|Abstract: ||Ontario, African, Caribbean and Black (ACB) migrants comprise 3.9% of the total popu-lation, yet account for 18% of the population who is HIV-positive. Women of this population are affected at an even higher rate, where they represent approximately 63% of the ACB population with HIV and over 50% of HIV-positive women in the province. In order to explore this phe-nomenon, I conduct a policy evaluation and review specific programs geared towards HIV-positive ACB women. I use the Population Health Approach as the theoretical framework to support the policy evaluation and to explore the underlying barriers that ACB women face in terms of their sexual health. This approach reflects how social determinants, such as economic and environmental fac-tors, can contribute to health outcomes. Using this approach, I first review the related policies and programs from the federal, provincial and municipal governments and non-governmental agencies. I then conduct a series of four elite interviews with participants working for various organizations that address HIV in the ACB community. Finally, I analyze the results of the inter-views and these results reflect findings in the literature.
I explore the most frequently stated barriers for ACB women and they are as follows; there are issues with the immigration system in how HIV can be perceived to affect one's immi-gration status; there is often a power imbalance between men and women in this community that makes it difficult for women to negotiate safer sex practices - and this is exacerbated by the lack of financial freedom and increased economic dependence experienced by ACB women; as well as social factors such as stigma towards HIV in the community, and the lack of awareness about the general prevalence of HIV in Canada.The results of this evaluation led me to offering three recommendations aimed at improv-ing the sexual health of ACB migrant women. My first recommendation is to increase collabora-tion between government sectors, non-governmental organizations and social service providers to address the many competing needs of ACB migrant women. Second, programs and policies cannot solely be geared at women, as there many external factors that are beyond their control that influence their health and well-being. Programs addressing men and youth will address these external barriers, because without a supportive and healthy male population, the women will continue to encounter complicated social restrictions. Finally, HIV stigma needs to be addressed, not only within the ACB community, but in society at large. HIV messaging needs be more visi-ble, as does culturally specific messaging surrounding HIV/AIDS. HIV programs need to be im-plemented to adequately reach the specific ACB population. Only then, with the valuable input of HIV-positive ACB women, will effective policies and prevention programs work together in a sufficient way to reverse the trend of ACB women being over-represented with HIV/AIDS.|