The intersection of race, gender, sexual orientation and HIV: understanding multi-dimensional forms of stigma and discrimination experienced by women living with HIV in
Presented by Carmen Logie (Canada).
C. Logie1, L. James2, W. Tharao2, M. Loutfy3
1University of Toronto, Faculty of Social Work, Toronto, Canada, 2Women's Health in Women's Hands CHC, Toronto, Canada, 3Women's College Research Institute, Toronto, Canada
Background: HIV-related stigma interacts with
structural inequities and may be exacerbated for marginalized populations. The
increased HIV infection rate among women in Canada, particularly among African/Caribbean
and Aboriginal women, underscores the importance of understanding
multi-dimensional forms of stigma and discrimination. We used a critical
feminist epistemology to explore experiences of stigma and discrimination among
women living with HIV from marginalized communities.
Methods: We conducted 15 focus groups with women living with HIV
across Ontario, Canada including: Aboriginal, African/Caribbean, sex worker,
injection drug user (IDU), lesbian/bisexual, and transgender women. Three focus
groups were implemented with HIV researchers and service providers in Ottawa,
Hamilton and Toronto. We used a semi-structured interview guide to explore
strengths and challenges experienced by women living with HIV. Focus groups
were digitally recorded, transcribed, entered into NVivo and examined with
narrative thematic techniques from grounded theory.
Results: Focus group participants (n=104; mean age=38 years; 23%
lesbian/bisexual; 22% transgender; 69% ethnic minority) attributed experiences
of stigma and discrimination to: HIV serostatus, sexism, racism,
homo/transphobia, and other marginalized identities (e.g. IDU). Participant
narratives highlighted widespread stigmatization across multiple realms (e.g.
familial, social, health care) that negatively impacted mental health, relationships,
and treatment access. Lesbian, bisexual, and transgender women described the
intersection of homo/transphobia with gender-based violence as a route of HIV
infection. Ethnic minority women and IDU reported that discrimination within
health care reduced utilization of health services. HIV-related stigma emerged
as major reason why women living with HIV remained in situations of domestic
Conclusions: Women living with HIV described interdependent and mutually
constitutive relationships between social identities and social inequities such
as HIV-related stigma, homo/transphobia and racism. Understanding the
deleterious effect of stigma(s) on HIV risk, mental health, and access to care
for women living with HIV can inform health care provision, domestic violence
programs, and multi-level stigma reduction interventions.
Back to the session -
Back to the Programme-at-a-Glance