Table of Contents
This booklet is for African, Caribbean and Black Christians in Ontario. Together we can stop HIV from spreading in our communities, and support people living with HIV to be healthy. But we need to know the facts about HIV.
What is HIV? How does it spread from one person to another?
What is HIV? What is AIDS?
HIV (or Human Immuno-Deficiency Virus) is a virus that weakens a person’s immune system—it weakens the body’s ability to fight disease and illness. Someone is diagnosed as HIV-positive when a special blood test shows HIV in their blood (see “How would I know I have HIV?” below).
We say that someone who is HIV-positive is a “person living with HIV” (a “PHA” or “PLHIV”). When referring to several people or a group, we say “people living with HIV” (PHAs or PLHIVs). Due to better drugs, HIV-positive people may live as long as those who do not have the virus. HIV is still spreading in Canada, but not as fast as in the 1980s or 1990s.
Someone who is HIV-positive can develop AIDS (or Acquired Immuno-Deficiency Syndrome) when their immune system cannot fight off other serious illnesses. For example, someone who is living with HIV may develop AIDS if they do not take their HIV medication as prescribed by their doctor. People in Canada still get HIV, but AIDS is less common than before because of big improvements in drugs and other treatments.
How does HIV spread?
- a pregnant woman who is living with HIV may pass the virus to her baby during pregnancy, birth or breastfeeding; however, pregnant women who are HIV-positive can be treated with drugs that drastically reduce the chance their newborns will be HIV-positive;
- someone can get HIV if they inject themselves (or someone injects them) with a needle that an HIV-positive person has already used (e.g., people who share needles to inject drugs);
- someone can get HIV if the virus enters their bloodstream through cuts or sores in their mouth when having oral sex without protection (such as condoms); however, this way of transmitting HIV is very
You cannot get HIV from:
- casual contact with someone who is HIV-positive, such as kissing, hugging and holding hands;
- sharing a cup or utensils, sitting on a toilet seat, or sharing a seat in church with someone who is HIV-positive;
- the tears, sweat, saliva or urine of someone who is living with
How would I know if I have HIV? Why is it important to know?
Getting an HIV test is the only way someone will know for sure if they are HIV-positive. People who are living with HIV do not look any different from anyone else. Without an HIV test, someone may be unaware for weeks, months or even years that they are HIV-positive.
In the first few weeks after the virus enters a person’s body, that person may feel like they have the flu or may have a rash on their body. But getting your blood tested for HIV is the only way to know for sure whether you have the virus. People living with HIV who get medical treatment as early as possible have better health, and can live as long as people who do not have HIV.
Getting tested for HIV also helps prevent HIV from spreading. Drugs to treat HIV reduce the amount of virus in the blood of HIV-positive people,2 which also reduces the chances that they will infect others. Also people who have been diagnosed with HIV are generally careful about not infecting others.
Getting an HIV test
Someone should get tested if they have sex without condoms or share needles to inject drugs. HIV testing is available throughout Ontario. You can request a blood test for HIV through your doctor, drop-in clinic, a sexual health clinic of your local public health unit, or a community health centre.
All HIV testing is confidential; however, if you test positive for HIV (i.e., your blood test shows that you have HIV), your result will be shared with local public health officials so that they can link you to care, treatment and follow-up.
In Ontario, you can get an “anonymous” HIV test at certain clinics set up by the Ministry of Health and Long-Term Care. In anonymous testing, individuals are given a code for their blood test instead of using their name. This means that if a person tests positive for HIV, they will be able to receive the results of the test, but they will remain anonymous to local health officials. Once the HIV-positive person seeks treatment and care, they will be tested again by their doctor, and their result will be shared with local health officials for care, treatment and follow up.
The clinics that offer anonymous HIV testing also provide rapid testing. The rapid test can provide results in 60 seconds (or about 20 minutes when counselling is included).
Anyone getting tested for HIV in Ontario may receive counselling before (pre-test counselling) and after the test (post-test counselling). This helps people understand HIV and their risk for getting infected. The counsellor also answers questions, and helps connect people to treatment and care if the test confirms that they are HIV-positive.
Who is at risk for HIV? Why some groups more than others?
Many people who have sex without condoms or share drug-use equipment may be exposed to HIV at some point.
In Ontario, certain groups are over-represented among people living with HIV. These include: gay and bisexual men; African, Caribbean and Black people; people who use/inject drugs; Indigenous people; and others who have intimate relationships with people from those population groups. But HIV is not confined to those groups only.
Our health (and our chances of being ill) depends on how well we are doing—how much money we are earning, whether we have safe and affordable housing, whether we are able to cope with life’s challenges, and so on. Also, racism and other forms of discrimination (such as sexism, homophobia and transphobia) may cause stress, or prevent people from getting the jobs, housing or education they need or deserve. Discrimination is bad for people’s health.
Here are a few examples that show why some groups of people may have better health than others:[3]
Income
People who make a good income on a regular basis tend to have better health. They are better able to afford nutritious food, good housing, and look after their basic needs. Also, they can afford to spend more time and money on their health, which help them to remain healthy.
Being connected to others
Some people are lonely and do not have family or friends to help them deal with life’s problems. We all need support from others to help us cope with problems and maintain good health.
Employment
People who are unemployed or working at low-paying jobs may have a hard time looking after their health. With a good job, we’re better able to provide for ourselves and our families, help others, and feel like we belong.
Fairness
When we’re treated fairly it’s easier to afford the necessities of life and get the support we need. Also, stress may come from being treated unfairly, which is not good for one’s health.
Environment
Everyone needs clean air, water and land, as well as safe neighbourhoods, reliable and affordable transportation, and open space for recreation and leisure.
How HIV affects African, Caribbean and Black people in Ontario
Here are a few points to help us understand how African, Caribbean and Black people in Ontario are affected by HIV:
- Black people make up a small share (about 4%) of Ontario’s population, but comprised 21% of the total number of HIV diagnoses in the province in 2013 and 2014;4
- from 1984 to 2011, 142 infants born in Ontario were diagnosed with HIV (i.e., they got HIV when their HIV-positive mothers were pregnant, giving birth or breastfeeding); 77 (or 57%) of those infants were born to women from Africa or the Caribbean;5
- in 2014, people from Africa and the Caribbean made up 19% (1 in 5) of people living with HIV in 6
Saying “No” to stigma, but “Yes” to kindness and understanding.
Stigma means the shame that others unfairly put on a person or group because of something about them that people think is wrong or bad (such as being Black, being gay, being an immigrant, etc.). Stigma is unfair. People living with HIV experience a lot of stigma.
Here are a few things that we know about stigma related to HIV
- many of us behave as though people who are living with HIV should be ashamed of themselves, as though they are sinful and deserve HIV, or brought the disease upon themselves;
- in Canada, HIV affects mainly people or groups that already experience stigma, discrimination or disadvantage; these include African, Caribbean and Black people, Indigenous people, gay men, transgendered people, and others;
- stigma often prevents people from getting tested for HIV, getting treatment and support, or discussing HIV in a meaningful
We can do better
Luke 8:43-48 tells us about a woman who was accused of being unclean. People were against her. She reached out to Jesus, and He cast aside her shame, saw her as whole, and sent her off in peace.
We should also heed 1 Corinthians 13:4-7 (NLT): “Love is patient and kind. Love is not jealous or boastful or proud or rude
… Love never gives up, never loses faith, is always hopeful, and endures through every circumstance.”
These principles help us understand the importance of being kind, compassionate and supportive to people living with HIV.
How we can prevent HIV from spreading in African, Caribbean and Black communities.
Practicing safer sex
The safer sex methods that you use depend on your sexual practices, but you should get advice from a healthcare professional about what’s best for you and your sexual partner. Here are some examples of safer sex practices:
Abstinence
Abstinence (or refusing sexual activity of any kind) is one method for people who want to decrease their chances of getting HIV. The Bible speaks about Christians abstaining from sex until marriage.7 But sex outside of marriage does occur, even among Christians. In these instances, there are ways to reduce your chances of getting or spreading HIV.
Monogamy (being committed to one sexual partner)
Being monogamous is part of the Christian faith. Committing to one intimate partner whom you know and trust is one way to reduce the likelihood of getting or spreading HIV.
Conversations about sex and relationships
“Can two people walk together without agreeing on the direction?”8 Spouses or sexual partners may need to talk with each other about things like their HIV status, their sexual practices (e.g., what they like and dislike), and whether they are being intimate with other people.
Using condoms
When used correctly and consistently, condoms are very effective at preventing HIV and most STIs (sexually transmitted infections).9 Even in a committed relationship, spouses or partners should agree on whether or when to use condoms.
Getting tested for HIV and STIs
It’s a healthy practice to get tested for HIV. Getting medical care early and regularly helps HIV-positive people to be healthy, and also helps reduce the spread of HIV. If you’re in a new relationship, it’s a good thing to know one another’s HIV and STI status by getting tested.
If you’re having condomless sex or sharing needles to inject drugs, it’s good to get tested regularly for HIV. But you should also seek advice from your doctor to understand your risk for getting HIV, and how often you should get tested.
Getting tested for STIs is also important. Having an STI makes it easier for someone to get or spread HIV. Also, if someone is HIV-positive and also has an STI, the treatment for one infection is more difficult because of the other—for example, an STI makes treatment for HIV more difficult.
Making drugs to treat HIV more available
Good drugs for HIV are available, and government programs or employee benefit programs can cover most of the costs. But some people may still have a hard time paying some of the costs, or even sticking to their treatment. The drugs work best when people living with HIV can afford all the other things that make people healthy. The drugs also help to prevent HIV from spreading.
Being careful not to share needles or other drug- using equipment (harm reduction)
We can spread HIV and other infections when we share needles and other drug-using equipment (e.g., syringes, pipes, etc.). If you use drugs, or know someone who does, here are a few tips to help reduce the risk of getting or spreading HIV:
- use your own equipment and do not share your equipment with others;
- practice good hygiene by washing your hands, using clean water, cleaning the spot on your body where you inject drugs, etc.;
- put your used equipment in a sharps container or another container set aside for safely disposing of needles, syringes and other equipment.
There are organizations and programs in many Canadian cities that can help people reduce harm from using drugs, or help them work toward giving up drugs.
Educating ourselves and working together
As individuals, we want to be careful not to get HIV or spread it to someone else. Each of us should also be respectful of people who are living with HIV. However, there is also strength in unity. By joining with others, we can influence our community to prevent HIV from spreading, help improve health in our community by promoting fairness and justice, and support HIV-positive people to live with dignity. Here are a few examples of how we may come together to make a difference.
Connecting with others
Talk with your family and your congregation about health, relationships and HIV. Also, encourage people in your family and congregation to get tested for HIV and STIs. You may also join, volunteer with or donate to organizations working to prevent HIV or improve health among African, Caribbean and Black people in your area. And, together with others, you may organize events in your church to help improve health among your congregation or the wider community.
Promoting fairness and justice
Having a job, earning enough money, and educating our children are some of the things that help us live in dignity. Living with dignity also means that we are treated fairly and respectfully, and do the same to others. Together we must continue to push for better education, better jobs, wider availability of prescription drugs, fairness, ending discrimination, and so on.
Showing leadership
All of us—those who are living with HIV and those who are not, young and old, women and men, gay and straight, persons who have a disability—can help make our communities healthy. African, Caribbean and Black people of faith have been leaders in our struggle for a better life in Canada. Let’s go forward in faith, with wisdom and compassion to make our communities strong, healthy and prosperous.
Where you can find more information or services related to HIV.
In General
Organizations that provide information or services for African, Caribbean and Black people in Ontario
National or Provincial
CHABAC (Canadian HIV/AIDS Black, African and Caribbean Network) www.icad-cisd.com ACCHO (African and Caribbean Council on HIV/AIDS in Ontario) www.accho.ca CAAT (Committee for Accessible AIDS Treatment) www.hivimmigration.caOttawa
ACO (AIDS Committee of Ottawa) www.aco-cso.ca Somerset West Community Health Centre www.swchc.on.caToronto
APAA (Africans in Partnership Against AIDS) www.apaa.ca Black CAP (Black Coalition for AIDS Prevention) ) www.black-cap.com CFT (Centre francophone de Toronto) www.centrefranco.org Women’s Health in Women’s Hands Community Health Centre www.whiwh.comPeel and Durham Regions
ACDR (AIDS Committee of Durham Region) www.aidsdurham.com PHAN (Peel HIV/AIDS Network) www.phan.caSouthwestern Ontario
ACCKWA (AIDS Committee of Cambridge, Kitchener, Waterloo and Area) www.acckwa.com ACW (AIDS Committee of Windsor) www.aidswindsor.org Positive Living Niagara www.positivelivingniagara.com RHAC (Regional HIV/AIDS Connection) www.hivaidsconnection.ca The AIDS Network (Hamilton, Halton, Haldimand, Norfolk and Brant) www.aidsnetwork.caReferences
2Drugs that can reduce the amount of HIV in an HIV-positive person’s body are known as anti-retrovirals or ARVs. These drugs do not cure HIV. Being HIV-positive is a lifelong condition, but the drugs help people to be healthy. Some of the drugs used to treat HIV can also stop HIV-negative people from getting the virus. PrEP (pre-exposure prophylaxis) and PEP (post-exposure prophylaxis) are the general names for these medications. Start a conversation with your doctor if you think that PrEP or PEP may be good for you.
3Adapted from the Peterborough County-City Health Unit (http://www. pcchu.ca/about-us/about-us-2/social-determinants-of-health).
4Personal Communication with Dr. Mark Gilbert, Ontario HIV Epidemiology and Surveillance