Presented by: Marvelous Muchenje Women’s Health in Women’s Hands CHC
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Transcript of Presented by: Marvelous Muchenje Women’s Health in Women’s Hands CHC
Washington D.C., USA, 22-27 July 2012www.aids2012.org
“We Walk With Fear”Experiences of HIV Criminalization and Disclosure Amongst African and Caribbean Migrant Women in
Ontario, Canada
Presented by:Marvelous Muchenje
Women’s Health in Women’s Hands CHC
Washington D.C., USA, 22-27 July 2012www.aids2012.org
No conflict of Interest
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Roots of Vulnerability to HIV/AIDS for Black Women in Canada
Vulnerability is unique and deeply rooted in:– Socio-cultural and structural factors that intersect with - Gender,
race, class, political and economic conditions
Lack of economic opportunitiesDeprivation of rights to autonomy and sexual
control over their bodiesCultural practices that increase risk of
infectionLimited educational opportunities
Washington D.C., USA, 22-27 July 2012www.aids2012.org
HIV Diagnosis
• Start of the journey……..• Great distress, shock, disorientation, disbelief, denial,
devastation, etc
• Complex experiences of loss:– Feelings of being victimized, regret, sadness, loss of
future dreams, hopelessness, fear, withdrawal, isolation, depression, suicidal thoughts, anger, etc
– Anxiety and grieving
• Period of coping, adjustment and acceptance
Washington D.C., USA, 22-27 July 2012www.aids2012.org
HIV
Dis
clos
ure
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HIV DisclosureHIV positive status disclosure is:
– an ongoing process– intimately personal and has considerable effects on families and
communities
Impacts access to information and services
Should be a component of support and care services offered for people living with HIV
Is a journey involving a number of stages
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DISCLOSURE
Is disclosure necessary?
Dis
clos
ure
Pro
cess
5.Accessing Potential Outcomes
4.Establishing
Motivation for
Disclosure
3.Evaluating the
Disclosure
Environment
2.Education
and Preparation
1. Acceptance and Empowerment
HIV Diagnosis
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“To Tell or Not to Tell”Confidentiality of medical informationRacist experiences with healthcare providers
Fear of:accusations of infidelityPartner abandonmentCommunity rejectionStigma and discriminationViolenceWithdrawal of immigration sponsorship
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“To Tell or Not to Tell” Feelings of shameIdeas that if practicing safer sex there is no
need to discloseRamification against family members,
communityLack of disclosure skillsInformation regarding their HIV status used
against them in the criminal justice system
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“HIV is not hurting me, but your ignorance
is …………”
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Criminalization of HIV Transmission, Exposure, or Non-Disclosure
Lack of clarity of law can adversely impact :– personal, social, behavioral and sexual choices
and decision making capacitiesAggravates the risk of violence and abuse
Reinforces gender inequalities
Promotes fear and stigma
Creates distrust in relation with health service professionals
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Criminalization of HIV Transmission, Exposure, or Non-Disclosure
Criminalization due to overrepresentation of ACB in corrections
Institutional racism in justice system
Lack of resources and support
Knowledge burdens on ASO and other health care providers with no experience providing legal support
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Criminalization of HIV Transmission, Exposure, or Non-Disclosure
Lack of awareness and knowledge of the law and how it applies to HIV transmission
Lack of awareness of HIV/AIDS transmission, disease progress and prevention
Police harassment, coercion and intimidation of people living with HIV e.g. sex workers, homeless
Relationship between police and media stakeholders
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Media coverage
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RecommendationsBuilding cross-sectoral knowledge
capacities around:– HIV transmission, Prevention, Criminalization
Further investigation and discussion of alternatives to criminalization– Mediation, Counselling, Restorative justice, Education, Support
services
Increase emphasis on the responsibilities of those seronegative
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Recommendation Increased resources for organizations to do targeted
outreach to ACB population in their primary language
Building relationships amongst: – ASOs, government stakeholders, ethno-specific
community leaders/agencies, media stakeholders, legal/justice stakeholders
Address the structural barriers:– colonialism, – oppression,– systemic racism and discrimination
Washington D.C., USA, 22-27 July 2012www.aids2012.org