Multilevel Barriers to Access Health and HIV Care Among African, Caribbean, and Black Men and Youths in Ottawa, Ontario: A Qualitative Study
Bibliographic record
Abstract
Background: Ontario is home to the largest proportion of African, Caribbean, and Black (ACB) people living in Canada. This group isdisproportionately affected by the HIV pandemic. However, there is limited evidence on how multilevel barriersintersect and mutually reinforce each other to restrict access to health and HIV care. This paper examines multilevel barriers to access health and HIV carebased on the lived experiences of ACB people in Ottawa and Ontario. Method: We conducted community based qualitative study with selfidentified ACB men aged 16 and over, living in Ottawa. Our approach is informed by intersectionality theory and Socio-Ecological Model (SEM). A purposive sampling technique was used to recruit participants. We conducted six Focus Group Discussions and 16 In-depth Interviews. Sixty-three people participated in this study. N Vivo software was used for data management and thematic analysis. Results: Six major themes were identified including barriers to access health and HIV care among heterosexual ACB men in Ottawa and Ontario, which is the focus of this paper. This theme is discussed through three subthemes:( 1)individual level low economic, knowledge,and racial identity;(2) community-level lack of culturally responsive services, few community leaders and lack of neighbourhood resources;and (3) system-level embedded discriminatory policies and practices, anti-Black racism, and traumasand legacies of colonialism. Conclusion: Addressing health inequality and enhancing the accessibility and provision of healthcare for ACB populations in Ontario is critical for their health and well-being. An inter sectionality lens and SEM should be given priority to guide understanding of the causes of inequities and the complex ways multilevel barriers to access healthcare relates, intersects, and mutually reinforces one another. Multiple level strategies with strong emphasis at a systemic level, and culturally appropriate approaches are crucial to address barriers while enhancing collaboration among multilevel stakeholders including heterosexual ACB men’s and ACB organizations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.017 | 0.007 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".