Some women would rather sacrifice their health than sacrifice their anonymity and confidentiality . In addition, fear of disclosure has kept many women from African and Caribbean communities from accessing health services and from establishing contacts with other HIV-positive women . Disclosure is considered one of the most difficult aspects of living with HIV in Aboriginal communities because of the resulting stigma, discrimination and feelings of being ostracized Footnote Discrimination against Aboriginal women living with HIV is compounded as gender discrimination adds to the stigma they experience [91;92].
Examples of exclusion are particularly pervasive in the lives of women who already experience other forms of discrimination, such as heterosexism, homophobia, transphobia, or racism. Women who have sex with women WSW are believed to be at increased risk of HIV due to their participation in behaviours that result in their discrimination and exclusion.
For example, a study conducted in British Columbia multiple locations and Seattle, WA USA , which used comparative data from surveys administered to high school students, revealed that gay, lesbian or bisexual adolescents report higher HIV risk behaviours than their heterosexual counterparts. Risk behaviours included, use of injection drugs, age at sexual debut, number of lifetime sexual partners, condom use during last sexual intercourse, history of previous STI diagnoses, and alcohol or drug use during last sexual encounter.
Another study conducted in Montreal found that having a female sexual partner or having a female sexual partner involved in sex work were predictors of involvement in sex work for street-involved female youth . No other sexual behaviours predicted initiation into sex work among this cohort of females. Sex workers also face increased vulnerability to HIV as a result of factors linked to their social exclusion.
For example, laws and society's attitudes regarding sex work stigmatize sex work, thereby limiting sex workers' access to services and health care for fear of discrimination. Further, difficult working conditions reduce sex workers' ability to negotiate and enforce safer sex behaviours. Racism and discrimination leave groups of people particularly vulnerable to HIV infection by excluding them from the social and economic mainstream and by denying them the social support needed to enhance and preserve life .
Studies show that for Black women, the experience of racism intersects with other issues, such as gender, sexual orientation and socio-economic status. This results in a level of social exclusion that elevates their risk of HIV infection and compounds their ability to cope with the disease [35;36;97].
Aboriginal women also feel the effects of racism and social exclusion in Canada. The complex vulnerabilities that Aboriginal women face stem from a legacy of colonization and the multigenerational effects of social isolation, discrimination, entrenched poverty, and the residential school system [59;81]. Support groups may be a source of resilience for women living with HIV. Support groups can encourage and inspire women living with HIV and remind them that they are not alone . In some cases, support groups act as alternate communities for women living with HIV, and can empower women by promoting their participation in society [88;90].
For example, a Vancouver-based study of female sex workers who use illicit substances found that peer-driven interventions positively affect HAART adherence for this population . Another study reveals that seropositive mothers rely on the support of family, friends and professionals, while men rely solely on one or more friends for support . Other studies show that a supportive network is a valuable asset for women living with HIV [88;].
However, some women living with HIV feel that support groups focus too heavily on the negative aspects of living with HIV and complain that not enough women are involved. Nothing else exists except having HIV. Community norms and values are propagated through social institutions and networks, which can either help with or act as barriers to HIV prevention. For instance, a qualitative study addressing HIV prevention and Black women in Toronto identified the church as an existing community structure that could be used to spread HIV prevention messaging to a key audience .
They may not be the highest income earners, but can find money to support their churches.
HIV Infection Among Incarcerated Women: Epidemic Behind Bars
Given their influence, churches should be considered as potential partners to foster resilience and begin dialogue about HIV and its affect on the Black community. The role of primary caregivers involves the provision of emotional support, bringing with it related pressures and stress. Acting as primary caregiver and living with HIV can be taxing, especially for single mothers . I have suppressed all my emotional needs so that becomes another source of stress. A study has found that HIV-positive mothers depend more often on their own children for social support than they do on friends .
The positive influence of children is one of the factors behind the strong presence of women living with HIV in society and their increased participation in the workforce [70;98]. Many studies clearly illustrate the relationship between homelessness, low income and socio-economic status and HIV risk behaviour [54; 61]. For instance, urban areas with concentrated homeless populations are ripe for non-market economies, such as theft and drug trafficking, that give rise to increased HIV risk behaviours, including sex work and drug use. However, even when socio-economic conditions are poor, neighbourhoods can reduce HIV risk behaviour by addressing the underlying issues related to physical environment — for example, by providing increased access to stable housing.
Many projects have been put in place to address the poor socio-economic conditions, which characterize the area.
These projects, which include affordable housing initiatives, mental health services, harm reduction services, addiction treatment services, and treatment for people living with HIV including women , are discussed in more detail in Chapter 6. The study noted that of the cohort from the MAKA project , the women who were most vulnerable — including young women of Aboriginal ethnicity, people who use injection drugs, and daily cocaine smokers -- were the least likely to use its services .
Activities associated with drug use have been shown to increase risk of HIV and other STIs and blood-borne illnesses [43;57;]. For instance, one study conducted in Toronto on mortality in homeless women found that homeless women 18 to 44 years of age were 10 times more likely to die prematurely than women in the general population of Toronto.
Another study based in Vancouver also found that mortality for women who used drugs was associated with unstable housing and HIV infection . Another study of street-involved women who inject drugs and who are also involved in sex work in two Canadian cities Montreal and Vancouver found that more women involved in sex work had a higher incidence of unstable housing than those who were not involved in sex work . Although the women involved in sex work who participated in this study reported high condom use, the study also found that the practice of borrowing used syringes was independently associated with the sex trade.
These studies are evidence of a clear link among homelessness, drug use and HIV risk behaviour.
Unpacking the connections between race, incarceration, and women’s HIV rates
This study also revealed that women living with HIV were more concerned about unstable housing than men living with HIV. Women living with HIV also reported higher rates of depression and lower overall mental health scores than male participants. For example, one study found the quality of life for women from African and Caribbean communities was improved by living in affordable housing .
Findings from this study highlight the need for culturally appropriate supportive housing services for this group of women and their children . For example, a qualitative research study conducted in the Maritimes suggests that isolation from urban centres has left many women with only a partial understanding of the facts surrounding HIV.
This study helps to explain how abstinence-based sexual education may prevent women from obtaining information on harm reduction and safer sex practices. Access to services is the biggest barrier. You may not have the knowledge. You may not have the ability.
Aboriginal people who live in remote communities may believe that their location, far from urban centres, offers them protection from HIV infection [;]. A study of street-involved young Aboriginal women found that there were few differences in terms of HIV risk behaviour e. Moreover, women living in rural and remote environments may be unable to access accurate HIV risk information, care or related services, as these services are more commonly available in larger urban centres. Many Aboriginal people face unique risks and barriers to good health as a result of the geographic isolation of their homes and communities.
Women in prisons are at increased risk of HIV infection when compared to the general population as a result of existing high prevalence rates and continued high-risk behaviours while incarcerated [;]. HIV prevalence among female offenders in federal prisons is significantly higher than that of the general population.
- white pages for ikeja lagos nigeria?
- HIV Facts & Figures?
- Services on Demand.
- sex offender in blue island il!
- owatonna steele co minn public records;
HIV prevalence among female inmates in federal prisons is even higher than HIV prevalence among males in federal prison . Women in prison continue to engage in many of the same risk behaviours that they engaged in prior to their incarceration, such as drug use, needle sharing, unprotected sex, and sharing of tattooing equipment [;].
However, in spite of higher participation rates among women, women in prison also reported that their access to these programs was limited by a lack of awareness, limited space, and competing clinical demands on nursing staff . Access to educational material on reducing risk has also been reported as lacking in prisons .
Personal health practices and coping skills refer to those actions by which individuals can prevent diseases and promote self-care, cope with challenges, and develop self-reliance, solve problems and make choices that enhance health . When women lack the power to make decisions about personal health practices and coping skills, they are more vulnerable to HIV infection. This is especially true for women struggling with sexual and reproductive health issues and issues around substance use. Women face increased risk of HIV infection when they lack the power to negotiate safer sex in intimate relationships.
Condom use is still the most effective way to prevent HIV transmission during heterosexual intercourse. Both male and female condoms are available in Canada; however, their consistent use is still not practised among all women and their sexual partners. Women who do not perceive themselves to be at risk for HIV or other STIs may not be concerned with using condoms regularly . For example, condom use is much more common among younger generations.
This may be explained by the fact that HIV prevention campaigns tend to target younger women.
Global information and education on HIV and AIDS
In a Montreal study, sexually active women not living with a partner were surveyed on the subject of condom use. In another Montreal study of young women accessing sexual health services, participants cited having a stable sexual partner and taking the birth control pill as principal reasons for not using condoms with partners . These findings are consistent with findings from another study which found that occasional partners use condoms more frequently than regular partners . While a monogamous sexual partner may reduce risk of HIV infection, monogamy does not eliminate risk.
For instance, as HIV and other STIs may not be accompanied by symptoms , a partner may enter into a monogamous relationship unknowingly infected. Also, repeat sexual exposure can increase the likelihood of transmission of infection, particularly for HIV . Extramarital or extra-relational affairs also create opportunities for introducing HIV or other STIs into seemingly monogamous partnerships.
These types of culturally specific attitudes about male and female sexuality present challenges in HIV prevention for this group of women.