New research raises concerns about the negative impacts of incarceration on HIV treatment outcomes among women living with HIV

November 29, 2019   |   Blog

The theme for World AIDS Day 2019 is “Communities Make the Difference.” To mark this day, we are shining a spotlight on the community-based participatory research CGSHE conducts with and for women living with HIV/AIDS as part of the SHAWNA Project.

Community-based, peer-reviewed research from the SHAWNA Project, first-authored by CGSHE doctoral student Margaret Erickson and recently published in AIDS & Behavior, raises serious concerns about the links between incarceration and HIV treatment outcomes among women living with HIV.

The SHAWNA Project (Sexual Health and HIV/AIDS Women’s Longitudinal Needs Assessment) is a community-based longitudinal research study, led by CGSHE in collaboration with community partners. Results of this study show that incarceration is a primary barrier to achieving optimal HIV treatment outcomes among women living with HIV in Metro Vancouver. The research team drew upon survey and virologic data from 292 cis and trans women living with HIV, collected over a seven-year period (2010-2017) in Vancouver, BC.

The results of this study show that:

  • Women living with HIV experience disproportionately high rates of criminalization and incarceration. 76% of study participants reported incarceration over their lifetime and 17% reported incarceration at one point over the seven-year study period.
  • Incarceration during the study period was linked to reduced likelihood of reaching HIV viral suppression among women living with HIV. HIV viral suppression is a key marker of measuring HIV treatment success.

“This study demonstrates that incarceration has direct and measurable negative impacts on the health of women living with HIV,” says Flo Ranville, Community Engagement Associate with the SHAWNA Project, who is also a woman living with HIV and has been impacted by the criminal justice system.

“We are currently conducting further research to better understand when during women’s incarceration trajectories the most significant gaps in access to care and supports exist,” says Dr. Andrea Krüsi, Research Scientist at CGSHE and Assistant Professor in the Department of Medicine at UBC. “We do know that women living with HIV experience severe structural vulnerabilities—such as disproportionate experiences of trauma and gender-based violence, HIV-related stigma, poverty, and homelessness—that need to be addressed to ensure optimal health.”

There have been recent positive changes following the study period. In October 2017, responsibility for health care provision within provincial correctional facilities in BC was transitioned to the Provincial Health Services Authority. “This shift presents an opportunity to facilitate continuity of care between correctional facilities and the community, to ensure women’s access to health care and promote overall health outcomes both during and after incarceration,” says first author and CGSHE Research Associate Margaret Erickson. “Initiatives to address health disparities for incarcerated women are already underway within the new leadership. This study is of timely importance to inform positive change and contribute to ongoing collaborative efforts to improve the health of incarcerated women.”

SHAWNA is committed to MIPA/GIPA principles of meaningful inclusion and greater involvement of women living with HIV. Since the study’s inception, women with lived experience have played a key role across the project, from community interviewers to Peer Research Associates and co-authors. Research into HIV/AIDS and gender and sexual health inequities must be led by communities most affected. We are grateful for the opportunity to shine the spotlight on the incredible work done by our community partners.

Click here to download the above infographic highlighting the key findings of this study.