Background: African, Caribbean, and Black (ACB) women are disproportionately affected by HIV in Canada due to intersecting social and structural inequities, accounting for the majority of new HIV diagnoses among women. The Women-Centred HIV Care (WCHC) Model is an evidence-informed, community-driven framework designed to improve clinical and psychosocial care among women living with HIV. This study assessed the acceptability and usability of the WCHC Model and Pocketbook for ACB women living with HIV in Ontario.

Methods: Between August and November 2025, we conducted four in-person Talking Circles with 33 ACB women and gender diverse people living with HIV at partnering community organizations in Ontario. We conducted reflexive thematic analysis following Braun and Clarke's approach, applying an Afrocentric and women-centred lens to guide coding, reflexivity, and interpretation.

Results: Participants found the WCHC Model acceptable because it validated experiences of systemic inequities: HIV stigma compounding racial discrimination across healthcare, complex disclosure during immigration, and barriers where newcomers face institutional stigma, lack medication, and fear disclosure. This affirmed their vision for holistic, non-judgmental care. However, participants emphasized Afrocentric adaptations to strengthen implementation. Key themes centered cultural representation and safety: Black providers who understand anti-Black experiences, cultural brokers navigating between ACB and Western healthcare, locally-rooted narratives, and spiritual/religious integration as foundational. Participants identified that sexuality taboos in ACB communities increase HIV vulnerability, requiring education and self-advocacy. They emphasized peer-led community outreach as a way of fostering "sisterhood" and facilitating care linkage. Implementation priorities include digital tools and materials; Black healthcare provider and cultural navigation; expanded reproductive health, spiritually-informed mental health, immigration counseling, and sexuality education addressing cultural taboos.

Conclusion: The WCHC Model demonstrated strong acceptability by validating ACB women’s experiences of systemic inequities. Implementation must centre Afrocentric principles, including spiritual integration, and address intersectional barriers such as colonial healthcare legacies.

Background:
Women and gender diverse people face unique risk factors to HIV and sexually transmitted and blood-borne infections (STBBIs) due to intersecting social, structural, and biological factors. Currently available HIV/STBBI prevention tools in Ontario and Saskatchewan fall short of addressing these challenges. Responding to this gap, we developed the Women-Centred Prevention (W-PREV) Model, a holistic, empowerment-based HIV/STBBI prevention model informed by women’s lived experiences and social determinants of health.

Methods:
The W-PREV Model was developed using Graham et al.’s knowledge-to-action framework. Phase one involved a web-based environmental scan, rapid scoping review, and stakeholder interviews. In phase two, the core research team reviewed and selected applicable evidence from phase one. In phase three, the W-PREV Model was developed and refined.

Results:
Our environmental scan identified a biomedical focus among currently available HIV/STBBI prevention services for women. Findings from the rapid scoping review and stakeholder interviews underscored the need for women and gender diverse peoples’ HIV/STBBI prevention efforts to: (1) address structural challenges; (2) involve community connection; (3) exist in non-clinical settings; (4) normalize sexual and reproductive health (SRH) discussions; (5) integrate SRH and HIV/STBBI services; (6) be sustainable.

The W-PREV Model addresses these findings by moving away from a biomedical model and integrating HIV/STBBI prevention and care with six interrelated domains: SRH care, gender-specific care, mental health, substance use and harm reduction, peer support and social connection, and individual capacity building. The model’s trauma- and violence-aware, person-centred, and culturally-responsive foundation emphasizes care that is empowerment-focused, community-based, and accessible.

Conclusions:
The W-PREV Model offers holistic HIV/STBBI prevention solutions that bridge clinical and community settings and integrate HIV/STBBI prevention with social supports, addressing the unique challenges and care needs of women and gender diverse people. Work continues to operationalize the W-PREV Model into a community-based intervention that can be adapted to local contexts.

Background:
Women living with HIV in Canada—particularly African, Caribbean, Black, Indigenous, newcomer, and parenting women face intersecting stigmas shaped by race, gender, migration status, motherhood, trauma, and socioeconomic marginalization. These factors limit self-expression, undermine emotional wellness, and reduce engagement with care. In response, PASAN coordinated an expressive-arts program in partnership with Black CAP, Teresa Group, and Hospice Toronto to provide culturally grounded healing spaces for diverse women living with HIV.

Methods:
Using a community-based participatory approach, coordinators from each organization mobilized different groups of women: Black CAP engaged Black women; Teresa Group engaged mothers living with HIV; and PASAN engaged Indigenous and criminalized women. An expressive arts therapist from Hospice Toronto facilitated all sessions. Workshops incorporated painting, beadwork, poetry, storytelling, music, and reflective dialogue. Participants acted as co-researchers, contributing to shared knowledge creation. Data were collected through facilitator observations, group discussions, feedback forms, and reflections on artwork. Thematic analysis explored how intersecting identities shaped participants’ experiences of healing, stigma, and empowerment.

Results:
Participants reported increased confidence, reduced isolation, and strengthened emotional and spiritual wellness. The expressive-arts space allowed women to process HIV stigma, racialized experiences, trauma histories, and migration and motherhood challenges in a culturally safe environment. Multi-organization collaboration strengthened peer networks, reduced fragmentation in HIV supports, and broadened cultural representation. Women described renewed identity beyond HIV, improved self-expression, deeper social support, and increased readiness for leadership roles within their communities and healthcare spaces.

Conclusions:
This partnership demonstrates that expressive arts are a powerful intersectional approach to healing and empowerment for women living with HIV. Community-led, culturally grounded programming fosters resilience, belonging, and stigma reduction across diverse groups. Findings support scaling and sustaining art-based interventions within HIV support frameworks across Canada.

Background: Northern and Indigenous adolescents in the Northwest Territories (NWT), Canada experience sexual health disparities rooted in historical and ongoing structural inequities. Climate–related emergencies, including recent wildfires, may exacerbate these inequities and contribute to cumulative stress that constrains HIV prevention engagement. Trauma-informed and violence-aware care (TVAC) is understudied within HIV prevention cascade domains. We explored HIV prevention experiences and TVAC-informed programming preferences among NWT adolescents.

Methods: This multi-method qualitative study with NWT youth aged 13-19 included: (a) focus groups (FGs) following land- and arts-based HIV prevention Peer Leader Retreats (PLR) to examine PLR experiences, and (b) a two-day youth think tank (TT) to examine wildfire impacts and support needs. Data were analyzed using framework thematic analysis informed by HIV prevention cascade domains (motivation; access; effective use) and TVAC principles (trauma impacts; safe environments; connection; coping capacity).

Results: FG participants (n=185; mean age: 14.91, standard deviation [SD]: 1.55; 64.3% cisgender girls, 24.9% cisgender boys, 10.8% gender diverse) and TT participants (n=14; mean age: 15.91, SD: 1.51; 28.6% cisgender girls, 50.0% cisgender boys, 21.4% gender diverse) were mostly Indigenous (FG: 81.1%, TT: 64.3%). PLR advanced HIV prevention motivation through strengthening HIV/STI knowledge, risk perception, and critical reflection on healthy relationships. Access was enhanced through bridging sexual health education gaps, fostering peer leadership, and creating culturally grounded, safer learning environments. Effective use was supported through improving safer sex skills, boundary communication, stigma reduction, and strengthening coping and emotional regulation. TT participants discussed how wildfire evacuations disrupted schooling, food security, and mental wellbeing, and emphasized the importance of integrating trauma-informed supports into community sexual health programming during climate emergencies.

Conclusions: NWT youth narratives document the potential of land- and arts-based, TVAC-informed approaches to strengthen the HIV prevention cascade. Integrating socio-environmental stressors into HIV prevention can advance youth-centred sexual health promotion in Northern Canadian contexts.

Background:
African, Caribbean, and Black (ACB) migrant women in Canada face disproportionate HIV vulnerability, acquiring HIV after migration in contexts marked by sexual violence and coercion. Post-migration challenges, such as limited social support and dependency on partners for housing or financial stability, constrain autonomy in sexual decision-making and increase exposure to abuse. Guided by the Theory of Gender and Power (TGP), this study examines how structural and relational factors shape relationship dynamics and post-migration HIV vulnerability among ACB women.

Methods:
We analyzed 21 semi-structured interviews with heterosexual women from the MSAFIRI Study, which investigated post-migration HIV acquisition among ACB migrants in Ontario. Participants were purposively sampled from the Ontario HIV Treatment Network Cohort Study (2015–2017). Thematic analysis was informed by TGP constructs (sexual division of labor, sexual division of power and cathexis).

Results: Three interconnected themes emerged:
Economic Dependency and Migration Barriers:
Financial insecurity and reliance on partners for housing or immigration support limited women’s ability to leave abusive relationships, reinforcing obligations to maintain partnerships for survival.

Power Imbalances in Sexual Decision-Making:
Participants described being unable to negotiate condom use or refuse sex, noting that partners were perceived as “stable” providers. Some felt compelled to satisfy partners’ needs to avoid conflict or losing support, reflecting relational control and heightened HIV risk.

Norms Reinforcing Dependency:
Isolation and lack of family support, combined with cultural expectations that men provide stability, contributed to remaining in unsafe relationships. These norms perpetuated tolerance of abuse and constrained women’s options for seeking safety.

Conclusion:
Post-migration dependency magnifies gendered power imbalances, limiting autonomy and increasing HIV vulnerability among ACB women. Using TGP as a lens highlights how economic insecurity and relational control intersect to shape HIV risk. Addressing these issues requires integrated interventions combining violence support with routine HIV screening that account for migration-related isolation and dependency.

Background: Adolescents in Northern and rural contexts experience intersecting structural vulnerabilities that may influence sexual health outcomes through co-occurring mental health challenges and substance use. Guided by syndemic theory, this study examined psychosocial pathways linking self-esteem, substance use, depressive symptoms, and condom use self-efficacy (CUSE) among adolescents in the Northwest Territories (NWT), Canada.

Methods: We analyzed cross-sectional survey data from 1,913 adolescents participating in FOXY and SMASH arts-based sexual health programs across the NWT. Generalized structural equation modeling (GSEM) examined pathways linking self-esteem, recent drug use, depressive symptoms, and CUSE, adjusting for intersecting sociodemographic and structural factors including gender, sexual orientation, Indigenous identity, household composition, rural residence, and food insecurity. Indirect effects were estimated using nonlinear combinations of model coefficients, with robust standard errors.

Results: The sample was predominantly Indigenous (70.1%) and rural (68.1%), with 47.3% identifying as cisgender girls and 19.6% as LGBQ+. Self-esteem was positively associated (β = 0.11; 95% CI: 0.07, 0.15; p < 0.001), and depression negatively associated (β = 0.18; 95% CI: 0.11, 0.25; p < 0.001), with CUSE. Higher self-esteem was associated with lower depressive symptoms (β = −0.28; 95% CI: −0.32, −0.24; p < 0.001), while recent drug use was associated with higher depressive symptoms (β = 1.96; 95% CI: 1.29, 2.63; p < 0.001). Self-esteem was indirectly associated with higher CUSE through lower depressive symptoms (indirect β = −0.05; 95% CI: −0.07, −0.03; p < 0.001), while recent drug use showed a significant indirect association with (lower?) CUSE via depressive symptoms (indirect β = 0.36; 95% CI: 0.18, 0.55; p < 0.001).

Conclusions: Findings underscore the importance of syndemic mental health pathways shaping sexual health self-efficacy among NWT adolescents. They also highlight the potential value of integrated interventions that address psychosocial resilience, mental health, and substance use in structurally marginalized contexts.

Peer-led community-based physical activity programming has been proposed as a potential modality to improve health, wellbeing, and social connection among women living with HIV (WLWH). The Positively Dance study was a community-based participatory research project designed by and for WLWH. At the conclusion of the project, we conducted a qualitative study to examine participants’ experiences engaging in peer-led dance classes. Overall, ten women participated in semi-structured interviews and data were analysed using reflexive thematic analysis.

Our findings demonstrate that WLWH sought an affinity space – that is, a space where people with shared identities and experiences can gather and support each other. Simultaneously, they also sought a space that decentred their illness and suffering, and instead prioritized strength and joy. This had implications for peer dance instructors, and the research team more broadly, as we sought to understand how to facilitate affinity spaces in ways that both made space for class attendees to share their lived experiences of HIV while also attempting to create a space that moved beyond HIV as the sole and primary focus. Within the context of our study, our findings suggest that hosting dance classes in a non-illness identifying space (i.e., dance studio) facilitated this shift by helping women expand their sense of community and belonging. Through dance classes, participants expressed feeling more connected and included in other communities, such as the dance community. Dance classes also served as an important point of connection into other community resources, allowing participants to share knowledge about current activities, resources, and supports available. Our findings demonstrate the ways in which physical activity can contribute to community building. More broadly, our findings also highlight the complexities of facilitating affinity spaces revolving around the shared experience of HIV while also seeking to decenter illness and prioritize joy and strength.

Background: Although Black people represent approximately 5% of Canada’s population, they account for 27.6% of people living with HIV, where race and ethnicity were reported. Despite four decades of HIV responses, systemic anti-Black racism and socio-economic disenfranchisement continue to limit the effectiveness of Canadian HIV strategies in Black communities. These abstract advances Black emancipation, self-determination, agency, and collective power as a community-led framework and intervention to address HIV inequities.
Methods: Between October 2024 and January 2025, forty-five Black women living with HIV participated in full-day cellphilm-making workshops, followed by facilitated group analysis and in-depth, semi-structured follow-up interviews. Data were analyzed using the DEPICT participatory method, in which participants collectively viewed and interpreted their cellphilms through a quilting process. Interview transcripts were thematically coded in NVivo and integrated with Cellphilms themes.
Results: Black emancipation and self-determination emerged as central, community-led responses to HIV inequities in Black communities. Participants critiqued current HIV research, policy, and programming as rooted in individualism, social-cognitive reductionism, and neoliberal logics that marginalize communal care and reproduce inequities, noting that tools developed within oppressive systems are insufficient to dismantle structural harm. Findings emphasized the need for interventions that challenge entrenched power structures and centre community authority through self-determination, collective care, cultural identity, spirituality, and collective action. Black health sovereignty emerged as a critical practice, defining wellness by communities rather than institutions and grounding interventions in asset-based approaches, including capacity building, leadership cultivation, peer support, material redistribution, and policy redesign accountable to community authority.
Conclusion: These findings demonstrate that effective HIV responses in Black communities require a shift from reformist, institution-centred approaches to emancipatory, community-governed models grounded in Black self-determination and health sovereignty. Centring community authority, lived experience, and Afrocentric values offers a transformative pathway to changing the HIV trajectory in Black communities in Canada.