Gender-Based Violence Against Immigrants and Refugees Living
with HIV/HIV-Risk in Canada: A Systematic Review
Forum on Gender-based Violence
Presenters:
Rita Dhungel, Karun Karki, and Kaleb Suedfeld
University of the Fraser Valley, BC
Liza Lorenzetti, Diane L. Lorenzetti, Sarah Thomas, Claire McGuinness
University of Calgary, AB
Acknowledgements:
Colleen Bell, University of the Fraser Valley, BC
Shireen Surood, Alberta Health Services, AB

Land Acknowledgement & Commitment
We would like to acknowledge that we are joining virtually from:
Traditional land of Indigenous people of Newar, Kathmandu, Nepal; Unseeded territory
of the Stó:lō people
We invite you to join us in our ongoing commitments to the 94 Calls to Action of the
Truth and Reconciliation Commission of Canada and the 231 Calls for Justice for
Missing and Murdered Indigenous Women and Girls and 2SLGBTQIA+ People

Introduction/Background
● Immigrant and refugee women bear a disproportionate burden of HIV and HIV-risk, and
experience a greater risk of gender-based violence (GBV), including interpersonal, community,
and structural violence;
●

Immigrant and refugee women living with HIV (IRLWH) and HIV-risk experience
intersectional oppression;

●

The National HIV Framework exacerbate intersectional oppression;

● Pandemic underscored an urgent need for research-informed progressive laws, policies,
practices, community services and supports; and
● Study was critical to understand the context of immigrant and refugee women’s dual
experiences of HIV/HIV-risk and GBV (HIV/GBV) from anti-racist and anti-colonial lenses.

Objectives and Research Questions
Objective: To explore how systemic racism, sexism, and social stigma intersect to
escalate the vulnerability of immigrant and refugee women living with HIV/ HIV-risk
in Canada.
Research Questions:
1. How systemic racism and sexism impact immigrant and refugee women’s dual
experiences of HIV/HIV-risk and GBV?
2.

What policies, programs, or services, or lack thereof, support or create barriers for
them and what changes are required?

Methodological Approach
●
●

Utilized an outline developed by the Centre for Reviews and Dissemination (2009)
Used the PRISMA guidelines in the reporting of systematic reviews (Page et al., 2021).

Inclusion Criteria:
We included Canadian literature reporting on:
● the health and social outcomes of first-generation racialized immigrant/refugee
women,
● with, or at risk of, HIV and having experiences of GBV, OR
● on policies, guidelines, and legislation affecting this population

PRISMA
chart

Findings: Study Design

Findings: Participant Demographics
●

Studies came from BC,
ON, QC, AB or included
data from BC, ON, and
QC

●

Participants’ ages ranged
widely, with most above
30 years old

●

A majority of the included
studies focused on
participants living with
HIV

Findings: Participant Demographics

●
●

Studies included participants living in Canada for a range of years
In terms of the ethnic origin, the majority of the participants in the studies were of African Origin
(n=8), not reported (n=6), Chinese (n=5)

Key Findings
We adopted the socio-ecological prevention framework (Dahlberg and Krug, 2002).
1. Hegemonic Masculinity:
● Objectification and commodification of women,
● Rights/agency to negotiate condom use with partners, husbands, and sex service users,
● Normalization of financial and emotional oppression,
● Physical and sexual violence by male actors (husband, sex service users, managers).
2. Structural Violence:
● Absence of protective and progressive HIV policies and frameworks,
● Influenced by state actors (e.g., police and immigration officers), and structural actors (e.g., media).

3. Deepened Social Isolation and Exclusion:
●
●

Intersectional oppression, stigma, social isolation, and limited support networks.
Increase reluctance to seek out HIV/GBV services, such as antiretroviral therapy and well-being

4. Health and Social Service Disparities:
●
●
●

Inadequate legal protections,
Criminalization of sex work,
Racism against IRLWHV/ HIV-risk by healthcare professionals.

Implications
Research
●

●

Community-based
participatory action
research is needed
focusing on well-being,
rights and justice for
racialized immigrants
and refugees living with
HIV
Robust, longitudinal
studies, and
disaggregated data must
be produced on IRLWH

Policy
●

Anti-oppressive and
culturally relevant policy
designed with IRLWH (ex.
Goldenberg et al, 2015)

●

Decriminalized approach to
sex work (Sou et al., 2019)

●

Stigma reduction
mechanisms
(Lacombe-Duncan, 2022)

Practice
●

Culturally appropriate
outreach, including to sex
workers (Sou et al., 2019)

●

Involvement of immigrant
and refugee women with/at
risk of HIV and GBV in the
development of programs peer support (Erickson, 2022)

●

Anti-discrimination, cultural
humility, trauma-informed
workplace training for health
and social services, law
enforcement, media

Conclusion
1.

Racialized immigrants and refugee women experience a dual burden of HIV/HIV-risk and GBV.

2.

Systemic racism, sexism, and social stigma intersect to escalate the vulnerability of racialized
immigrant and refugee women living with HIV/HIV-risk to GBV in Canada.

3.

Understanding the impact of systemic racism and sexism within the context of immigrant and refugee
women’s dual experiences of HIV/HIV-risk and GBV (HIV/GBV) is necessary.

4.

Progressive and protective laws, policies and practices should be developed using anti-colonial and
anti-racist lenses to promote gender justice.

Evidence Brief: https://ufv.arcabc.ca/islandora/object/ufv%3A46681

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Thank you
Questions/Comments?

For more information please contact:
Rita.dhungel@ufv.ca