Margaret Erickson1, Kate Shannon1,2, Flo Ranville1, Sherri Pooyak3, Terry Howard4, Bronwyn McBride1, Neora Pick2,5, Ruth Elwood Martin2,6, Andrea Krüsi7,8. 1. Centre for Gender and Sexual Health Equity, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada. 2. Department of Medicine, University of British Columbia, Vancouver, BC, Canada. 3. Canadian Aboriginal AIDS Network, SK, Fort Qu'Appelle, Canada. 4. GlassHouse Consultants, Vancouver, BC, Canada. 5. Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, BC, Canada. 6. School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada. 7. Centre for Gender and Sexual Health Equity, 1190 Hornby St, Vancouver, BC, V6Z 2K5, Canada. Dr.Krusi@cgshe.ubc.ca. 8. Department of Medicine, University of British Columbia, Vancouver, BC, Canada. Dr.Krusi@cgshe.ubc.ca.
Abstract
OBJECTIVES: Given the gender disparities in HIV outcomes for women living with HIV (WLWH) who experience incarceration, and the impact of HIV-related stigma on HIV care, this qualitative study investigated how HIV-related stigma within prison settings shapes HIV care for WLWH. METHODS: Drawing from SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment), a community-based research project with cisgender and transgender WLWH in Metro Vancouver, peer and community interviewers conducted 19 qualitative interviews (May 2017-February 2018) with recently incarcerated WLWH focused on factors that shape incarceration trajectories. Drawing on socio-ecological frameworks and using participatory analysis, this analysis sought to characterize how HIV-related stigma shapes experiences and access to care for incarcerated WLWH. RESULTS: Participants' responses focused predominately on experiences in provincial correctional facilities and the ways through which HIV-related stigma within correctional settings was linked to access to HIV care. Experiences of HIV-related stigma within prisons led to isolation and discrimination for WLWH which was reinforced through institutional processes, compromised privacy, and uncertainty about confidentiality. Experiences of HIV-related stigma informed decisions for some participants to withhold HIV status from healthcare staff, compromising access to HIV treatment during incarceration. CONCLUSION: Amid ongoing efforts to improve healthcare delivery within Canadian correctional facilities, these findings have important implications for the provision of HIV care for incarcerated WLWH. Culturally safe, trauma-informed programming focused on reducing HIV-related stigma, improved communication regarding medical privacy, and interventions to change processes that compromise privacy is critical to improve healthcare access in correctional facilities.
OBJECTIVES: Given the gender disparities in HIV outcomes for women living with HIV (WLWH) who experience incarceration, and the impact of HIV-related stigma on HIV care, this qualitative study investigated how HIV-related stigma within prison settings shapes HIV care for WLWH. METHODS: Drawing from SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment), a community-based research project with cisgender and transgender WLWH in Metro Vancouver, peer and community interviewers conducted 19 qualitative interviews (May 2017-February 2018) with recently incarcerated WLWH focused on factors that shape incarceration trajectories. Drawing on socio-ecological frameworks and using participatory analysis, this analysis sought to characterize how HIV-related stigma shapes experiences and access to care for incarcerated WLWH. RESULTS: Participants' responses focused predominately on experiences in provincial correctional facilities and the ways through which HIV-related stigma within correctional settings was linked to access to HIV care. Experiences of HIV-related stigma within prisons led to isolation and discrimination for WLWH which was reinforced through institutional processes, compromised privacy, and uncertainty about confidentiality. Experiences of HIV-related stigma informed decisions for some participants to withhold HIV status from healthcare staff, compromising access to HIV treatment during incarceration. CONCLUSION: Amid ongoing efforts to improve healthcare delivery within Canadian correctional facilities, these findings have important implications for the provision of HIV care for incarcerated WLWH. Culturally safe, trauma-informed programming focused on reducing HIV-related stigma, improved communication regarding medical privacy, and interventions to change processes that compromise privacy is critical to improve healthcare access in correctional facilities.
Authors: Andrew R Hatala; Kelley Bird-Naytowhow; Tamara Pearl; Jen Peterson; Sugandhi Del Canto; Eddie Rooke; Stryker Calvez; Ryan Meili; Michael Schwandt; Jason Mercredi; Patti Tait Journal: Qual Health Res Date: 2018-04-20
Authors: Margaret Erickson; Kate Shannon; Ariel Sernick; Neora Pick; Flo Ranville; Ruth E Martin; Andrea Krüsi Journal: AIDS Date: 2019-01-27 Impact factor: 4.177
Authors: Ingrid T Katz; Annemarie E Ryu; Afiachukwu G Onuegbu; Christina Psaros; Sheri D Weiser; David R Bangsberg; Alexander C Tsai Journal: J Int AIDS Soc Date: 2013-11-13 Impact factor: 5.396