Data Blog
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How has COVID-19 impacted access to STBBI-related health services, including harm reduction services, for African, Caribbean and Black (ACB) people in Canada? Published: ()
Since the start of Canada’s COVID-19 pandemic, challenges in delivering healthcare services including sexually transmitted and blood-borne infection (STBBI) prevention, testing and treatment services, including harm reduction services, have been reported across the country. These disruptions may have had a greater impact on populations most at risk for HIV and/or hepatitis C including African, Caribbean and Black (ACB) communities.
Additionally, social determinants of health including mental health, food security and structural barriers in accessing healthcare are known to account for differential health risks and health outcomes among these populations at risk.
To better understand how the COVID-19 pandemic has affected access to STBBI-related health services for ACB people, the Public Health Agency of Canada (PHAC) conducted an anonymous online survey between May and July 2021. The survey included anyone 18 years or older who was living in Canada during this time and self-identified as a person of ACB background. In total, 1556 people from across Canada participated in the survey.
1556 participants
1/2
51% were under the age of 40
9 in 10
Self-identified as:
- Black African (63%)
- Black Caribbean (28%)
Less than 1 in 10 self-identified as:
- Black Indigenous or Black Canadian (7%)
- Multiracial (7%)
- Black American (2%)
- Black Latin American (1%)
- Another Black race/ethnicity (2%)
2/3
66% identified as a Cisgender female
1 in 5
18% reported a sexual orientation other than heterosexual or straight
3/4
77% were born outside Canada
2 in 3
64% were Canadian citizens
More than 8 in 10
88% had more than a high school education
6 in 10
62% were living with family at the time of survey
1 in 5
20% were living alone at the time of survey
Less than 1 in 10
6% were living in precarious or inadequate housing
Mental health and wellness
1/2
47% reported their mental health was excellent or very good at the time of survey
Less than 1 in 10
6% reported their mental health was poor at the time of the survey
1/3
33% reported their mental health status was worse since the start of the COVID-19 pandemic
2/5
42% tried to access mental health services, of whom 62% were not always able to access these services
Financial and food security
7 in 10
69% were employed before the COVID-19 pandemic
1/3
36% reported reduced hours and/or pay, or had to stop working since the start of the COVID-19 pandemic
3 in 5
61% reported a major, moderate or mild impact of the COVID-19 pandemic on the ability to pay bills
1/2
53% experienced food insecurity since the start of the COVID-19 pandemic
Drug and alcohol use since the start of the COVID-19 pandemic
1/2
50% reported using alcohol since the start of the COVID-19 pandemic, of whom 38% reported increased use of alcohol
1/4
24% reported using cannabis since the start of the COVID-19 pandemic, of whom 56% reported increased use of cannabis
Less than 1 in 10
- 4% reported using cocaine or crack, of whom 38% reported increased use
- 3% reported using speed, methamphetamine or crystal meth, of whom 20% reported increased use
- 5% reported using hallucinogens, of whom 41% reported increased use
- 3% reported using heroin, fentanyl or other non-medical opioids, of whom 23% reported increased use
Less than 1 in 10
3% responded ‘Yes’ to the question, “Since the start of the COVID-19 pandemic, did you access, consider accessing or want to access substance-related services (needle or syringe distribution, on-site consumption, drug checking, naloxone training and provision, etc.)?”
Less than 1 in 10
5% responded ‘Yes’ to the question, “Since the start of the COVID-19 pandemic, did you access, consider accessing or want to access substance-related treatment services (counselling, opioid substitution treatment (OST), inpatient services, community-based programs and services, etc.)?”
Impact of COVID-19 on access to STBBI-related services
9 in 10
91% did not access or considered accessing STBBI prevention, testing and treatment services
1 in 10
9% accessed or considered accessing STBBI prevention, testing and treatment services
Top reasons why people were not able to access STBBI-related services:
- Difficulty getting a referral, appointment or contacting a doctor or nurse to get information or advice
- Difficulty accessing service because of COVID-19 related public health measures
- Service was not available at time required
- Waited too long between booking an appointment and visit
- Waited too long to get healthcare service (i.e., in-office waiting)
1 in 10
10% were living with HIV at the time of the survey
Less than 2 in 5
38% of those living with HIV experienced challenges accessing an HIV care provider or clinic since the start of the COVID-19 pandemic
Less than 1 in 10
1% reported a lifetime history of hepatitis C infection
Note: The aim of this Data Blog is to provide a general snapshot of the key findings from this survey. Additional details on the various questions asked of survey participants, measured indicators, methods employed for analysis and assumptions relating to these data will be available in the forthcoming national report.
Acknowledgements
The success of this survey and the Data Blog was possible because of the Public Health Agency of Canada’s collaboration and partnership with several community stakeholders including community researchers, organizations and members to ensure community engagement at every step of the survey including planning and implementation. Key stakeholders include the University of Ottawa and Women’s Health in Women’s Hands (WHIWH) who assembled a National Expert Working Group (NEWG) to guide the implementation of the survey. The NEWG consisted of ACB researchers, service providers, and community members and leaders. The authors gratefully acknowledge and thank all the members of the NEWG, Peer Research Assistants and the participants.
Suggested citation:
Survey of the impact of COVID-19 on access to STBBI-related health services including harm reduction services among African, Caribbean and Black community members in Canada. Public Health Agency of Canada, Centre for Communicable Diseases and Infection Control. 2021.
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