Women, HIV and the Law: Systematic Reviews of the Global Evidence

PROJECT SUMMARY In most parts of the world, the criminalization of HIV continues to supersede public health approaches to reducing social and health related harms associated with HIV transmission to individuals and communities. Research suggests that criminalization of HIV non-disclosure can have particularly devastating effects on Women Living with HIV (WLWH), by fostering a fear of police arrest, violence, abuse and engendering concerns regarding breach of confidentiality, 1 exacerbating HIV-related stigmatization, 2, 3 and reducing trust in health care providers and counselors. 4 In many cases, the public release of personal information about HIV+ status has resulted in their increased social marginalization and exclusion, detainment and criminalization, as well as deportation for migrants. 5-7 Criminalization of HIV and associated HIV-related stigma are highly gendered 8 and intersect with other forms of stigma and oppression, including racism, homophobia and transphobia, as well as stigma against key affected populations (e.g. sex workers, people who use drugs). In an effort to address critical gaps between public health evidence and public policy, and address key issues brought forward by knowledge users (e.g. affected community, service providers, and human rights and legal experts), the proposed grant aims to systematically review and synthesize the evidence on women, HIV and the law both in Canada and globally. The proposed knowledge synthesis efforts herein will aim to document and unpack how sex- and gender- dimensions (e.g. social ascribed aspects of gender) shape women’s experiences of the law and HIV, and how this subsequently affect their physical, sexual and emotional health outcomes and access to HIV care. Specifically, over the course of the year, the team will systematically review two key topics on women, HIV and the law: 1. The impact of criminalization of HIV non-disclosure on WLWH’s condom negotiation and associated risks (e.g. sexual violence) among WLWH 2. The impact of criminalization of HIV non-disclosure on WLWH’s access and experiences with HIV care (e.g. delayed HIV testing or HAART initiation; lack of trust with HIV providers; stigma and discrimination) Over the course of the one-year study, the knowledge synthesis grant will include a comprehensive suite of integrated knowledge translation (iKT) efforts to evaluate the strengths, limitations, and gaps in the scientific literature and inform policy and practice pertaining to women, HIV and the law. The iKT efforts will include engaging knowledge users (e.g. policy and practice leaders, WLWH) in reviewing the evidence and implications of the global review, and creation of community and policy-oriented outputs (e.g. plain language summaries, policy briefs, rights cards).. The interdisciplinary and intersectoral research team for this knowledge synthesis bridges academic (e.g. Gender and Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS; Youth Sexual Health Team, University of British Columbia; Women’s College Research Institute, University of Toronto), legal/policy (e.g. Canadian HIV/AIDS Legal Network) and HIV practice experts (e.g. Positive Women’s Network, Pacific AIDS Network) in women, HIV and the law.