Alexandra de Pokomandy

McGill University | McGill · Department of Family Medicine

Background Scholars recommend providing migrants living with HIV (MLWH) with free treatment, rapidly, once linked to care to optimize their HIV-related experiences and health outcomes. Quantitative evaluations of patient-reported measures for MLWH in such models are necessary to explore the viability of these recommendations. Methods Within a 96-w...

Objectives Knowledge gaps exist regarding the effects of experiencing child protective services ( CPS ) out‐of‐home care (e.g. foster homes) among women with HIV . We examined whether CPS out‐of‐home care was associated with HIV clinical outcome trajectories among women with HIV in a longitudinal cohort study in Ontario, British Columbia, and Quebe...

Objectives The community-based, longitudinal, Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) explored the experiences of women with HIV in Canada over the past decade. CHIWOS’ high-impact publications document significant gaps in the provision of healthcare to women with HIV. We used concept mapping to analyse and present...

The Lubricant Investigation in Men to Inhibit Transmission of human papillomavirus (HPV) Infection randomized control trial in gay, bisexual, and other men who have sex with men (gbMSM) found that carrageenan use neither reduced acquisition of anal HPV infections nor influenced infection clearance. To investigate carrageenan's lack of protective ef...

Background Using data from a national cohort study and focus groups, the Women-Centred HIV Care (WCHC) Model was developed to inform care delivery for women living with HIV. Methods Through an evidence-based, integrated knowledge translation approach, we developed 2 toolkits based on the WCHC Model for service providers and women living with HIV i...

Objective Multidisciplinary care with free, rapid, and on‐site bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) dispensation may improve health outcomes among migrants living with HIV. However, models for rapid B/F/TAF initiation are not well studied among migrants living with HIV, and an understanding of how social determinants of health...

Introduction The effect of antiretroviral therapy (ART), particularly integrase strand transfer inhibitors (INSTIs), on non‐alcoholic fatty liver disease (NAFLD) in people with HIV remains unclear. We evaluated the effect of switching non‐INSTI backbone antiretroviral medications to raltegravir on NAFLD and metabolic parameters. Materials and Meth...

Background: HIV-related stigma, gender discrimination and racial discrimination harm mental health and hamper HIV treatment access for women living with HIV. Maladaptive coping strategies such as substance use can further worsen HIV treatment outcomes, while resilience can improve HIV outcomes. We examined resilience and depression as mediators of...

BACKGROUND The COVID-19 pandemic unprecedently challenged public health systems, with 95% of cases in Quebec, Canada, sent home for self-isolation. To ensure continuous care, we implemented a patient-portal (Opal) supported intervention to remotely monitor at-home COVID-19 patients with daily self-reports of symptoms, vital signs, and mental health...

Background: Although sexual activity and function decline in older women living with HIV, positive dimensions of sexual health, such as satisfaction, are relatively unexplored. We evaluated prevalence of sexual satisfaction for midlife women with HIV and assessed its relation to women's physical, mental, and socio-structural experiences. Setting:...

Background: Breastfeeding is not recommended for women living with HIV (WLWH) in Canada. We described the prevalence of breastfeeding and explored experiences of care, support, and stigma related to infant feeding. Setting: Quebec, Ontario, and British Columbia (Canada). Methods: Data were obtained from the HIV Women's Sexual and Reproductive Healt...

Background: The impact of different therapeutic classes of drugs in antiretroviral therapy (ART) regimens on the CD4/CD8 ratio is not well documented in people treated for HIV. The objective of this study was to analyse the long-term effect of exposure to integrase strand transfer inhibitor (INSTI) on CD4/CD8 ratio compared to non-nucleoside rever...

Background: Self-report of human papillomavirus (HPV) vaccination has ~80-90% sensitivity and ~75-85% specificity. We measured the effect of nondifferential exposure misclassification associated with self-reported vaccination on vaccine effectiveness (VE) estimates. Methods: Between 2017-2019, we recruited sexually active gay, bisexual, and othe...

Introduction: Chronic cytomegalovirus (CMV) infection is very frequent in people living with HIV (PLWH). High anti-CMV IgG titres, which may be linked to transient CMV replication, have been associated with earlier mortality, CD8 T-cell expansion, lower CD4/CD8 ratio and increased T-cell senescence. We previously showed that anti-CMV IgG titres co...

Background: Real-world evidence of human papillomavirus (HPV) vaccine effectiveness (VE) against longitudinal outcomes is lacking among gay, bisexual, and other men who have sex with men (GBM). We compared 12-month incidence and persistence of anal HPV infection between vaccinated and unvaccinated GBM. Methods: We recruited GBM aged 16-30 years...

Background: Menopause is a high-risk period for osteoporosis, which may be exacerbated by HIV and/or antiretroviral therapy (ART). Objective: To study the impact of switching from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF) on bone mineral density (BMD) in peri and early post-menopausal women living with HIV. Methods: A...

Background The Greater Toronto Area (GTA) is home to 39% of Canada’s population living with HIV. To identify gaps in access and engagement in care and treatment, we assessed the care cascade of women living with HIV (WLWH) in the GTA versus the rest of Ontario and Canada (in this case: Quebec and British Columbia). Methods We analyzed 2013–2015 se...

This study aimed to explore the experiences of migrant people living with HIV (MLWH) enrolled in a Montreal-based multidisciplinary HIV care clinic with rapid antiretroviral treatment (ART) initiation and cost-covered ART. Between February 2020 and March 2022, 32 interviews were conducted with 16 MLWH at three time-points (16 after 1 week of ART in...

Life expectancy for people living with HIV has increased, but management of HIV is now more complex due to comorbidities. This study aimed to measure the prevalence of comorbidities among women living with HIV in Canada. We conducted a cross-sectional analysis using data from the 18-months survey (2014–2016) of the Canadian HIV Women’s Sexual and R...

Background: The HIV care cascade is an indicators-framework used to assess achievement of HIV clinical targets including HIV diagnosis, HIV care initiation and retention, initiation of antiretroviral therapy, and attainment of viral suppression for people living with HIV. Methods: The HIV Care Cascade Research Development Team at the CIHR Canadi...

Background Understanding the natural history of anal high-risk human papillomavirus (hrHPV) infection is key for designing anal cancer prevention programmes but has not been systematically characterised. Methods We reanalysed data from 34 studies with 16 164 individuals in six risk groups defined by HIV status, gender, and male sexuality: men who...

Introduction: Women living with HIV across global contexts are disproportionately impacted by food insecurity and housing insecurity. Food and housing insecurity are resource insecurities associated with poorer health outcomes among people living with HIV. Poverty, a deeply stigmatized phenomenon, is a contributing factor towards food and housing...

Engagement along the HIV care cascade in Canada is lower among women compared to men. We used Fuzzy Cognitive Mapping (FCM), a participatory research method, to identify factors influencing satisfaction with HIV care, their causal pathways, and relative importance from the perspective of women living with HIV. Building from a map of factors derived...

Background Women living with HIV (WLHIV) have a high risk of anal cancer. Identifying risk factors for anal HPV 16 infection, the most significant risk factor for anal cancer, is essential for prevention and screening strategies. Methods In the EVVA Cohort study, 151 WLHIV had cervical and anal HPV testing with genotyping every 6 months for 2 year...

Background Starting in 2015/16, most Canadian provinces introduced publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) aged ≤ 26 years. We estimated 12-month changes in HPV vaccine coverage among community-recruited GBM from 2017 to 2021 and identified baseline factors associa...

Background: Sexual relationship power (SRP) inequities, including having a controlling partner, have not been widely examined among women living with HIV (WLWH). We measured prevalence, and key outcomes of relationship control among WLWH in Canada. Methods: Baseline data from WLWH (≥16 years), reporting consensual sex in the last month enrolled...

Action on the World Health Organization Consolidated guideline on sexual and reproductive health and rights of women living with HIV requires evidence-based, equity-oriented, and regionally specific strategies centred on priorities of women living with HIV. Through community–academic partnership, we identified recommendations for developing a natio...

Background: Age-specific data on anal, and corresponding cervical, human papillomavirus (HPV) infection are needed to inform female anal cancer prevention. Methods: We centrally re-analyzed individual-level data from 26 studies reporting HPV prevalence in paired anal and cervical samples by HIV status and age. For women living with HIV (WLWH) wi...

Introduction: Sex workers are disproportionately impacted by the HIV pandemic across global contexts, in part due to social and structural contexts of stigma and criminalization. Among women living with HIV, there is a dearth of longitudinal information regarding dynamics of sex work engagement and associated social and health outcomes. In order t...

Objectives People living with human immunodeficiency virus in Canada can face criminal charges for human immunodeficiency virus non-disclosure before sex, unless a condom is used and their viral load is <1500 copies/mL. We measured the reported impact of human immunodeficiency virus non-disclosure case law on violence from sexual partners among wom...

Objectives We assessed the prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada. Methods We analyzed cross-sectional survey data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (2017–2018). Self-identified women living with HIV were asked about sexual concerns post-HIV...

Preclinical studies have demonstrated carrageenan’s anti–human papillomavirus (HPV) activity. We assessed efficacy of a carrageenan-based gel compared to a placebo gel in increasing the clearance of anal HPV infections among gay, bisexual, and other men who have sex with men (gbMSM). Of 255 enrolled gbMSM, 134 were HPV positive at baseline and had...

Anyplex II HPV-28 (HPV-28) can detect individually 28 HPV genotypes. We assessed the agreement between linear array HPV genotyping (LA-HPV) and HPV-28 for detection of 27 HPV genotypes in 410 stored anogenital samples (75 anal samples, 335 physician-collected cervical samples) collected over 5 years from 410 individuals (13 men, 397 women), includi...

Objective: Women living with HIV (WLWH) are commonly symptomatic during perimenopause and menopause (≥1 y without menstruation), however, little is known of risks for symptoms and their timing. We analyzed these unwanted experiences to inform care. Methods: WLWH (≥40 y) in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study rate...

Background Adherence to antiretroviral therapy (ART) remains problematic. Regular monitoring of its barriers is clinically recommended, however, patient-provider communication around adherence is often inadequate. Our team thus decided to develop a new electronically administered patient-reported outcome measure (PROM) of barriers to ART adherence...

Background: Increasingly, women living with HIV are entering menopause (i.e., cessation of menses for ≥1 year) and experiencing midlife symptoms. Menopausal hormone therapy (MHT) is first-line therapy for bothersome hot flashes and early menopause (i.e, before age 45), however, its use in women living with HIV is poorly described. We conducted a c...

Background Some Canadian jurisdictions offer publicly funded HPV vaccine to gay, bisexual, and other men who have sex with men (GBM) aged ≤26 years. We characterized factors associated with being in different stages of HPV vaccination. Methods Engage is a sexual health study of GBM in the three largest Canadian cities recruited via respondent driv...

Antiretroviral therapy effectively prevents sexual and vertical transmission of HIV. Yet, some women living with HIV report having unmet needs for reproductive health care. This study measured the prevalence of women discussing reproductive goals with any current healthcare provider and assessed the effect of the current HIV care provider’s gender...

Background: Women represent one quarter of the population living with HIV in Canada and are an increasingly important sector of the HIV community. While some women's health issues such as cervical cancer screening and management are well addressed in HIV management guidelines, others are not. These include sexual and reproductive health factors su...

Background Women with an undetectable viral load can become pregnant and have children with no risk of HIV transmission to their sexual partners and low risk of transmission to their infants. Contemporary pregnancy intentions of women living with HIV in Canada are poorly understood, evidenced by high rates of unintended pregnancy and low uptake of...

Background: Starting in 2015, human papillomavirus (HPV) vaccine has been publicly funded for gay, bisexual, and other men who have sex with men (GBM) aged ≤26 years in Canada. Methods: Self-identified GBM who reported having sex with another man within the past six months were enrolled using respondent-driven sampling (RDS) between February 201...

Using baseline data from a community-collaborative cohort of women living with HIV in Canada, we assessed the prevalence and correlates of help-seeking among 1,057 women who reported experiencing violence in adulthood (≥16 years). After violence, 447 (42%) sought help, while 610 (58%) did not. Frequently accessed supports included health care provi...

Background Robust age-specific estimates of anal human papillomavirus (HPV) and high-grade squamous intraepithelial lesions (HSIL) in men can inform anal cancer prevention efforts. We aimed to evaluate the age-specific prevalence of anal HPV, HSIL, and their combination, in men, stratified by HIV status and sexuality. Methods We did a systematic r...

Background Carrageenan, a non-toxic gelling agent derived from red algae, has potent anti-human papillomavirus (HPV) activity in in vitro and animal studies. We assessed, in an interim analysis, the efficacy of a carrageenan-based gel in reducing the risk of new detections of anal HPV among gay, bisexual and other men who have sex with men (gbMSM)....

Introduction In 2015/2016, Canada’s largest provinces implemented publicly-funded human papillomavirus (HPV) vaccination programs for gay, bisexual, and other men who have sex with men (GBM) ≤ 26 years old. We sought to describe HPV vaccine uptake among GBM and determine barriers and facilitators to vaccine initiation with a focus on healthcare acc...

In Canada, women make up 25% of the prevalent HIV cases and represent an important population of those living with HIV, as a high proportion are racialized and systemically marginalized; furthermore, many have unmet healthcare needs. Using the knowledge-to-action framework as an implementation science methodology, we developed the “Women-Centred HI...

People living with HIV (PLWH) often have worse health outcomes compared to HIV-uninfected individuals. We characterized PLWH followed at a tertiary care clinic in Montreal who acquired COVID-19 and described their outcomes during the first wave of the pandemic. A retrospective chart review was performed for PLWH followed at the Chronic Viral Illnes...

Opal (opalmedapps.com), a patient portal in use at the Cedars Cancer Centre of the McGill University Health Centre (MUHC) (Montreal, Canada), gives cancer patients access to their medical records, collects information on patient-reported outcome measures (PROMs), and has demonstrated patient satisfaction with care. This feasibility study aims to ev...

Carrageenan, an extract from red algae, was identified over a decade ago as a potent inhibitor of human papillomavirus (HPV) infection in vitro. Following this discovery, several studies evaluated carrageenan's anti-HPV activity in cells, experimental animals, and humans. We reviewed the evidence for carrageenan's anti-HPV activity. Studies had to...

IntroductionSustained undetectable viral loads (UDVLs) on antiretroviral therapy (ART) eliminate sexual HIV transmission. We measured prevalence and correlates of sexual anxiety among women living with HIV.Methods We used questionnaire data collected between August 2013 and May 2015 from 1422 women ≥ 16 years in the Canadian HIV Women’s Sexual and...

The relationship between the First Peoples of Canada and researchers is changing as processes of self-determination and reconciliation are increasingly implemented. We used storytelling and ceremony to describe a historic event, the Indigenous Women’s Data Transfer Ceremony, where quantitative data of 318 Indigenous women living with HIV were trans...

There is uncertainty regarding the potential virologic outcome associated with a change in antiretroviral therapy (ARV) among PLHIV who had previous documented virologic failure or who have been exposure to mono/dual nucleoside reverse transcriptase inhibitors (NRTI) therapy. The objective was to measure the potential impact of exposure to previous...

Guided by an Indigenous Methodology and a participatory research approach, we explored the experiences and priorities of Indigenous women living in Quebec regarding HIV prevention and care, overall health, and well-being. We drew from our research process to identify recommendations for conducting research with Indigenous women. These lessons inclu...

Background Switching antiretroviral regimens when HIV viremia is controlled for a new regimen is challenging when there is the potential for prior nucleoside reverse transcriptase inhibitor (NRTI) resistance. The objective was to study virologic outcomes after switching to dolutegravir compared to remaining on a boosted protease inhibitor (PI/r) re...

Certain population groups are known to have higher than average anal cancer risk, namely persons living with HIV (PLHIV), men who have sex with men (MSM), women diagnosed with human papillomavirus (HPV)‐related gynecological precancerous lesions or cancer, solid organ transplant recipients (SOTRs) and patients with autoimmune diseases. Our aim was...

Introduction: Women living with HIV in Canada experience barriers to comprehensive HIV care. We sought to describe care gaps across a typology of care. Methods: We analyzed baseline data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS). A typology of care was characterized by primary HIV physician and care setting...

Women living with HIV (WLWH) are over-represented in corrections in Canada, yet little is known about women’s experiences post-release. We used CHIWOS cross-sectional data from WLWH to estimate associations between social determinants of health and HIV-related care outcomes among WLWH with recent (within past year) or ever (before past year) incarc...

Background: Care services have not been sufficiently adapted to meet the comprehensive care needs of women living with HIV. Our study objective was to engage patients and providers in codesigning care recommendations to improve care for this population in the province of Quebec. Methods: We conducted a 5-hour deliberative dialogue workshop in Ap...

Transitioning from pediatric to adult care is a complicated process for youth with chronic illnesses. This study elucidates the unique factors affecting transition preparedness and perception of adult HIV care among a cohort of young women with HIV. Between 2013 and 2015, 48 women with HIV, who had experience with pediatric HIV care, were enrolled...

Antiretroviral therapy adherence among transgender (trans) women living with HIV (WLWH) is negatively impacted by depression and post-traumatic stress disorder (PTSD). Yet, little is known about factors associated with depression or PTSD among trans WLWH. Using cross-sectional data from a national community-based study of 1422 WLWH (n = 53 trans wo...

Introduction Gay, bisexual and other men who have sex with men (gbMSM) have an increased risk of human papillomavirus (HPV) infection and HPV-associated diseases, such as anal cancer and anogenital warts. A carrageenan-based lubricant could prevent HPV infection, thereby reducing the disease burden in this population. This paper describes the proto...

The current study aimed to document intervention practices, challenges, and training needs concerning the intersections between HIV and intimate partner violence (IPV) among community service providers (n = 12). A direct content analysis using the Trauma-Informed Approach was performed. Results revealed that community service providers need to crea...

In 2012, the Supreme Court of Canada ruled that people with HIV are legally obligated to disclose their serostatus before sex with a “realistic possibility” of HIV transmission, suggesting a legal obligation to disclose unless they use condoms and have a low HIV viral load (< 1500 copies/mL). We measured prevalence and correlates of ruling awarenes...

Objectives To measure the prevalence and correlates of abnormal menstruation among women living with HIV (WLWH) in Canada. Methods We used cross-sectional questionnaire data from the community-based Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS), which enrolled WLWH aged ≥16 from British Columbia (BC), Ontario, and Quebe...

Abstract Background Migrants represent an increasing proportion of people living with HIV in many developed countries. We aimed to describe the HIV care cascade and baseline genotypic resistance for newly diagnosed asylum seekers referred to the McGill University Health Centre (MUHC) in Montreal, Quebec, Canada. Methods We conducted a retrospective...

Objective: Menopause is a pivotal transition for women. Previous studies have suggested increased risk of early menopause (40-45 years) and premature menopause (<40 years) for women with HIV. We aimed to determine age of menopause, prevalence of early menopause and premature menopause, and risk factors for menopause <45 years in Canadian women wit...

Objective: HIV-infected patients are at increased risk of nonalcoholic steatohepatitis (NASH). Vitamin E is recommended for treatment of NASH in the general population. However, its safety and efficacy among HIV-infected patients remain unknown. Design: Single-centre, phase IV, open-label, single arm clinical trial. Methods: HIV mono-infected...

Objectives We examined how multiple, nested, and interacting systems impact the protective process of resilience for women living with HIV (WLWH). Methods Using data from a Cohort Study, we conducted univariate analyses, multivariable logistic regression, and a 2-step structural equation modeling for the outcome, high resilience (N = 1422). Resul...

Introduction: Women living with HIV (WLHIV) experience stigma and elevated exposure to violence in comparison with HIV-negative women. We examined the mediating role of experiencing recent violence in the relationship between stigma and depression among WLHIV in Canada. Methods: We conducted a cohort study with WLHIV in three Canadian provinces....

Background: A community-based research (CBR) approach is critical to redressing the exclusion of women-particularly, traditionally marginalized women including those who use substances-from HIV research participation and benefit. However, few studies have articulated their process of involving and engaging peers, particularly within large-scale co...

Background Transgender (trans) women are overrepresented among people living with HIV, yet trans women living with HIV (WLWH) experience lower access to HIV care. Access to medical transition may facilitate access to HIV care among trans WLWH. This study sought to describe barriers and facilitators to access to medical transition among trans WLWH....

Scant research has explored the engagement of transgender (trans) women living with HIV (WLWH) in the HIV care cascade, particularly in universal health care settings like Canada. This convergent parallel, mixed-methods study drew on cross-sectional quantitative data from 50 trans WLWH in the Canadian HIV Women's Sexual and Reproductive Health Coho...

Background Stigma produces stress for women living with HIV (WLHIV) and is associated with poorer physical quality of life. Cannabis use may help to manage HIV-related symptoms, including stress and pain. Limited research has explored intersectional stigma and associations with bodily pain and physical functioning, or cannabis use as a stigma copin...

Background Canada was one of the first countries to offer publicly funded programs providing HPV vaccine free of charge to gbMSM. In 2015–2016, the provinces of British Columbia (BC), Ontario (ON), and Quebec (QC) implemented programs for gbMSM aged 9–26 years. We sought to explore where men received the HPV vaccine and the influence of healthcare...

Background Internationally, Canada was one of the first countries to offer free HPV vaccination to young gbMSM. The provinces of British Columbia (BC), Ontario (ON) and Quebec (QC) implemented HPV vaccination programs in 2015–2016 for gbMSM aged 9–26. We explored HPV vaccine initiation and among unvaccinated men, potential barriers to uptake. Meth...

Background: Cervical cancer screening might contribute to the prevention of anal cancer in women. We aimed to investigate if routine cervical cancer screening results-namely high-risk human papillomavirus (HPV) infection and cytohistopathology-predict anal HPV16 infection, anal high-grade squamous intraepithelial lesions (HSIL) and, hence, anal ca...

Love remains hidden in HIV research in favor of a focus on risk. Among 1424 women living with HIV in Canada, we explored (1) whether eight facets of sex and intimacy (marital status, sexual activity, physical intimacy, emotional closeness, power equity, sexual exclusivity, relationship duration, and couple HIV serostatus) may coalesce into distinct...

Objective: This study assessed and compared physical and mental health components of quality of life (QoL) for older and younger women living with HIV (WLWH). Method: Using survey data from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study, demographic, well-being, and physical and mental health-related QoL (HR-QoL) variables wer...

Background: Cisgender women with HIV experience an elevated risk of cervical cancer compared with HIV-negative women, but this cancer can be prevented through regular cervical cancer screening. Our study objective was to measure adherence to current national cervical cancer screening guidelines among women with HIV in 3 Canadian provinces and iden...

Background Women living with HIV (WLWH) continue to experience poorer outcomes across the HIV care cascade and overall health, an appreciable proportion of which may not be disease-related but due to socio-structural barriers that impact health. We compared socio-structural determinants of health and self-rated health between WLWH and expected gene...

Previous maternity experiences may influence subsequent reproductive intentions and motherhood experiences. We used latent class analysis to identify patterns of early motherhood experience reported for the most recent live birth of 905 women living with HIV enrolled in the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS)....

Resilience, positive growth in contexts of stress and adversity, is shaped by social ecological factors. Among people living with HIV, resilience is associated with myriad positive health benefits and improved health-related quality of life (HR-QoL). Identifying contextual factors associated with resilience among women living with HIV (WLWH) is par...

Objectives The reported prevalence of chronic obstructive pulmonary disease (COPD) in people living with HIV (PLWHIV) varies widely. Our objective was to estimate the prevalence of airflow obstruction and COPD in unselected PLWHIV and identify characteristics that increase the risk of nonreversible airflow obstruction in order to guide case finding...

Background: Effective two-drug regimens could decrease long-term drug exposure and toxicity with HIV-1 antiretroviral therapy (ART). We therefore aimed to evaluate the efficacy and safety of a two-drug regimen compared with a three-drug regimen for the treatment of HIV-1 infection in ART-naive adults. Methods: We conducted two identically designed,...

Plain English summary Patient-oriented research (POR) has received increasing attention in recent years. In this approach, patients’ experiential knowledge, derived from their experiences of living with a condition or illness and of interacting with the healthcare system, is recognized, valued, and seen as complementary to scientific knowledge. Ear...

People living with HIV are disproportionately affected by food and housing insecurity. We assessed factors associated with experiencing food and/or housing insecurity among women living with HIV (WLHIV) in Canada. In our sample of WLHIV (N = 1403) 65% reported an income less than $20,000 per year. Most (78.69%) participants reported food and/or hou...

Purpose Women living with HIV experience high levels of trauma exposure before and after diagnosis. One of the most challenging outcomes following trauma exposure is posttraumatic stress disorder. Despite high exposure to traumatic events, the presence and contributors to posttraumatic stress disorder symptoms have not been examined in women living...

Introduction: In Canada, individuals living in northern and rural regions report more barriers to health service access. For people living with HIV, these barriers may be exacerbated by experiences of HIV-related stigma, and women living with HIV can be disproportionately affected because of intersections of multiple forms of oppression, including...

Background: HIV infection and substance use synergistically impact health outcomes of people with HIV. In this study, we assessed the prevalence of substance use among women living with HIV (WLWH) and compared them with expected values from general data. Methods: Cigarette smoking, frequency of alcohol consumption, last-month non-prescribed cann...

Sexual orientation differences in health and wellbeing among women living with HIV (WLH) are underexplored. Limited research available, however, suggests that sexual minority WLH may experience barriers to HIV care. Cross-sectional baseline data was analyzed from a Canadian cohort study with WLH (sexual minority women [SMW]: n = 180; heterosexual w...

Background: In North America, women have lower engagement across the HIV cascade of care compared with men. Among women living with HIV (WLWH) in Canada, we measured the prevalence and correlates of attrition across cascade stages overall, and by key sub-populations. Methods: We analyzed baseline survey data regarding six nested stages of the HI...