Written by Micaela Pereira Bajard
The Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS, www.chiwos.ca) is a community-based research study seeking to measure the use and impact of women-centred care for women living with HIV. The study meaningfully engages HIV-positive women throughout the research process and aims to create new knowledge that can be used to advance their health and well-being. As of May 2015, 1,425 women living with HIV across Canada enrolled into CHIWOS. Of these, 356 were from BC.
One way that we sought to give back to our BC community was through the creation of infographics, or visual fact sheets. Through these infographics, we hope that participants will learn more about the vibrant CHIWOS community they are now a part of, and that HIV clinics and ASOs will benefit from knowing what services they are using most as well as what barriers they experience when wanting to access them. Below is a brief description of the statistics presented in each infographic. Please note they refer to BC participants only.
First, in the Demographics infographic, we provide a picture of who our BC participants are. Nearly half (45%) identify as Indigenous, 39% as Caucasian, 8% as African, Caribbean, Black Canadian and another 8% as other ethnicities. Some (7%) of our participants are under the age of 30, with roughly equal distributions across the remaining age groups (30-39, 40-49, and >50). Close to one-fifth (17%) of our participants reported their sexual orientation as lesbian, gay, bisexual, two-spirited or gender queer. A large proportion have ever injected drugs (62%) or been incarcerated (63%), while few (10%) are currently engaged in sex work. In terms of sexual and reproductive health indicators, 57% of our provincial cohort has had sex in the 6 months before their interview (defined as consensual oral, anal, or vaginal sex) and 79% has had children (measured as ‘live births’ and explored more thoroughly in wave 2). Overall, participants are well-connected to HIV care, with 89% on treatment and 80% having an undetectable viral load. These indicators highlight the diversity of women with HIV in BC, which underscore the importance of a women-centred approach throughout levels of the HIV response.
Clinic Service Utilization
Second, in our Clinic Service Utilization infographics, we describe the patterns of HIV clinical care utilization, including how far women are traveling to access care, how long they have been receiving this care, what services are available to them, and whether they feel they are receiving women-centred care. Out of the 356 BC participants, 335 provided information to answer these questions. Most (70%) of our participants accessed an HIV clinic in the Vancouver Coastal Health area, yet more than 1 out of 3 (35%) reported having to leave their town or city to access care, and approximately 1 out of 2 (52%) had to travel over 30 minutes. The five services that were cited by our cohort as most available at their HIV clinics are the following: health information and materials, onsite pap tests and sexual health services, dietician consults, substance use treatment and mental health services. Eighty seven percent of our cohort thought women-centred care was important, and over 60% perceived the care they received at their HIV clinic and their HIV doctor as women-centred. Overall, 9 out of 10 (91%) of our participants were satisfied with the care they received from their HIV doctor.
ASO Service Utilization
Lastly, the ASO Service Utilization infographic showcases the support services that women living with HIV are accessing in BC. Seventy one percent of our participants used support services, with 25% using only one, 21% using two, and 17% using three or more services. Importantly, 29% of women reported experiencing barriers to accessing supportive services, with almost half of them (47%) saying that their biggest barrier was that there were no services where they live. Food and nutrition services—including food banks, meal programs, community kitchens and vitamins—were reported as the most accessed service. This was followed by the following services: receiving/providing peer support, participating in social activities such as retreats, and accessing health information materials.
We gratefully acknowledge all the women living with HIV who contribute to CHIWOS. We also thank all of our partners for supporting the study. In BC, the following organizations have partnered with CHIWOS to provide interview space: AIDS Vancouver Island, BC Centre for Excellence in HIV/AIDS, Cool Aid Community Health Centre, Downtown Community Health Clinic, Keys Housing and Health Solutions (Positive Haven), Living Positive Resource Centre, Oak Tree Clinic, Positive Living Fraser Valley, Positive Women’s Network, Positive Living North, and Vancouver Island Persons with AIDS Society. CHIWOS is supported by the Canadian Institutes of Health Research (CIHR) Institute of Gender and Health and CIHR Canadian HIV Trials Network (CTN 262).