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Health equity

In Canada, certain groups are disproportionately affected by HIV. This means that the prevalence of HIV within these groups is higher than the overall prevalence in Canada. The groups most affected by HIV in Canada include:

  • Two Spirit, gay, bisexual, queer, and other men who have sex with men (cisgender and transgender)
  • Trans women
  • People who inject drugs
  • Indigenous peoples (First Nations, Inuit, Métis)
  • African, Caribbean and Black communities
  • Sex workers
  • People living in or recently released from correctional facilities

Being a member of any of these groups does not automatically put a person at increased risk for HIV. However, people in these groups experience a range of structural and social factors that can make them more likely to get HIV, and can create barriers to accessing prevention, testing, treatment, and appropriate care. Being a member of more than one of these groups can further increase risk for HIV.

Some of the structural factors that lead to health inequities in HIV include racism, colonization, homophobia and criminalization of sex work and drug use. As a result of these structural factors, people in these groups are more likely to experience social factors that can make it difficult for them to achieve optimal health and well-being. Some of these social factors include poverty, underemployment, housing and food insecurity and incarceration.

Service providers who work in prevention, testing or care need to provide information and resources directly related to HIV (such as access to condoms and harm reduction supplies, referrals to HIV treatment etc.).  However, these things alone will not address the factors that lead to inequities in HIV in Canada. It is crucial for service providers to be aware of, and to actively work to address these factors. In other words, service providers should strive towards health equity, where everyone has access to the resources, support, and services that they need to be healthy.

There are many ways to work towards health equity, and what is needed most will vary depending on the needs of an individual or a community. Some ways that service providers can work towards health equity can include adapting services to reduce barriers and increase access; supporting people and communities to meet other needs not directly related to HIV (e.g., housing, food security, mental health); providing timely and appropriate referrals to other services, including navigation support to promote linkage to care; and, continually identifying opportunities to address challenges that prevent people from accessing quality healthcare.

To learn more about health equity, check out:

HIV Basics – This self-directed course for service providers provides an introduction to HIV, including testing, prevention and treatment.

The Inequities Driving the HIV Epidemic – This video illustrates how structural factors and social factors can lead to HIV health inequities among some populations in Canada.