Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada

Abstract

Despite advances in HIV treatment and care, the current care landscape is inadequate to meet women's comprehensive care needs. A women-centered approach to HIV care, as envisioned by women living with HIV, is central to guiding policy and practice to improve care and outcomes for women living with HIV in Canada.

Supporting choices about HIV disclosure in the workplace: A cross-Canada survey of strategies

“…For some people, a structured and interactive approach may be needed to help them weigh the implications of disclosure options and make decisions that are best for them. The findings from the open-ended responses reinforced the importance of peer-based support, a strategy for supporting people living with HIV that is highly favored in the literature [34][35][36]. In our study, respondents living with HIV had more experience and were more confident in supporting workplace decision-making than respondents who are not living with HIV.…”

Cervical cancer screening among women living with HIV: a cross-sectional study using the baseline questionnaire data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)

“…Research where performing a Pap smear is problematic for either the provider or the patient, potential solutions may include office/schedule organization; 22,41 systematic reminders; 42,43 collaboration with a nurse, female colleague, family physician or gynecologist to provide cervical cancer screening; 23,33,44 or offering HPV self-sampling. Indeed, HPV self-sampling for cervical cancer screening has been shown to be very acceptable and feasible for hard-to-reach women, including ethnic minorities and Indigenous women, 45,46 particularly when the kits are mailed or delivered home in person.…”

“…Part of their success is likely due to the "one-stop shop" approach, which means that women do not have to seek to have all of their care needs met through fragmented care delivery. 44,54 When this approach is not possible, effective communication between providers is essential to ensure integrated care. 44…”

Contraceptive Choice and Use of Dual Protection Among Women Living with HIV in Canada: Priorities for Integrated Care

“…A number of HIV clinical characteristics were assessed: years living with HIV; current receipt of ART; self‐reported undetectable viral load (shown to have a high sensitivity and specificity when compared with laboratory‐confirmed viral load); self‐reported current CD4 cell count (a low count indicates poor immune system health); perception of how taking ART changes HIV transmission risk; perception that the respondent's HIV doctor provides women‐centered HIV care; and whether the respondent has a health care provider whom she feels comfortable talking to about reproductive goals. Receipt of women‐centered HIV care was assessed using a five‐point Likert scale measuring agreement with the statement “Overall, I think that the care I have received from my HIV doctor has been women‐centered.” (This statement was preceded by a definition of women‐centered HIV care that was developed from a comprehensive literature review; consultation with women with HIV, health care providers and other stakeholders; and qualitative work . The definition was subsequently tested for construct validity.)…”