HIV disclosure without consent linked to increased violence against women living with HIV in a Canadian setting

ABSTRACT

Our study examined the association between HIV disclosure without consent and verbal and/or physical violence due to HIV status among women living with HIV (WLWH). This study draws on baseline data of a sample (N = 316) from SHAWNA, a longitudinal community-based open cohort with WLWH in Metro Vancouver, Canada (2010-2019). Bivariate and multivariable logistic regression was used to investigate factors associated with physical and/or verbal violence due to HIV status. Adjusted odds ratios (AOR) and 95% confidence intervals [95%CIs] are reported. In total, 46.5% experienced non-consensual disclosure of HIV status without consent and 34.2% experienced physical and/or verbal violence related to HIV status in their lifetime. In multivariable analysis, HIV disclosure without consent was associated with increased odds of experiencing HIV-related physical and/or verbal violence (AOR: 7.46[4.21-13.21]). Lifetime exposure to homelessness was also associated with increased odds of physical and/or verbal violence due to HIV status (AOR: 2.15[1.03-4.49]). This research underscores the reality of HIV stigmatization and criminalization and suggests a critical need to remove HIV disclosure from the reach of criminal law and ensure women’s rights to confidentiality. Governments and organizations must work to identify and address the drivers of various levels of stigma and gender-based violence and invest in inclusive, trauma-informed, culturally safe support and care programs and policies designed in collaboration with WLWH.

KEYWORDS:

• HIV
• criminalization
• women
• gender-based violence
• homelessness

Acknowlegments

We thank all those who contributed their time and expertise to this project, particularly participants, peer research associates, community engagement associates, SHAWNA community advisory board members and partner agencies, and the current SHAWNA project staff, including: Elissa Aikema, Tara Axl-Rose, Emma Kuntz, Melanie Lee, Lois Luo, Desire King, Katherine Mortimer, Candice Norris, Colleen Thompson, Larissa Wakatsuki and Akanée Yamaki. We also thank Hanah Damot, Riley Tozier, Kate Milberry, Shivangi Sikri, Amber Stefanson and Peter Vann for their operations, communications, research and administrative support and Mary Kestler from Oak Tree Clinic, the Study Physician.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the Canadian Institutes of Health Research (PJT169119), the US National Institutes of Health (R01MH123349), and the Canadian HIV Trials Network (CTN-333).