“CWGHR,” I responded to my new friend at the 2016 International AIDS Conference in Durban, South Africa. I pronounce our acronym like, “Quigger.”
“Oh, I’ve never heard of Quitter.”
“… that’s because the name is actually, CWGHR”.
Picture it … Quebec City, 1998, thirty people with diverse interests, identities and professions meet to discuss the idea of HIV and rehabilitation for the first time. All were curious, but unsure of the connection between rehabilitation and HIV prevention, treatment, care and support and the role they could play. There the Canadian Working Group on HIV and Rehabilitation (CWGHR) was born! As people were no longer expecting to die of AIDS, this group of pioneers could see that rehabilitation – in a broad sense – was key to enabling people living with HIV to not only survive, but also thrive.
Lack of access to HIV treatment and care among other complex factors contributes to these alarming rates: in many rural or remote areas, HIV-specific services are simply not available, or the small size of the community creates concerns around confidentiality for those accessing care. Indigenous people in Canada — many of whom are surviving a legacy of colonization and the intergenerational effects of residential schools — continue to experience systemic discrimination and extremely high rates of incarceration. In this context, the criminalization of HIV non-disclosure may be perceived as yet another form of institutionalized violence and discrimination, amplifying the negative impact of the HIV epidemic on Indigenous communities.
Many of you may have noticed the ebb and flow of the community-based HIV movement, influenced by medical and scientific breakthroughs, funder priorities, community activism and larger political, social and economic forces. Throughout my 20-plus years in HIV community-based work and volunteering, I have tried to ground myself in a few bedrocks as a way of anchoring my work. The essential connection between health and human rights. The need for policies, programs and services grounded in evidence and lived experience. Recognition of the central role played by the social determinants of health. And a commitment to social justice and taking seriously the voices of those most affected. That’s why I signed on to The Canadian Consensus Statement on the health and prevention benefits of HIV antiretroviral medications and HIV testing. The Consensus Statement uses these same foundations to ground a comprehensive, community-driven, holistic response to the HIV epidemic that combines HIV treatment and prevention, and health and human rights.
By Sarah Flicker and the Native Youth Sexual Health Network
Taking Action II is a community-based action research project about building and supporting Indigenous youth leadership in the HIV/AIDS movement. We are a group of Indigenous youth leaders, Indigenous community-based organizations and university-based researchers. We wanted to create awareness around HIV, sexual health, and decolonization in First Nations, Métis, and Inuit communities across Turtle Island (also known as Canada).
In Taking Action I, we worked with over 100 youth in six Indigenous communities across Canada to make art about the links between HIV and colonization. We did this as a way of broadening the conversations about HIV – to move away from the individual shame-and-blame discourse. We wanted to help communities understand and respond back to all the structural factors that have conspired to make them vulnerable to HIV: racism, poverty, land theft, residential schools, loss of language/culture, epidemics of addiction, the Sixties Scoop (the practice of taking Indigenous children and placing them in foster homes beginning in the 1960s) and ongoing child welfare involvement, incarceration, etc. Youth created a lot of amazing art that took up these themes. They loved our workshops and asked for more opportunities to get together with youth from other communities.
A global study released last year revealed alarming figures concerning women living with HIV and violence. Among 945 women living with HIV from 94 countries who participated in the study, 89 per cent reported having experienced or feared violence before, since and/or because of their HIV diagnosis. Violence they experienced was reported to be higher after HIV diagnosis from their intimate partner and others in their social network. The troubling nexus between HIV and gender-based violence spurred the Canadian HIV/AIDS Legal Network, HIV & AIDS Legal Clinic Ontario and METRAC to produce a legal information guide for women living with HIV who are facing — or at risk of — “intimate partner violence” — that is, physical, sexual or psychological harm from a current or former partner or spouse.
In addition to being an exceedingly common experience among women living with HIV, intimate partner violence and HIV are both stigmatized, isolating people who are affected. Intimate partner violence also increases women’s vulnerability to HIV. Women who have violent partners are more likely to have forced sex, are less likely to negotiate condom use, and are more likely to be abused when they insist on condom use— which poses greater risks of HIV transmission.
The CATIE Blog is written for people and organizations working and volunteering in Canada’s response to HIV and hepatitis C and hosts the views and opinions of frontline service providers.