In 2021, it was reported that the HIV epidemic had led to over 80 million people being infected and over 40 million deaths globally [1]. The World Health Organization reported in 2021 that approximately 38.4 million people worldwide are living with HIV [1]. In Canada, 4.5 people per 100,000 were diagnosed with HIV in 2021 [2]. For over 4 decades, the Black community has been disproportionately impacted by HIV [3]. Although the Black community makes up less than 5% of Canada’s total population, 25% of new HIV infections are Black people [3-5]. Additionally, in 2023, Statistics Canada reported higher HIV-related mortality rates among Black Canadians when compared with other ethnicities [6].

In 2014, the Joint United Nations Programme on HIV/AIDS organization, a global initiative aimed at eradicating HIV, developed the 95-95-95 approach (where 95% of people living with HIV are diagnosed, 95% of those diagnosed are on treatment, and 95% of those on treatment have a suppressed viral load) [7]. The Government of Canada aims to end the transmission of HIV by 2030 by adopting the 95-95-95 approach [8,9]. Canada’s action plan includes tracking prevalence, increasing access to HIV care and treatments, and focusing on prevention and the care cascade [3,9]. It is unclear how this goal will be fulfilled in the Black community, although Canada’s Federal Initiative to Address HIV/AIDS aims to address inequities. In 2016, the results of a Canada-wide census illustrated lower educational attainment, housing access, income, and employment in the Black population when compared with the White population [10]. A study by Husbands et al [11] found that Black Canadian participants were less likely to be tested for HIV if they had racist experiences. Systematic disadvantages, lower income, poorer living conditions, higher rates of unemployment, stigma, precarious work, and many other socioeconomic factors plague the Black community and impact the effectiveness of HIV control and care [3,5,12]. These factors also affect Black people’s ability to achieve and maintain viral suppression, which is necessary to end transmission [13].

In addition to behavioral modifications to prevent HIV infection, preventive treatment options for persons at high risk of acquiring HIV include pre-exposure prophylaxis, a combination of antiretroviral drugs [3]. On the other hand, people living with HIV can achieve viral suppression through antiretroviral therapy, therefore decreasing the risk of transmission [3]. Although these options are available, there are still many barriers to accessing them for people in the Black community [8]. A study conducted by Etowa et al [14] identified multilevel barriers, including those at the individual and health system levels that require community-level, health policy, and intersectional interventions. Barriers also remain at other stages of the cascade, such as diagnosis, adherence to antiretroviral therapy, and sustaining care over time [8]. Black French speakers living in predominantly English-speaking provinces also face additional language and communication barriers in HIV diagnosis and treatment [15]. Black people in Canada living with HIV may also be overlooked in surveillance data due to a lack of ethnicity- and race-based data [5]. Therefore, it is beneficial to review the available health literature pertaining to the people living with HIV in the Black community to capture the overall progress toward achieving the 95-95-95 and equitable care.

Some researchers are concerned that once the government of Canada meets the 95-95-95 target, investments in HIV care and research may wane, thus compromising outcomes for the Black community and other subgroups of people who have not met these targets [3]. Identifying the gaps in Black health literature related to HIV is necessary as it will help us better understand the specific vulnerabilities to HIV infection faced by Black people and identify how Black people living with HIV can be better supported. Additionally, having this knowledge can help in the development of a more inclusive HIV response plan and provide the necessary information to fulfill Canada’s Federal Initiative [16].

Although several studies have investigated HIV in Black people, this evidence has not been synthesized in a systematic way, and therefore the state of the evidence is unknown and knowledge gaps have not been thoroughly mapped. This scoping review will highlight areas of HIV research that require further evaluation and identify gaps in the current research regarding HIV and Black people in Canada. A preliminary search was conducted using the Cochrane Database of Systematic Reviews and MEDLINE; no scoping or systematic reviews were found on this topic. The purpose of this scoping review is to inform health policy makers, HIV organizations, and researchers on the state of the evidence on the disproportionate burden of HIV on the Black community in Canada and its impact on their lives.

We have identified 447 articles as of May 2023. A critical appraisal of the articles collected will be conducted for the extraction of relevant information. Tables and charts will be used to illustrate similarities and differences in data from various articles. Screening will start in November 2023, and we anticipate publishing the scoping review in June 2024.