Picturing change: a study of the social structural determinants of health of Sub-Saharan African women migrants living with HIV in British Columbia, Canada
Date
2025
Authors
Joe-Ikechebelu, Ngozi
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Abstract
Since 2016, migration data reports have continuously shown that sub-Saharan Africans are the second largest ethnic group on the move to Canada. Sub-Saharan African women migrants living with HIV (SSAWMLH) in British Columbia (BC), Canada, are among those who left their sending nations because of challenging social and structural determinants of health, including HIV-related stigma. In BC, Black women represent a disproportionate share of the HIV population, including among immigrants. The aim of this culturally responsive, arts-based (photovoice and photo elicitation), community-based research study was to understand the social and structural determinants of health of SSAWMLH in BC. As community (Afro-Canadian Positive Network of BC) and academic researchers, we collected data from 12 participants (mean age of 49 years) using images and narratives through a photovoice focus group and semi-structured photo-elicitation interviews. From our participants’ narratives and pictures, we conducted data analysis using NVivo. Our first chapter revealed three themes: knowledge and awareness of U=U, HIV disclosure, and factors influencing U=U. The second chapter generated two main themes, along with sub-themes: Need for culturally connected care, along with sub-themes on i) lacking education, ii) interpersonal anti-Black racism, when accessing essential services, iii) connecting with others and forming social relationships, iv) vulnerabilised disadvantaged populations, v) religious communities, faith, and religion; and gendered discrimination, including HIV-related stigma. This dissertation concludes by reflecting on the significance of the study and the implications for the HIV response, healthcare, social services, and transnational global policy.
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Keywords
Sub-Saharan Africa, women, social structural determinants of health, migration, U=U, disclosure, stigma, community-based research, HIV prevention, photovoice, photo-elicitation, intersectionality, discrimination