Globally, people living with HIV (PLWH) are disproportionately affected by food insecurity. Yet there is limited understanding of the impacts of food insecurity among cisgender and transgender women living with HIV (WLWH) in high‐income countries. Thus, it is critical to examine the lived experiences of WLWH and food insecurity to inform policy and service provision. As part of the community‐based SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment) study, we conducted 64 semistructured qualitative interviews with WLWH in Vancouver, Canada (2015–2017). Drawing on a socio‐ecological framework, this analysis explores the lived experiences of navigating food security and health among WLWH in Metro Vancouver. Our findings indicate that WLWH relied heavily on food banks and other food‐related supportive services. Despite the abundance of programs, access to nutritious foods remained difficult, and women often relied on processed foods that were more affordable and readily available. For many, food insecurity was exacerbated by unresponsive food services regulations that did not reflect the actual needs of food service users in terms of opening hours and locations, and a lack of nutritious food. Additionally, the absence of trauma‐aware, women‐centred and culturally responsive services, as well as, spatial and material barriers related to the recent loss of funding for HIV‐specific support services, impeded food security among WLWH. Our findings emphasise that recognizing and addressing the social and structural disparities that exist for WLWH in high‐income setting are essential for addressing food insecurity and ultimately optimal health among this population.
This chapter focuses on cis and trans sex workers’ experiences with law enforcement, and how various regimes of regulating sex work including full and partial criminalisation, legalisation, and decriminalisation shape the human rights and the work environments of sex workers globally including access to occupational health and safety, police protection, and legal recourse. Criminalisation and policing of sex work constitute forms of structural violence that perpetuate and exacerbate experiences of interpersonal violence and negative health outcomes among sex workers globally. Country spotlights from the global North and South provide examples of different regimes of regulation and draw attention to how laws and regulations interact with specific work environments in various settings to shape sex workers’ lived experiences of health, safety, and human rights. This chapter highlights how various approaches to criminalising and policing sex work undermine sex workers’ safety, health and human rights, including violence and poor health and concludes with an evidence-based call for the decriminalisation of sex work globally.
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