The proportion of HIV infection attributed to adult women has gradually increased over the last 10 years. As of 2008, it is estimated that women account for 17% of people living with HIV and 26% of all new HIV infections in Canada. While the annual number of positive HIV tests among women has varied over the last decade, it is not declining. Approximately three quarters of the new infections that occurred among women in 2008 can be attributed to heterosexual sex exposure, and more than one third of new infections can be attributed to exposure through injection drug use. On a positive note, the proportion of infants confirmed to be infected with HIV through perinatal transmission decreased from 9.3% in 2000 to 1.7% in 2008.
The report recognizes that certain groups of women in Canada, such as Aboriginal women, women from countries where HIV is endemic, women who use injection drugs, and women in prison, continue to be over-represented and disproportionately affected by HIV/AIDS. For instance, Aboriginal women are almost as equally affected by HIV as Aboriginal men, and women who come from countries where HIV is endemic represent more than half (54.2%) of the positive HIV test reports attributed to women. Also notable is that the rate of HIV infection for women in prisons is higher than the rate of HIV infection for men in prisons (4.7% as compared to 1.7%).
While women’s biological differences render them more susceptible to HIV than men, a number of socio-economic factors, also known as “determinants of health”, influence women’s vulnerability to HIV. Determinants of health, such as gender, income, education, unemployment, access to stable housing, access to health services, social support services and social networks, social environments (e.g., geographically isolated communities, prison environments, disadvantaged urban or rural environments), racism, and early childhood development, can either increase or decrease women’s vulnerability to HIV. In addition to the broad determinants of health, other factors, such as sexual violence, culture, and HIV/AIDS-related stigma and discrimination, have also been shown to contribute to women’s vulnerability to HIV.
This report details some of the lived experiences of women in relation to these determinants and underscores the need for approaches that address the root causes of HIV. It is important to consider how gender, a key determinant, intersects with multiple other forms of social inequality to contribute to women’s vulnerability to HIV. In identifying and discussing the factors that create resilience or increase vulnerability to HIV/AIDS, the report strives to reflect the diversity of the female population and the complexity of women’s lives.
The report identifies 87 Canadian time-limited research projects underway between 2006 and 2009 that focused on HIV/AIDS among women in Canada. General areas of research included prevention, interventions and treatment strategies. Many projects also focused on specific population segments of women, including women living with HIV/AIDS, women involved in sex work, women from countries where HIV is endemic, female youth at risk, Aboriginal females, women who use injection drugs, lesbian and bisexual women, transwomen, and women in prison settings.
The report also examines the current response to HIV/AIDS among women at the policy and programmatic levels. This includes an overview of population-specific strategies at the national and provincial/territorial levels; population-specific networks, coalitions and advisory bodies; and organizations and projects focused on the delivery of programs and projects addressing HIV/AIDS among women and the response to HIV/AIDS for women in prisons. The report found that interventions which focus on women’s empowerment and recognize the importance of building leadership among women at risk of HIV/AIDS play an important role in building women’s resilience against HIV.
Projects and research synthesized as part of the report indicate that a broad range of organizations are involved in delivering prevention, care, treatment and support services to women. Organizations involved in the response include community-based HIV/AIDS service organizations, health or sexual health services, and governmental organizations. These communities and organizations across Canada have taken up the challenge and are doing their part to reduce the number of HIV infections in this population and to meet the needs of women living with, and at risk for, this disease. Despite these important and significant efforts, much remains to be done. Effective, tailored and continued efforts in preventing the transmission and acquisition of HIV and improving the quality of life of women living with HIV/AIDS are required to successfully address HIV and AIDS among women.