Background: Despite a disproportionate HIV burden, Black communities in Canada remain sidelined in HIV research, policy, and governance, as structural anti-Black racism within public systems shapes access to care and protection. This paper theorizes Refusal as a Black emancipatory framework, grounded in global Black liberation traditions.
Development of the Theory: Refusal is theorized as an Activist Afrocentric Critical Theory that guides research design, data generation, analysis, and implementation. Grounded in Afrocentric philosophy, Ubuntu ethics, Pan-Africanism, Black feminist thought, and critical race theory, refusal functions as an ethical stance, methodology, and worldview that shifts research from extraction to collaboration and from institutional control to community sovereignty. It positions Black people as knowledge producers and offers a transferable, community-governed analytic framework that centres care, relationality, and collective power, reimagining HIV research and governance as moral, cultural, and liberatory practices.
Pillars of Ukataaji: Meaning and Implications: Refusal is grounded in five interrelated pillars that translate refusal into actionable, community-led HIV practices. Mapinduzi (Revolution) aligns with structural outcomes, including policy advocacy, community governance, and Black-led system redesign. Ulinzi (Sanctuary) informs care-based interventions by emphasizing the creation of safe community spaces, mutual aid networks, and culturally grounded healing practices that strengthen trust, retention, and well-being. Nguvu (Agency) supports leadership development, peer mentorship, community organizing, and the mobilization of lived experience into collective action and service advocacy. Uhuru (Freedom) advances innovative, creative methods and cultural expression to expand intervention design beyond traditional models and enable future-oriented, community-defined measures of wellness. Furahà (Joy) informs sustainability and resilience outcomes by positioning joy, rest, creativity, and spiritual affirmation as essential practices for healing and long-term community capacity.
Conclusion: Ukataaji offers an innovative Activist Afrocentric framework that centres Black self-determination and community authority in HIV responses grounded in community-governed systems that sustain equity, healing, and collective power.

Background: African, Caribbean, and Black (ACB) women face historically rooted and socio-structural inequities, yet research about positive pathways that support their engagement in the HIV care continuum is limited. The study aimed to highlight positive coping among ACB women living with HIV in Winnipeg and what facilitates the ability of women to commit to care, be resilient and thrive despite experiences of adversity and/or trauma.

Methods: The community-based study involved 10 ACB women living with HIV in Winnipeg, along with 12 care staff. Guided by critical race and feminist theories, the qualitative study incorporated principles of intersectionality and constructivist grounded theory to inform data collection, organization, and analysis. Conducted in collaboration with HIV-focused clinics, the study used in-depth, semi-structured interviews to explore ACB women's experiences.

Results: ACB women's narratives reveal a deep sense of commitment to care and acceptance of their HIV status that shaped care use. Women are more moved to access care when they are treated with dignity and understanding. Their motivation centred on providers fostering respectful, caring, nonjudgmental, and emotionally supportive environments, as well as positive social connections and social supports. The healthcare clinic was also perceived as a safe space for accessing treatment, contributing to improved health and overall well-being.

Conclusions: This study makes a significant contribution to our understanding of the resilience of ACB women and underscores the importance of holistic, empathetic, and nonjudgmental patient engagement. It highlights the need for policy interventions that recognize the emotional and social dimensions of HIV care for racialized women, as well as the importance of social network strategies to strengthen connections among ACB women living with HIV and help women in accepting an HIV diagnosis, advancing toward self-acceptance, and sustaining care use.

Background: There is a significant paucity of national research and data on strategies to improve HIV outcomes for Black Canadians. The limited number of supported Black researchers with HIV-focused research agendas, combined with national measurement approaches failing to capture the racial and cultural realities of Black communities, constrains effective policy and system responses. Evidence of HIV inequities and need is well established. In Ontario home to over 50% of Canada’s Black population, Black individuals accounted for 24% of new HIV diagnoses in 2020.

Objectives: To generate community-informed data on the current realities and priorities of Black communities affected by HIV across Canada, and to use this knowledge to inform the development of a national, Black community–led research and policy strategy advancing population-level health system solutions beyond descriptive analyses of disparity.

Method: We conducted a descriptive qualitative study using six semi-structured focus groups (N=42) with Black community members living with HIV in Ontario. Participants represented diverse subpopulations, including youth, newcomers, cisgender women (English-speaking and Francophone), cisgender men, and 2SLGBTQIA+ individuals. Data was analyzed using conventional content analysis to identify overarching themes and priorities.

Results: Participants identified key priorities for a national HIV research and policy strategy, including aligning HIV prevention with spiritual and cultural values, addressing gaps in disaggregated demographic data, and evaluating culturally tailored awareness and education approaches. Additional priorities included the impacts of HIV disclosure and disclosure protections on care-seeking, aging with HIV, maternal and infant health, migration-related barriers to care, transitions from pediatric to adult services, PrEP access and uptake, and strengthened community education and engagement in HIV research.

Conclusion: Transformative Black HIV equity research and policy must move beyond documenting disparities to addressing avoidable and unjust inequities rooted in historical and contemporary injustices, advancing equitable health systems and outcomes for and led by Black communities in Canada.

Background: Manitoba has the highest HIV rate in Canada, with African, Caribbean, and Black (ACB) communities disproportionately affected among new diagnoses. The Ubuntu-Pamoja study examined experiences, perspectives, and the acceptability of various HIV and sexually transmitted and blood-borne infection (STBBI) testing methods among ACB community members in Manitoba.

Methods: We used a community-based participatory approach, conducting qualitative interviews (n=33), an online survey (n=351), and follow-up post-test interviews (n=10) with ACB community members. Participants were offered different HIV testing options, including self-testing and facility-based testing by trained healthcare providers. Qualitative data were analyzed using iterative, inductive, and thematic methods, while quantitative data were analyzed descriptively.

Findings: Among survey respondents, 245 individuals (69.7%) reported having been tested for HIV and 106 (30.3%) reported never being tested, while only 124 of 329 respondents (37.7%) reported having been tested for a sexually transmitted infection other than HIV, compared with 205 (62.3%) who had not. Among 114 respondents who evaluated their testing experience in Manitoba, most rated it positively: 40.4% described it as satisfactory, 32.5% as good, and 21.9% as excellent, while only 5.3% reported a bad or very bad experience. Qualitative findings revealed limited healthcare access, lack of information about testing options, HIV-related stigma, absence of culturally sensitive programs, and the centralization of testing clinics as barriers to HIV and STBBI testing.

Conclusions: while most respondents who accessed HIV and STBBI testing reported positive experiences, testing uptake—particularly for STBBIs other than HIV—remains low, indicating that barriers are primarily structural rather than experiential. Limited access, lack of information, centralized services, stigma, and the absence of culturally safe programs continue to constrain testing engagement. Expanding decentralized, community-based, and culturally responsive testing models alongside targeted outreach and stigma reduction is essential to improving equitable access to care.

Background: Arts-based knowledge translation and exchange approaches can support accessible, engaging, and community-responsive sharing of research. The objective of this study was to develop and implement a co-creation process for producing an animated video to disseminate synthesized findings from qualitative research.
Methods: Qualitative findings were drawn from Drive for Change, a three-year community-based participatory action research project to address systemic racism and HIV stigma experienced by Black African, im/migrant people living with HIV in British Columbia’s healthcare system. The co-creation approach was conceived through a collaborative, community-engaged process, led by the community partner (Afro-Canadian Positive Network of BC) and in collaboration with the Community Advisory Team and a visual strategy studio. Iterative feedback cycles with the Community Advisory Team guided script refinement and visual design to uphold principles of community-based research. This process prioritized accessibility, cultural responsiveness, and respectful representation of lived experiences.
Results: Researchers, community partners, and people with lived experience co-created key messages, narrative framing and a visual representation of the narrative, ensuring that complex insights about healthcare experiences, systemic barriers, and opportunities for change were translated into clear, relatable visual and verbal language. Key themes from qualitative research findings of experiences in healthcare settings that were amplified in the video included: harms of disclosure of HIV status without consent, experiences of discrimination and exclusion, community resilience and determination to continue accessing care; and assertions that healthcare settings can be welcoming, culturally responsive and accountable.
Conclusions: This work illustrates an engaged approach to converting qualitative research findings into a digital media knowledge translation product that respects and amplifies community voices while promoting research uptake and system-level discussion and supports collective understanding and action toward healthcare equity among Black African im/migrant people living with HIV in Canada. The video is publicly accessible on the Drive for Change website (https://driveforchange.med.ubc.ca/knowledge-translation/).