Uncovering HIV Vulnerabilities Beyond the Usual Layers: Practices of Masculinity and HIV Risk Among Heterosexual Black Men in London, Ontario, Canada.

Abstract

In Canada, Black men are overburdened with HIV. Some studies have suggested that traditional masculinity practices are key drivers of new HIV infections as they endorse high-risk behaviors. However, critical scholars have also highlighted complex pathways through which Black men's masculinity practices and their associated health impacts may be influenced by their structural circumstances in Canada. Informed by these, we draw on analyses of interviews (n = 13) and focus group discussions (n = 17) with self-identified heterosexual Black men resident in London, Ontario, to understand how they construct and practice masculinity in response to their HIV vulnerability. Using a mixed inductive-deductive thematic approach to data analysis, our findings suggest that in response to their HIV vulnerability and poor health outcomes, Black men practice progressive masculinities that empower them to engage with their health needs and help build resilience against HIV. Furthermore, race-based discrimination, stereotypes, societal expectations, and the 'othering' of Black men in Canada may engender the performance of traditional masculinity by some younger Black men, which may deplete their capacity to build resilience against HIV. We recommend that health policy stakeholders in Canada leverage these findings to engage Black men in addressing their structural vulnerabilities to HIV.