Populations Most Impacted
Social determinants of health significantly impact the lives of individuals and communities, putting some people at higher systemic risk for HIV than others. WHAI is working to address these inequalities in our work.
AFRICAN, CARIBBEAN, AND BLACK (ACB) WOMEN
ACB women are overrepresented among women living with HIV.
For ACB women, systemic risk for HIV is associated with social determinants of health, sexism, racism, and transphobia. HIV-stigma is compounded by intersecting stigma, discrimination and oppression rooted in sexism, racism, and transphobia.
Almost 60%
OHESI: HIV Diagnoses in Ontario, 2019 (2021)
CENTRING WOMEN'S EXPERIENCES
“The reality is the way we’ve been framed in the media around this issue, really contributes to us being more at risk of HIV. I think it pushes people from have a conversation about HIV in our community, I think it pushes people from our community from the possibility of getting tested.”
— Person living with HIV, “Our Voices: HIV, Race, and the Criminal Law. An ACCHO Special Report.” (2013)
INDIGENOUS WOMEN
Many systemic factors lead to increased HIV risk among Indigenous women.
Indigenous women face many intersecting forms of oppression as a result of colonialism, which contribute to increased risk for HIV acquisition. Systemic factors that maintain these realities include historical, multigenerational and intergenerational trauma, social and economic marginalization, lack of will, and ignoring the expertise of Indigenous women, girls and 2SLGBTQQIA people.
11%
OHESI: HIV Diagnosis in Ontario, 2019 (2021)
CENTRING WOMEN'S EXPERIENCES
"The ability of Indigenous women to determine and develop our own priorities in the areas of health, education, climate change, gender equality, and safety is vital to the success of reconciliation. In order to create positive and sustainable change, we need to draft ideas for programs tailored to our distinct needs and strategies for implementation…”
— Francyne D. Joe, Interim President, Native Women’s Association of Canada
TRANS WOMEN
Trans women experience higher rates of HIV.
There are no up-to-date statistics for Ontario, but a study in 2012 showed Trans women were 10 times more likely to report having been diagnosed with HIV than Ontarians overall.
Source: Bauer GR, Scheim AI, Deutsch MB, Massarella C. Reported Emergency Department Avoidance, Use, and Experiences of Transgender Persons in Ontario, Canada: Results from a Respondent-Driven Sampling Survey. Annals of Emergency Medicine 2014; 63(6): 713-720.
A NOTE ABOUT LANGUAGE
"Woman" and "Women"
People have different preferences, and these preferences can change depending on the context, situation, sense of safety, or personal identity. WHAI strives to be inclusive of all women, including Trans and cis women, people who are designated or assigned female at birth, people who are female-identified that are Trans or Non-Binary and people that are on the Transfeminine spectrum.
The terms “woman” and “women” are often used throughout our resources and website to encompass a wide range of identities, and in places we specify Trans or cis to help clarify or remind us of the importance of striving to build inclusivity. At times, the terms “female” and “male” are also used. This reflects how data is gathered in sources we are referencing, in cases where it is referencing sex rather than gender. Regardless of our comfort levels, for the safety of all women and in an effort to create accessible, respectful, and inclusive spaces, it is important to address people by whatever terms they identify with.
For more information on WHAI’s work toward Trans inclusion and gender-inclusive work, please see WHAI’s Trans Inclusion Pocket Guide at whai.ca. For helpful information on language and terminology, check out The 519’s Glossary of Terms at the519.org
10x
CENTRING WOMEN'S EXPERIENCES
"In order to enhance care for Trans women living with HIV, it is essential that health care and social service workers receive training and resources to make their services more accessible."
WOMEN WHO USE DRUGS
For women, the risk of HIV transmission from needle sharing is significantly higher than risks associated with vaginal sex.
While drug use can increase the risk for HIV and hepatitis C transmission, criminalization of drug use and stigma present barriers to engagement and maintenance with HIV care for people who use drugs. Racialized and Indigenous women, and women who are pregnant or parenting face especially high rates of stigma and barriers to services.
21%
OHESI: HIV Diagnoses in Ontario, 2019 (2021)
CENTRING WOMEN'S EXPERIENCES
“I avoid using services that require my name or health card or whatever. I don’t feel safe in public spaces and/or anywhere I am required to identify myself because you never know where the info is going. I only use services that have a good reputation and can be trusted.”
— Woman who uses drugs, Ontario
WOMEN WHO EXPERIENCE VIOLENCE
Gender-Based Violence (GBV) is any form of violence based on gender, gender expression, or gender identity and is rooted in entrenched gender inequality.
GBV creates increased barriers for women to engage with HIV prevention, testing, and treatment. Women who experience violence may face barriers to negotiating safe sex or harm reduction practices, as well as accessing and maintaining HIV care. In some cases, the presence of HIV may also increase the risk of violence for women.
The risk for GBV is even greater for women who face other social inequities, such as Indigenous, racialized, 2SLBTQQIA women, and women who use drugs.
Almost 50%
- The OHTN Cohort Study (OCS)
CENTRING WOMEN'S EXPERIENCES
“I never had consensual sex with my husband. He didn’t tell me that he had HIV but he started to look ill. Every time I told him ‘no.’”
— Woman living with HIV, Ontario
WOMEN WHO ARE INCARCERATED
Women who are incarcerated (or have been incarcerated) face a range of systemic barriers that can increase the risk of acquiring HIV and create barriers to positive health outcomes.
People experiencing incarceration in Ontario’s correctional system were reported to have higher rates of HIV than the general population in 2014. Among people living with HIV, HIV rates were higher among incarcerated women than men. The most significant risk factor for people who were currently or formerly incarcerated was injection drug use.
1% to 9%
CENTRING WOMEN'S EXPERIENCES
“Women who are incarcerated in Canadian prisons, for example, are more likely than their male counterparts to experience health complications from past physical and sexual abuse, poverty, pregnancy, and malnourishment, among other conditions. For Indigenous and Black women, these experiences are compounded by the legacies of colonization, slavery, and racism.”
RESOURCES
HIV Stigma in African, Caribbean, and Black Communities
CHABAC's resource on HIV stigma within African, Caribbean, and Black communities.
On Point
Recommendations for Prison-Based Needle and Syringe Programs in Canada.
Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls
National inquiry into Missing and Murdered Indigenous Women and Girls.
Inside and Out: Backgrounder
Report on changing the course of the HIV prevention, engagement, and care cascade for current and former prisoners.
Women in Prison, HIV and Hepatitis C
The Canadian HIV/AIDS Legal Network's information sheet on the human rights of women living with HIV in prison.
TransPULSE Resource Guide
TransPULSE's resource list for Trans people in Canada.