Indigenous Women Voicing Experiences of HIV Stigma and Criminalization Through Art

Indigenous women living with HIV are disproportionately affected by the criminalization of HIV nondisclosure. The purpose of this paper is to better understand how the criminalization of HIV nondisclosure shapes the lived experiences of HIV-related stigma, disclosure, and health service among cis and transgender Indigenous women living with HIV (IWLWH). This study was developed based on a community roundtable on HIV criminalization with engagement of legal experts, HIV service organizations, and IWLWH on the unceded traditional territory of the Coast Salish Peoples, including the territories of the x(w)me theta k(w)eyem (Musqueam), Skwxwu7mesh (Squamish), and Selilwetal (Tsleil-Waututh) Nations (Vancouver, British Columbia, Canada) in 2016 to 2018. Drawing on community-based participatory photovoice methodology, Indigenous Peer Researchers played a central role throughout this project, including planning, facilitation of photo-voice workshops, and analysis. This analysis includes 17 IWLWH. Through a peer-engaged analysis process, the photovoice images and narratives illustrated how the criminalization of HIV nondisclosure is intertwined with colonial violence to shape experiences of social isolation and exclusion, disclosure, access to safe health care, responsibility, fear, and resilience. The legal requirements of HIV nondisclosure are unattainable for many IWLWH who are not able to safely disclose their HIV status, negotiate condom use, and maintain a low viral load. In line with the Truth and Reconciliation Commission of Canada and National Inquiry into Missing and Murdered Indigenous Women and Girls, the justice system must be reoriented from punishment and oppression to healing and wellbeing for all Indigenous women living with HIV. Simultaneously, we call for culturally safe services that protect privacy and recognize strengths of IWLWH.

Automated summary

Indigenous women living with HIV are disproportionately affected by the criminalization of HIV nondisclosure. This study, conducted from 2016 to 2018 in Vancouver, Canada, with legal experts, HIV service organizations, and IWLWH, aims to understand how HIV nondisclosure laws impact the experiences of stigma, disclosure, and healthcare access for Indigenous women. Through community-based photovoice methodology, it was found that criminalization of HIV nondisclosure intertwines with colonial violence to affect social isolation, access to care, and resilience for IWLWH. The study calls for a justice system that focuses on healing and wellbeing rather than punishment for Indigenous women living with HIV, along with culturally safe services that respect the strengths of IWLWH.