Gender-based violence against immigrants and refugee women living with HIV/risk in Canada: A systematic review

About the project

Immigrant and refugee women in Canada bear a burden of HIV/risk, and simultaneously experience a greater risk of gender-based violence (GBV), including interpersonal, community and structural violence. The observed increase in multiple forms of GBV during the recent COVID-19 pandemic underscores the urgent need for research-informed progressive policies, practices and community services to support this population.

Understanding the impact of systemic racism and sexism within the context of immigrant and refugee women’s dual experiences of HIV/risk and GBV is necessary to effectively develop comprehensive strategies that can challenge structural barriers and promote equity, social inclusion and psycho-social well-being. This project sought to understand:

  • how systemic racism and sexism impact immigrant and refugee women’s dual experiences of HIV/GBV, and
  • what policies, programs or services, or lack there-of, support or create barriers for immigrant and refugee women experiencing HIV/GBV and what changes are required.

A systematic review of the broadly defined literature focusing on GBV and immigrants and refugee women living with HIV and HIV-risk (IRWLHIV/risk) was conducted to explore how systemic racism, sexism and social stigma intersect to escalate the vulnerability of immigrant and refugee women in Canada. A review of Canadian HIV-related policies and programs was also undertaken to identify existing initiatives and policy, program and service recommendations to address the specific issues and concerns of this population.

The findings from this project were analyzed through a neo-colonial and transnational feminist lens. A socio-ecological framework further guided the identification and articulation of themes.

Key findings

An underlying thematic plot emerged from the literature that centres on the intersecting oppressions of racism, sexism and migration status, coupled with the invisibilization of IRWLH/HIV-risk and GBV. We further noted the absence of population-specific identifiers, findings, policies and recommendations in much of this research. Four key themes emerged from this narrative:

  • Hegemonic masculinity. This pervasive oppressive force impacts the personal, interpersonal, community and institutional experiences of racialized IRWLH/HIV-risk and GBV. Factors such as the objectification and commodification of women; rights/agency to negotiate condom use with partners/husbands and sex service users/clients; physical and sexual violence; and the normalization of male dominance (i.e., economic oppression and emotional and psychological oppression) contribute to heightening the risk of HIV and GBV prior to and post diagnosis.
  • Structural violence. Structural violence against IRWLHIV/risk is predicated on the intersecting factors of race, gender and migration status, and is enshrined within systems, social norms and relational practices. The state of progressive and protective laws and policies which maintain a climate of structural violence increases the risks faced by immigrant and refugee women for HIV and GBV. This can adversely impact HIV/GBV reporting for immigrant and refugee women at enhanced risk for deportation and/or imprisonment (e.g., sex workers), and subject to judgements by community and family, and internalized shame and stigma.
  • Disparities in health and social service and support. At the policy level, HIV test screening and protocols for immigration status, inadequate legal protections, and the criminalization of sex work can increase the risk of HIV/GBV that negatively impact help-seeking behaviour services. The absence of culturally and linguistically appropriate health and social services that incorporate the dual lens of HIV/GBV, and potential exposure to racism, and HIV and occupational stigma can limit their willingness to access available health and social services.
  • Deepened social isolation and exclusion. HIV/risk and GBV experience myriad intersectional oppressions that substantially impact their personal and interpersonal lives. Cultural norms prohibiting discussions of sensitive health issues can enhance feelings of social exclusion for IRWLHIV/risk. Moreover, stigma, social isolation, and limited support networks can further exacerbate their risk of HIV and GBV and increase reluctance to seek out HIV/GBV services such as antiretroviral therapy and support for mental and emotional wellbeing.

Policy implications

  • Call for visibility. The absence of critical discourse on the experiences, rights and service needs of racialized IRWLHIV/risk and GBV by researchers, policymakers, health and social service providers and community actors, specifically through the lens of race and racism, marginalizes this population within the realms of Canadian policy, academia, service provision and public discourse. There is an urgent need to focus future research efforts on raising awareness of the significant racist hetero-patriarchal factors that profoundly impact the lives of these women.
  • Transformational change. The commodification of migrants and sex workers, and the dehumanization experienced by IRWLHIV/GBV, calls for transformational reform to address issues of racism and objectification of women. The development, implementation and prioritization of progressive and humanizing policies and anti-oppressive services are necessary for social norms change. Policies and services must centre the voices of racialized IRWLHIV/risk and be rooted in a decolonizing, anti-oppressive, culturally relevant and primary prevention framework.

Further information

Read the full report

Contact the researchers

Dr. Rita Dhungel (Principal Investigator), Assistant Professor, School of Social Work and Human Services, University of the Fraser Valley:

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