Sexual Health, HAART and HIV Care Amongst Women Living with HIV: A Longitudinal Investigation of the Impacts of Structural, Social, and Policy Environments

Recent evidence suggests an increasing number of new HIV infections among women in Canada. Among women living with HIV (WLWH), most HIV infections are due to heterosexual transmission, with women of Aboriginal ancestry disproportionately affected. Moreover, the sexual and reproductive health needs of WLWH have been largely overlooked, despite that many WLWH, including in Canada, are living with or intending to have children. To date, while there is a large body of research on the individual behavioural, biological, and clinical factors that shape HIV care outcomes, we know far less about the role that laws, policies, gender, stigma, and geography play in shaping access and uptake of HIV care and sexual and reproductive health for WLWH. This is of particular concern, given calls for women-centered sexual health and HIV care and growing concerns of the role of criminalization of HIV non-disclosure and its potential negative effects on women's experiences with HIV care. This grant brings together an interdisciplinary and intersectoral team, including social scientists, epidemiologists and clinical researchers, together with knowledge users and collaborators representing community and legal/policy experts to examine the social and policy factors shaping WLWH's access to HIV care and sexual and reproductive health. The project will hire WLWH as peer researchers to help guide the research and dissemination. Given limited studies conducted over time, the proposed project (Sexual Health, HIV/AIDS Care & Women's Longitudinal Needs Assessment, or SHAWNA) will enrol and follow 500 WLWH in Metro Vancouver, Canada over the next five years. This study will create an evidence base to inform improved women-centred sexual health and HIV care. Knowledge translation and exchange will be conducted throughout the study, which will play a key role in informing policy and programs that best promote women-centred sexual health and HIV care in BC, and can be replicated across Canada.