Open Collections

Pannu, Sagar

University of British Columbia

Background: HIV community-based organizations (CBOs) are critical in supporting people living with HIV yet remain underfunded in Canada. Amid increasing CBO closures and stagnant funding, limited quantitative research exists on what social-structural factors are associated with HIV CBO engagement among women living with HIV, how engagement is associated with health services access and support, and the impacts of HIV CBO closures on women. Methods: Data were drawn from the SHAWNA Project (2014–2025), a community-based cohort of 389 cis and trans women living with HIV in Metro Vancouver. Multivariable logistic regression with generalized estimating equations (GEE) assessed associations between social-structural factors (e.g., race/ethnicity, food insecurity, age) and two types of HIV CBO engagement: service use and community participation (e.g., volunteering, working, or participating). Further analyses examined whether HIV CBO engagement was associated with health services access and support outcomes. Effects of HIV CBO closures were described using univariate statistics. Multiple imputation addressed missing data. Results: Women had a median age of 48 years (Q1-Q3: 40-54) and 54.1% (n=146) were Indigenous. Women who were older (aOR:1.03 [1.01-1.05] per year), Indigenous (aOR:1.58 [1.01-2.45]), racialized (aOR:2.37 [1.25-4.50]), and food insecure (aOR:1.39 [1.11-1.75]) had higher odds of HIV CBO service use. Women who were older (aOR:1.05 [1.01-1.09] per year) and had graduated high school (aOR:1.91 [1.02-3.60]) had higher odds of HIV CBO community participation, while women who used criminalized substances had lower odds (aOR:0.55 [0.36-0.86]). HIV CBO service use was associated with receiving antiretroviral therapy (ART) (aOR:1.83 [1.17-2.85]) and access to health services when needed (aOR:2.07 [1.32-3.26]). HIV CBO community participation was associated with having social support to take ART (aOR:1.62 [1.08-2.44]). Food insecurity, social support, and a sense of community were identified as top funding priorities. Discussion: Findings suggest that HIV CBOs engage marginalized women living with HIV while some women still face barriers in HIV CBO engagement. Results suggest the importance of HIV CBOs in supporting food security, social health, and health services access and support among women. Increased funding of HIV CBOs through government, integration with health systems, and social enterprises is proposed to sustain support for women living with HIV.

Text

2025-06-27

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/91465

Population and Public Health

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/