Title: Access to and engagement with comprehensive HIV care: An intersectional examination of the experiences of migrant women living with HIV
Thesis Supervisors: Eli Puterman
Committee Members: Vicky Bungay, Erica Bennett
Chair: Guy Faulkner
Abstract:
As of 2020, approximately 62,790 people were living with HIV in Canada, of which a growing proportion are women – approximately 25% of all infections. The Canadian government has designated both women and migrants from countries where HIV is endemic as priority groups, with the acknowledgment that migrant women living with HIV (WLWH) experience particular intersecting oppressions which increase their vulnerability to HIV and impact their access to and engagement with healthcare services. Furthermore, while HIV research has historically focused on access to HIV care and treatment, it is increasingly recognized that WLWH experience numerous healthcare needs that extend beyond HIV-specific care. More specifically, recent community-based research efforts have emphasized the need for comprehensive HIV care which includes HIV-specific care, treatment for other chronic medical conditions, sexual and reproductive health and rights (SRHR), mental healthcare, as well as assessment of social factors impacting health.
Despite the documented need for comprehensive HIV care, no studies to date have examined the experiences of migrant WLWH in accessing and engaging care. While studies more broadly have shown that migrant WLWH experience numerous barriers to HIV-specific care, there remains a need to understand the contextual factors shaping migrant WLWH’s experiences of healthcare. Moreover, given that migrant WLWH are often located at the intersections of gender, race, migration, and other interlocking oppressions, it is imperative that these examinations of comprehensive HIV care be grounded in critical perspectives which can attend to the ways in which the historical, political, and sociocultural context shape access to and engagement with care. Therefore, the purpose of this dissertation is 1) to understand how migrant WLWH access, navigate, and engage the healthcare system and 2) to analyze their experiences within a wider political, historical, and sociocultural context to understand how contextual factors, as well as power relations and systems of oppression shape their engagement with and access to comprehensive HIV care. To this end, I propose an interpretive description study. Grounded in an intersectional approach, the proposed dissertation will employ semi-structured interviews and document review to answer the following questions:
- What are the experiences of migrant women living with HIV in accessing and engaging comprehensive HIV care?
- What are the contextual factors influencing and contributing to those experiences?
- How do these factors shape migrant WLWH’s experiences within the healthcare system?