How am I going to love in this country?

December 1st was World AIDS Day.  Every year our community comes together to host events and public campaigns to honour this date. In Manitoba, this is led by our partners at Nine Circles, who are the leaders in HIV prevention and planning in Manitoba.  You still have time to participate in the Hands Up for HIV Prevention contest- you can read what our Sexuality and Reproductive Heath Facilitator Linda wrote in the Pilipino Express about it, for the Ask Ate Ana column. “Across the country, the week of November 21 to December 1 marks Canadian HIV/AIDS Awareness Week. It’s an occasion to raise awareness surrounding HIV/AIDS issues nationally and culminates in the international observance of World AIDS Day on December 1st  of each year – a day dedicated to increasing awareness of HIV/AIDS issues worldwide as we support the UNAIDS visionary goal to end the AIDS epidemic by 2030.” http://www.cdnaids.ca/events/world-aids-day/ The 2016 WAD campaign is called Sex Happens and focuses on the importance of getting tested even if you are in a relationship. You can participate using hashtags like #WorldAIDSDay2016 and #SexHappens – the goal is always to raise numbers for testing and treatment; in Canada 21% of people infected do not know it, and the reality is that with HIV in the modern world, treatment is prevention. So why don’t people get tested? One of the reasons that we know people may avoid testing is the myths, stigma and discrimination surrounding HIV and AIDS.  We know that the criminalization of HIV through mandatory status reporting has probably increased the likelihood of people taking the stance of ‘better not to know’, particularly in historically stigmatized communities. At SERC (Sexuality Education Resource Centre MB) we use our community development approach, and history working with immigrant communities, to better understand this issue and decrease stigmatization. In honour of World AIDS Day, we released a report on the work and qualitative research we have been doing through the Knowledge Into Action (KIA) project with African immigrant women who have HIV in Winnipeg.  The goal of the study is the goal of the study is to explore and understand experiences of care and support. I had the opportunity to sit in as our research and evaluation coordinator Paula presented the results to a packed room of service providers and partners on December 2^nd. The goal of the presentation was to interpret stigma affects women’s understandings of their intimate relationships and, more broadly women’s sexuality.   She started with talking about what stigma is so we can all be on the same page.  Here are the definitions SERC used:

• Stigma is an attribute, behavior, or reputation which is socially discrediting in a particular way
• Intersectional Stigma – multi-layered stigmas based on multiple identities of women living with HIV (e.g., race, gender, gender identity, race, national identity, migration, race)

As well as some important stats about why focusing on impacted communities is important, and who participated in the project:

• Racialized women in Canada are particularly dis-proportionally affected by HIV.
• According to 2013 national surveillance data, about 40 percent of new HIV diagnoses in women were identified a “Black” (PHAC 2014).
• A high proportion of women living with HIV were born outside Canada (PHAC 2009)
• Arrived in Canada between 4 and 18 years ago. Most have been in Canada under 7 years.
• Identifying 6 different African countries as their country of origin. Many having lived in other African countries prior moving to Canada.
• All of them have children, and most live with their families. A few were single, and a few were in serodiscordant relationships.
• Most were diagnosed with HIV prior coming to Canada, a few through the immigration process.
• All were receiving clinical care for their HIV.

So what did they tell us? They told us that, not surprisingly, the stigma of HIV is often more unbearable then actually having it. “And with the HIV for me, many times, when I look at it, the disease is not the killing part like when it comes to disclosure thing, you know. The bad news is not the disease. But the bad thing it’s that’s confidentiality thing. It hurts so bad when you disclose your status and by the time you know it, the whole community is talking about it. That kills you.” “Women, women they are looked at as the source of evil. When it comes to HIV, men are, the frustration men go through it’s lighter than what women go through. Your in-laws, they will mistreat you. Your own people will mistreat you. This community says, ‘that woman is a prostitute.’ They don’t look at the man. They look at the wife as you know. So, it’s crazy.” “I was going crazy, my friends they attacked me, (…) people judged me…at that time people talked about me, like ‘[name] has this.’ Day after day, whenever they saw me: ‘don’t talk to that girl, she has this.’ It was like, how am I going to love in this country? People keep talking about me (…) and then, someone put on my Facebook I have HIV, and I didn’t say that, and that would hurt me. Why people hate me like this?” And what did they have to say about the disclosure laws? “For me, [it] is kind of frustrating and very unfair, in particular the law on disclosure. Okay, you are sick and you have to tell, but again, what are the measures put in place to support disclosure. All this is telling you that you are a criminal. You are criminalizing HIV and sex.” “I always tell them, ‘this is what I am…I take my medication, and my [viral] count is low’, because this is what I heard from [the HIV clinic], and from you, guys. I don’t want to go to prison.” When Paula was asked, what she hoped would come out of this work and this report she responded that she hoped these stories would mobilize people, change policy and end stigma. One of her examples included the mandatory testing of immigrants, which suggests it is an immigrant problem: why not test all Canadians? If we know that treatment is the most successful way to lower transmissions, then testing should be a priority, for all populations.  Once we recognize that ending HIV and AIDS is an issue that is all of ours, then we have to accept so is ending stigma and discrimination.  Let’s hope the words of these women can help make that happen. To access the full report please visit: http://www.serc.mb.ca/research/african-immigrant-women-and-hiv-perspectives-care-and-support You also may be interested in the recent positive plus one study released: http://www.positivelite.com/component/zoo/item/positive-plus-one-study-an-update