interventions meant to solve the issues identified. Another service outlined by the study is that of informing, educating, and empowering communities on the different health issue. The intervention strategy also aims at mobilizing community partnerships, which promotes the identification and solving of health problems. Community intervention through community research also involves research of innovative solutions to and new insights to the issue of HIV infection in the ACB community.
The community-based intervention strategy aims at promoting prevention of HIV infections among the African, Caribbean, and Black communities in Canada. Community engagement will involve holding events aimed at promoting dialogue between different members of the community. These dialogues help to reduce the level of stigma surrounding HIV. Community engagement would also allow people to discuss openly the various factors promoting the high HIV rates among ACB communities. This sort of engagement would also promote education on the various safe sexual practices; therefore, promoting positive social behavior.
References
Ahari, S. S., Habibzadeh, S., Yousefi, M., Amani, F., & Abdi, R. (2012). Community based needs assessment in an urban area: A participatory action research project. BMC Public Health, 12(1), 161–168
Catalani, C., Philbrick, W., Fraser, H., Mechael, P., & Israelski, D. M. (2013). mHealth for HIV Treatment & Prevention: A Systematic Review of the Literature. The Open Aids Journal, 12-41. Retrieved from http://bentham-open.com/contents/pdf/TOAIDJ/TOAIDJ-7-41.pdf
Charania, M. R., Marshall, K. J., Lyles, C. M., Crepaz, N., Kay, L. S., Koenig, L. J., . . . Purcell, D. W. (2014). Identification of Evidence-Based Interventions for Promoting HIV Medication Adherence: Findings from a Systematic Review of U.S.-Based Studies, 1996–2011. Aids Behaviour, 646-660. doi:10.1007/s10461-013-0594-x
Cornish, F., Priego-Hernandez, J., Campbell, C., Mburu, G., & McLean, S. (2014). The impact of Community Mobilisation on HIV Prevention in Middle and Low Income Countries: A Systematic Review and Critique. AIDS Behaviour, 2110-2134.
Earnshaw, V. A., Bogart, L. M., Dovidio, J. F., & Williams, D. R. (2013). Stigma and Racial/Ethnic HIV Disparities: Moving Toward Resilience. Americal Psychology, 225-236. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3740715/
Mugavero, M. J., Amico, K. R., Horn, T., & Thompson, M. A. (2013). The State of Engagement in HIV Care in the United States: From Cascade to Continuum to Control. Clinical Infectious Diseases, 1164-1171. doi:10.1093/cid/cit420
Rhodes, S. D., Kelley, C., Simán, F., Cashman, R., Alonzo, J., McGuire, J., . . . Martínez, O. (2013). Using Community-Based Participatory Research (CBPR) to Develop a Community-Level HIV Prevention Intervention for Latinas: A Local Response to a Global Challenge. Womens Health Issues, 293-301. doi:10.1016/j.whi.2012.02.002
Shimeles, H., Husbands, W., Tharao, W., Adrien, A., & Pierre-Pierre, V. (2011). African, Caribbean and Black Communities in Canada. Social Research Center. Retrieved from http://www.icad-cisd.com/pdf/CHABAC/RelatedResources/African-Caribbean-and-Black-Communities-in-Canada-A-Knowledge-Synthesis-Paper.PDF
Suthar, A. B., Ford, N., Bachanas, P. J., Wong, V. J., Rajan, J. S., Saltzman, A. K., . . . Baggaley, R. C. (2013). Towards Universal Voluntary HIV Testing and Counselling: A Systematic Review and Meta-Analysis of Community-Based Approaches. doi:10.1371/journal.pmed.1001496
