Our partners at the Women & HIV/AIDS Initiative (WHAI) have compiled a list of considerations for AIDS Service Organizations like ours in responding to the impact of Covid 19 in a way that is mindful of the specific intersectional concerns of this Priority Population (which includes women living with HIV, African, Carribean and Black women, Indigenous women, trans women, women who use substances, women who experience violence, and women who are or who have been incarcerated).
The AIDS Network echo’s WHAI’s message that AIDS Service and Harm Reduction Organizations as well as any service that works with women who experience these marginalizing factors should consider the realities that may impact women’s safety and wellbeing during this current public health emergency and tailor a response that is gender inclusive and mindful of these factors, which include:
INCREASED RISK OF VIOLENCE
Women living with or facing systemic risk for acquiring HIV face heightened rates of intimate partner violence . As public health measures require people to isolate, relationship stresses can increase. Adding to this, we are seeing increased economic pressures and caregiving pressures, all of which can contribute to increased stress and relatedly, risk for increased violence. As social services are adjusted to reduce the risk of COVID-19 transmission, direct service access (i.e. violence against women services, shelters, support services, foodbanks, harm reduction services, sex work support services etc.) have become restricted, limiting access to violence against women support.
Women who are homeless often “crash” at people’s homes or “hook up” in order to have a safe place to sleep. With the requirement for physical distancing and self-isolation, we increasingly hear about the impact on women’s ability to find safe places to stay. In addition, we are hearing about women’s shelters that are unable to accept new intakes from women who may be experiencing violence, and some that are discharging women when they reach their maximum stay. These realities, combined with the safety risks of living outdoors, limited capacity to prevention practices such as hand washing, and stress related to this current public health emergency, pose increased risks to women’s safety and wellbeing.
CHILD WELFARE INVOLVEMENT
WHAI’s priority populations of women, and in particular ACB and Indigenous women and women living in poverty, are already disproportionately impacted by child welfare involvement. Public health measures to reduce risk for COVID-19 transmission may impact these services. In some communities, this has included the cancellation of supervised visits as well as services required to facilitate parent-child visits (i.e. counselling). These measures also create challenges for families in shared custody agreements who are managing self-isolation or quarantine.
Many women, and in particular, WHAI’s priority populations of women, face economic instability . In this current public health emergency, the combination of job loss, increased difficulties accessing services such as EI, ODSP, OW, Child Benefits and other economic subsidy programs; along with service limitations to food banks, meal programs and shelters – all contribute to increased economic pressures. In addition to WHAI’s priority populations of women, loss of income is a reality for many including sex workers, many migrant workers, panhandlers, and other non-unionized workers not covered by economic subsidy programs.
SEXUAL AND REPRODUCTIVE HEALTH
Sexual and reproductive health is important for all women, and women’s access to these services may be impacted by the response to COVID-19. The obvious requirements for physical distancing create pressures to avoid direct sexual contact with people who do not live in the same home as you, and yet for others, it may create increased pressure to have sex with those in the same living space. Access to birth control may be limited as well as access to abortion care and STBBI testing. Conversely, for those who are pregnant, access to pre and post-natal care may be impacted by the response to COVID-19, and information regarding the transmission of COVID-19 in the context of pregnancy, delivery and infant feeding is still limited.
Women play a significant role in caregiving across Ontario within families and communities. As stated in the Ontario HIV Epidemiology and Surveillance initiative (OHESI) Women & HIV in Ontario Factsheet, 73% of women living with HIV were caring for children, compared to 23% of men. We also know that women are more likely to be working in health and social care jobs in the community, roles often on the frontlines of this public health emergency. For example, women make up more than 90% of all nurses across Canada. In light of COVID-19, pressures associated with these roles are heightened, especially when combined with economic hardship and reduced social support.
ACCESS TO TREATMENT
Women living with HIV may already face barriers to HIV treatment which can impact their viral load and health outcomes. This is especially true for women living in rural and remote regions, including Indigenous women. With COVID-19 public health measures, there may be further barriers to phone or online healthcare due to lack of communication technology, or reduced support-based services. Given that these services help to facilitate engagement in care, an inability to access them could result in less viral load suppression and diminished health.
Women living with HIV and women who face systemic risk for HIV acquisition face heightened rates of depression and mental health challenges and face ongoing stigma and discrimination. During this public health crisis and with the aforementioned barriers, there may be increased isolation, stigma and mental health challenges with limited access to support, particularly for WHAI’s priority populations of women.
You can download the full resource here : Strategies for a Gender-Inclusive Responce COVID 19