Intersectionality is a theory that uncovers interlocking inequalities fueled by racial, gender, class, sexual and other inequities. These inequities cannot be separated from the systems that produce them (e.g. policies, societal attitudes, including stigma, political and economic systems).
When applying the intersectional lens to HIV research, we can ask how these inequalities shape the likelihood of exposure to HIV; the realities of living with HIV; as well as medical, programmatic, political, and social-scientific responses. The goal of intersectional research is to analyze individual behaviors and experiences in relation to multiple contexts.
This year’s CAHR conference featured several oral presentations that incorporated the intersectional lens in their research. I will discuss three of my favorite presentations that do not explicitly mention intersectionality but certainly engage with it. All of these presentations identify:
- The underlying structural and institutional factors and their interaction with the lives of people living with HIV – from the immigration system and health care protocols to the system of criminalization and incarceration;
- The social disadvantage informed by individual identity (the intersectional positions of having HIV and being a newcomer/expectant mother/Indigenous and incarcerated woman;
- The power imbalances and inequities interlocking with personal experiences.
This presentation highlighted the challenges that newcomers with HIV experience when they navigate access to treatment in Canada. The research project adhered to the principles of GIPA/MEPA and used a variety of qualitative methods to identify the barriers. Some of the structural challenges discussed in the presentation include financial barriers (cost of services, low income, insurance co-payment, maximum claim limits), administrative (waiting periods for newcomers, complexities of health coverage) as well political barriers (low involvement of decision makers, inconsistent approaches across the federal and the provincial levels of government).
Using the method of institutional ethnography that explores the ongoing activities of people in the world, this presentation investigated the relationship between the lived experiences of expectant mothers diagnosed with HIV and the social processes (in health care settings) that produce these experiences.
Through the qualitative interviews with expectant mothers, this research project unveiled the ways in which women’s HIV status and pregnancy undergo surveillance. Despite women taking significant measures to prevent HIV transmission, their concerns were often overshadowed by authoritative practices that required women to provide evidence of treatment adherence on a regular basis, increase the frequency of their HIV and prenatal visits and overall challenged women’s parenting capacity.
The presentation provided an overview of the RED Path (Re-forging connections, Empowering Indigenous Women to heal, and Driving Change for a healthy future) – HIV/HCV Initiative. The project aims to develop sustainable, evidence-based, and culturally safe STBBI interventions for Indigenous women in federal correctional facilities.
The project adopted a strengths-based approach, GIPA/MEPA principles and decolonizing methodologies that integrated traditional knowledge and culture. Through 7 sharing circles held in 4 correctional facilities, the project explored the experiences around STBBIs and effective interventions and supports. This approach fostered a sense of community that worked to decrease the feelings of isolation and stigmatization. The knowledge gathered informed the development of an interactive, culturally safe, gender based and trauma-informed STBBI learning modules delivered over three days with a goal to increase knowledge, reduce stigma, dispel misconceptions and increase awareness of STBBIs.
All of these presentations engage with the principles of intersectionality and contribute meaningfully to the social dimensions of HIV by putting the lived experiences at the forefront. Intersectionality has a significant potential to not only identify some of the complex social and health issues but also offer new ways of addressing them.
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Alfiya Battalova, Evaluation Manager