The Challenge: Most studies of HIV and health in African, Caribbean and Black (ACB) communities have taken place in large urban centres and rarely examine how the interactions between racism, gender, HIV-related stigma and multiple forms of oppression affect health and HIV vulnerability. This lack of information negatively impacts HIV prevention and health promotion efforts for ACB communities. Our Approach: The BLACCH Study uses a community-based approach to collect extensive information about the health of ACB communities in Middlesex County, Ontario. The first stage of the project consists of semi-structured interviews to collect information about the breadth of health-related experiences in Middlesex County’s ACB communities. A purposive sample of 30 persons will be interviewed—seven (7) persons providing health or support services to the local ACB communities and twenty-three (23) ACB community members. ACB persons involved in the interviews are from diverse backgrounds and represent a cross-section of these communities. The interview topics include: gender; migration; general health; religion; nationality; HIV-related beliefs, behaviours, knowledge, experiences, stigma and services; social network characteristics; socio-economic status and housing. The interviews are being analyzed using a modified grounded theory approach to identify emergent themes based on lived experiences. Key Findings: We learned the following: health is viewed holistically, and participants largely classified themselves as healthy; diabetes and HIV are important health issues in the community; many people obtain health information through the Internet; most participants believe their risk of contracting HIV is quite low; ACB persons are not utilizing HIV services; there should to be more of an ACB presence in HIV/AIDS, health and social service organizations; organizations need to have multiple employees from ACB communities with different ethnic backgrounds; health and social service organizations need to build trust with ACB communities; and rather than asking ACB persons to seek services and information, service providers should bring services and information to ACB communities. Impact on Policy and Practice: This first phase of the study builds the capacities of community members, academic researchers and organizations in Middlesex County to mobilize to address the needs of ACB communities. In the long run, the BLACCH Study will help interested parties gain a better understanding of the HIV-related experiences of ACB persons who reside in areas with small ACB populations and limited HIV/AIDS resources.