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Racialized minority and newcomer communities are over-represented in positive HIV cases in Canada. Stigma has been identified as one of the barriers to HIV prevention, testing, and treatment. Faith, media, and social justice sectors have historically served a vital role in promoting health issues in these communities. However, they have been relatively inactive in addressing HIV-related issues. The purpose of this paper is to report on the results of an exploratory study that engaged faith, media, and social justice leaders in the African-Caribbean, Asian, and Latino communities in Toronto.

This study used a qualitative interpretive design and focus groups to explore the challenges and opportunities in addressing HIV stigma. A total of 23 people living with HIV and 22 community leaders took part in seven focus groups. Intersectionality was used as an analytical lens to examine the social processes that perpetuate HIV stigma.

This paper focuses on the perspectives of community leaders. Five themes were identified: misconception of HIV as a gay disease; moralistic religious discourses perpetuate HIV stigma; invisibility of HIV reinforces community denial; need to promote awareness and compassion for people with HIV; and the power of collective community efforts within and across different sectors.

Although affected communities are faced with many challenges related to HIV stigma, effective change may be possible through concerted efforts championed by people living with HIV and community leaders. One important strategy identified by the participants is to build strategic alliances among the HIV, media, faith, social justice, and other sectors. Such alliances can develop public education and HIV champion activities to promote public awareness and positive emotional connections with HIV issues, challenge HIV stigma and related systems of oppression, and engage young people in HIV championship.

Canadian HIV/AIDS researchers, service providers and policy-makers are faced with new challenges of providing effective and inclusive care that meets the needs of the changing populations infected with and affected by HIV. Since 2005 immigrants and refugees from ethno-racial minority communities have comprised close to 20 percent of all new HIV infections in Canada. Anecdotes shared by PLWHAs and service providers indicated that mental health challenges faced by newcomer PLWHAs was a priority concern for HIV prevention, treatment and care. This paper reports on the results of an exploratory study, which examined the complex factors that influence the mental health of immigrants and refugees living with HIV/AIDS (IR-PLWHAs).

This exploratory study is informed by a critical social science paradigm, which acknowledges that the everyday reality is shaped by interlocking systems of social processes and unequal power relations. The paper used a qualitative interpretative design and focus groups to explore the intersecting effects of living with HIV/AIDS, migration and settlement, and HIV stigma and discrimination on the mental health of IR-PLWHAs.

The paper found that in addition to social and economic marginalization, IR-PLWHAs experienced multiple stressors associated with their HIV status: neurocognitive and physical impairments, HIV stigma and discrimination, and fear of deportation. The paper also found that the experiences of stigma and discrimination among IR-PLWHAs were complex and contextual, closely linked to their social positions defined by the intersecting dimensions of race, class, gender, citizenship, sexualities, body norms, and HIV status. The paper concludes that effective HIV prevention, treatment and care, and mental health promotion in newcomer and ethno-racial minority communities must consider the bio-psycho-social connections of different stressors and the interlocking systems of oppression faced by IR-PLWHAs.

This study was exploratory in nature with a small number of participants who were recruited through AIDS organizations in Toronto. Consequently, the recruitment strategy may reach only those who were connected to the AIDS organizations. The paper believes that IR-PLWHAs who were not connected to the AIDS organizations might experience even more social exclusion and marginalization. These factors may limit the transferability of this study.

This is the first study that explores the bio-psycho-social connections and intersecting determinants of mental health among immigrants and refugees living with HIV and AIDS in Canada. The results of this study contribute to cross-sector dialogue among practitioners and researchers in the HIV/AIDS, mental health, and immigration and settlement services sectors.