Black Emancipation and the Burden of Canada's HIV Epidemic among Black Communities.

Black communities account for a hugely disproportionate and increasing burden of Canada's HIV epidemic. According to the Public Health Agency of Canada, Black people made up 27% of new HIV cases in 2023 even though, according to the census of Canada, slightly less than 5% of the country's population identifies as Black. Moreover, Black people have an elevated risk of dying from AIDS compared to white Canadians. This disproportionality has been building for the last 40 years, but the research and policy communities have not responded with the urgency, imagination, or resources that the crisis warrants. Evidently, health and research policy have failed Black communities. In 2022, the Interim Committee on HIV among Black Communities in Canada developed the Black HIV Manifesto in support of its self-determined, community-focussed, evidence-informed advocacy to address the crisis of HIV affecting Black communities. In this paper, we explicate the concept of 'Black Emancipation' as a transformational framework, orientation and goal for understanding and responding to HIV and related inequities among Black communities. We underline a distinction between legal emancipation in the 19th century (1830-1880 s) and the prolonged systemic amputation of Black livelihoods up to the present, and discuss how HIV-related public health and research policy may be implicated in reproducing inequities in health and wellbeing. Finally, we identify new directions that foreground critical community-focussed scholarship and practice to change the trajectory of HIV among Black communities.