Embodied Exclusion: Young Mothers' Experiences of Exclusion from Formal and Informal Sexual Health Education

Pregnant teenagers and young mothers experience embodied exclusion due to the range of attempts aimed at controlling their sexual behaviour. Embodied exclusion in this context is the result of having the sexual health needs and experiences of pregnant teenagers and young mothers excluded from formal and informal sexual health education. Résumé Les adolescentes enceintes et les jeunes mères vivent une exclusion incorporée due à l'étendues des tentsatives visées à controller leur comportement sexuel. L'exclusion incorporéedans ce contexte est le résultat d'avoir exclu les besoins de la santé sexuelles et les experiences des adolescentes enceintes et des jeunes mères, de l'éducation sexuelle formelle et informelle

Issue 1: “It’s Better Late Than Never”: A Community-Based HIV Research and Training Response to Supporting Mothers Living with HIV Who Have Child Welfare Involvement (Part I)

Grounded in community-based research (CBR) principles and an anti-oppression framework, the Positive Parenting Pilot Project (P4) aimed to develop, implement, and evaluate an HIV education and training module to enhance the provision of support for families affected by HIV and who are at risk of or already involved with child protection services. We set out to strengthen the ability of Children’s Aid Societies (CAS) in Ontario to provide anti-oppressive services to families affected by HIV from diverse communities by increasing the capacity of social workers who support these families. Applying the principles of CBR, we increased communication and forged new collaborative relationships within and between CAS agencies, the HIV service sector, parents living with HIV, and researchers in order to better address family needs at societal and structural levels. The goal of this project was to develop, provide, and evaluate a framework for an anti-oppressive education and training module related to the multiple layers of oppression that are experienced by families living with HIV including HIV-related stigma and discrimination, racism, sexism, violence and poverty. This paper presents the qualitative analysis of pre- and post- focus groups with CAS workers who participated in P4 and the emerging practice implications for working with families living with and affected by HIV

Supporting The Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types

In the context of HIV, a focus on protecting others has overridden concern about women’s own sexual wellbeing. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual life, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n=675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women’s rights, which are critical to overall well-being

How Women Living With HIV React and Respond to Learning About Canadian Law That Criminalises HIV Non-disclosure: ‘How Do You Prove That You Told?’

The Women, ART and the Criminalization of HIV Study is a qualitative, arts-based research study focusing on the impact of the HIV non-disclosure law on women living with HIV in Canada. The federal law requires people living with HIV to disclose their HIV-positive status to sexual partners before engaging in sexual activities that pose what the Supreme Court of Canada called a ‘realistic possibility of transmission’. Drawing on findings from seven education and discussion sessions with 48 women living with HIV regarding HIV non-disclosure laws in Canada, this paper highlights the ways in which women living with HIV respond to learning about the criminalisation of HIV non-disclosure. The most common emergent themes included: the way the law reproduces social and legal injustices; gendered experiences of intimate injustice; and the relationship between disclosure and violence against women living with HIV. These discussions illuminate the troubling consequences inherent in a law that is antithetical to the science of HIV transmission risk, and that fails to acknowledge the multiple barriers to HIV disclosure that women living with HIV experience. Women’s experiences also highlight the various ways the law contributes to their experiences of sexism, racism and other forms of marginalisation in society

Criminal Code reform of HIV non disclosure is urgently needed : Social science perspectives on the harms of HIV criminalization in Canada

The criminalization of HIV non-disclosure represents a significant issue of concern among people living with HIV, those working across the HIV sector, public health practitioners, and health and human rights advocates around the world. Recently, the government of Canada began a review of the criminal law regarding HIV non-disclosure and invited feedback from the public about potential reforms to the Criminal Code. In light of this public consultation, this commentary examines social science research from Canadian scholars that documents the intersecting damaging effects of HIV criminalization. Canadian social scientists and other researchers have shown that HIV criminalization is applied in uneven and discriminatory ways, impedes HIV prevention efforts, perpetuates HIV stigma, and has a damaging impact on the daily lives of people living with HIV. We argue that there is an urgent need for reforms that will significantly restrict how the criminal law is applied to HIV non-disclosure

The Problematization of Sexuality among Women Living with HIV and a New Feminist Approach for Understanding and Enhancing Women’s Sexual Lives

In the context of HIV, women’s sexual rights and sexual autonomy are important but frequently overlooked and violated. Guided by community voices, feminist theories, and qualitative empirical research, we reviewed two decades of global quantitative research on sexuality among women living with HIV. In the 32 studies we found, conducted in 25 countries and composed mostly of cis-gender heterosexual women, sexuality was narrowly constructed as sexual behaviours involving risk (namely, penetration) and physiological dysfunctions relating to HIV illness, with far less attention given to the fullness of sexual lives in context, including more positive and rewarding experiences such as satisfaction and pleasure. Findings suggest that women experience declines in sexual activity, function, satisfaction, and pleasure following HIV diagnosis, at least for some period. The extent of such declines, however, is varied, with numerous contextual forces shaping women’s sexual well-being. Clinical markers of HIV (e.g., viral load, CD4 cell count) poorly predicted sexual outcomes, interrupting widely held assumptions about sexuality for women with HIV. Instead, the effects of HIV-related stigma intersecting with inequities related to trauma, violence, intimate relations, substance use, poverty, aging, and other social and cultural conditions primarily influenced the ways in which women experienced and enacted their sexuality. However, studies framed through a medical lens tended to pathologize outcomes as individual “problems,” whereas others driven by a public health agenda remained primarily preoccupied with protecting the public from HIV. In light of these findings, we present a new feminist approach for research, policy, and practice toward understanding and enhancing women’s sexual lives—one that affirms sexual diversity; engages deeply with society, politics, and history; and is grounded in women’s sexual rights

Breast cancer : the social construction of beauty and grieving

Coming to terms with breast loss and its effect on body image, femininity and self-esteem are major issues confronting women who have lost a breast to cancer. Furthermore, messages from the media, cosmetic industry and health care profession perpetuate the 'beauty myth' affecting the self-esteem of breast cancer patients. This emphasis on the aesthetic often takes precedence the grief associated with losing a body part that for many women is strongly linked to their self-concept. Based on interviews with nine breast cancer survivors in Winnipeg, Manitoba and Montreal, Quebec, three issues will be addressed: first how the cultural influences that support and perpetuate the 'beauty myth' affect breast cancer survivors; how, as a result of this issue, the grieving process is hindered and third, the experiences of women treated for breast cancer within the medical system. Implications for social work will also be discussed