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AIDS and Behavior

, Volume 22, Issue 6, pp 1987–2001 | Cite as

Sexual Orientation Differences in Health and Wellbeing Among Women Living with HIV in Canada: Findings from a National Cohort Study

  • Carmen H. Logie
  • Ashley Lacombe-Duncan
  • Ying Wang
  • Angela Kaida
  • Alexandra de Pokomandy
  • Kath Webster
  • Tracey Conway
  • Mona Loutfy
Original Paper

Abstract

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 women: n = 1240). SMW (median age 38 years, IQR 13) included bisexual (58.9%), lesbian (17.8%) and other sexualities (23.3%). In multivariable analyses adjusting for age, poverty, education, and ethnicity, SMW identity was associated with increased odds of: clinical (80% vs. 100% antiretroviral adherence), intrapersonal (previous/current injection drug use [IDU] vs. no IDU history, depression, lower resilience), interpersonal (childhood abuse, sex work, adulthood abuse), and structural (HIV support services barriers, unstable housing, racial discrimination, gender discrimination) factors in comparison with heterosexual identity. Sexual minority WLH experience social and health disparities relative to heterosexual WLH, highlighting the need for interventions to promote health equity.

Keywords

HIV Women Lesbian Bisexual Health status disparities 

Notes

Acknowledgements

The CHIWOS Research Team would like to thank women living with HIV for their contributions to this study. We also thank the national team of co-investigators, collaborators, and Peer Research Associates and acknowledge the national Steering Committee, our three provincial Community Advisory Boards, the National CHIWOS Aboriginal Advisory Board, the BC Centre for Excellence in HIV/AIDS for data support and analysis, and all our partnering organizations for supporting the study. Listed here are all research team members and affiliated institutions. The CHIWOS Research Team: British Columbia: Aranka Anema (University of British Columbia), Denise Becker (Positive Living Society of British Columbia), Lori Brotto (University of British Columbia), Allison Carter (British Columbia Centre for Excellence in HIV/AIDS and Simon Fraser University), Claudette Cardinal (Simon Fraser University), Guillaume Colley (British Columbia Centre for Excellence in HIV/AIDS), Erin Ding (British Columbia Centre for Excellence), Janice Duddy (Pacific AIDS Network), Nada Gataric (British Columbia Centre for Excellence in HIV/AIDS), Robert S. Hogg (British Columbia Centre for Excellence in HIV/AIDS and Simon Fraser University), Terry Howard (Positive Living Society of British Columbia), Shahab Jabbari (British Columbia Centre for Excellence), Evin Jones (Pacific AIDS Network), Mary Kestler (Oak Tree Clinic, BC Women’s Hospital and Health Centre), Andrea Langlois (Pacific AIDS Network), Viviane Lima (British Columbia Centre for Excellence in HIV/AIDS), Elisa Lloyd-Smith (Providence Health Care), Melissa Medjuck (Positive Women’s Network), Cari Miller (Simon Fraser University), Deborah Money (Women’s Health Research Institute), Valerie Nicholson (Simon Fraser University), Gina Ogilvie (British Columbia Centre for Disease Control), Sophie Patterson (Simon Fraser University), Neora Pick (Oak Tree Clinic, BC Women’s Hospital and Health Centre), Eric Roth (University of Victoria), Kate Salters (Simon Fraser University), Margarite Sanchez (ViVA, Positive Living Society of British Columbia), Jacquie Sas (CIHR Canadian HIV Trials Network), Paul Sereda (British Columbia Centre for Excellence in HIV/AIDS), Marcie Summers (Positive Women’s Network), Christina Tom (Simon Fraser University, BC), Lu Wang (British Columbia Centre for Excellence), Kath Webster (Simon Fraser University), Wendy Zhang (British Columbia Centre for Excellence in HIV/AIDS). Ontario: Rahma Abdul-Noor (Women’s College Research Institute), Jonathan Angel (Ottawa Hospital Research Institute), Fatimatou Barry (Women’s College Research Institute), Greta Bauer (University of Western Ontario), Kerrigan Beaver (Women’s College Research Institute), Anita Benoit (Women’s College Research Institute), Breklyn Bertozzi (Women’s College Research Institute), Sheila Borton (Women’s College Research Institute), Tammy Bourque (Women’s College Research Institute), Jason Brophy (Children’s Hospital of Eastern Ontario), Ann Burchell (Ontario HIV Treatment Network), Allison Carlson (Women’s College Research Institute), Lynne Cioppa (Women’s College Research Institute), Jeffrey Cohen (Windsor Regional Hospital), Tracey Conway (Women’s College Research Institute), Curtis Cooper (Ottawa Hospital Research Institute), Jasmine Cotnam (Women’s College Research Institute), Janette Cousineau (Women’s College Research Institute), Annette Fraleigh (Women’s College Research Institute), Brenda Gagnier (Women’s College Research Institute), Claudine Gasingirwa (Women’s College Research Institute), Saara Greene (McMaster University), Trevor Hart (Ryerson University), Shazia Islam (Women’s College Research Institute), Charu Kaushic (McMaster University), Logan Kennedy (Women’s College Research Institute), Desiree Kerr (Women’s College Research Institute), Maxime Kiboyogo (McGill University Health Centre), Gladys Kwaramba (Women’s College Research Institute), Lynne Leonard (University of Ottawa), Johanna Lewis (Women’s College Research Institute), Carmen Logie (University of Toronto), Shari Margolese (Women’s College Research Institute), Marvelous Muchenje (Women’s Health in Women’s Hands), Mary (Muthoni) Ndung’u (Women’s College Research Institute), Kelly O’Brien (University of Toronto), Charlene Ouellette (Women’s College Research Institute), Jeff Powis (Toronto East General Hospital), Corinna Quan (Windsor Regional Hospital), Janet Raboud (Ontario HIV Treatment Network), Anita Rachlis (Sunnybrook Health Science Centre), Edward Ralph (St. Joseph’s Health Care), Sean Rourke (Ontario HIV Treatment Network), Sergio Rueda (Centre for Addiction and Mental Health [CAMH]), Roger Sandre (Haven Clinic), Fiona Smaill (McMaster University), Stephanie Smith (Women’s College Research Institute), Tsitsi Tigere (Women’s College Research Institute), Wangari Tharao (Women’s Health in Women’s Hands), Sharon Walmsley (Toronto General Research Institute), Wendy Wobeser (Kingston University), Jessica Yee (Native Youth Sexual Health Network), Mark Yudin (St-Michael’s Hospital). Quebec: Dada Mamvula Bakombo (McGill University Health Centre), Jean-Guy Baril (Université de Montréal), Nora Butler Burke (University Concordia), Pierrette Clément (McGill University Health Center), Janice Dayle, (McGill University Health Centre), Danièle Dubuc, (McGill University Health Centre), Mylène Fernet (Université du Québec à Montréal), Danielle Groleau (McGill University), Aurélie Hot (COCQ-SIDA), Marina Klein (McGill University Health Centre), Carrie Martin (Native Women’s Shelter of Montreal), Lyne Massie, (Université de Québec à Montréal), Brigitte Ménard, (McGill University Health Centre), Nadia O’Brien (McGill University Health Centre and Université de Montréal), Joanne Otis (Université du Québec à Montréal), Doris Peltier (Canadian Aboriginal AIDS Network), Alie Pierre, (McGill University Health Centre), Karène Proulx-Boucher (McGill University Health Centre), Danielle Rouleau (Centre Hospitalier de l’Université de Montréal), Édénia Savoie (McGill University Health Centre), Cécile Tremblay (Centre Hospitalier de l’Université de Montréal), Benoit Trottier (Clinique l’Actuel), Sylvie Trottier (Centre Hospitalier Universitaire de Québec), Christos Tsoukas (McGill University Health Centre). Other Canadian provinces or international jurisdictions: Jacqueline Gahagan (Dalhousie University), Catherine Hankins (University of Amsterdam), Renee Masching (Canadian Aboriginal AIDS Network), Susanna Ogunnaike-Cooke (Public Health Agency of Canada).

Funding

The study was funded by: Canadian Institutes of Health Research (MOP-111041), the CIHR Canadian HIV Trials Network (CTN 262), the Ontario HIV Treatment Network (OHTN), and the Academic Health Science Centres (AHSC) Alternative Funding Plans (AFP) Innovation Fund.

Author Contributions

CHL conceptualized the manuscript, contributed to study design and analytic methods, and led writing the manuscript. ALD contributed substantially to writing the manuscript. YW conducted data analysis. AK, MRL, ADP were principal investigators and designed the study, contributed substantially to data collection, and provided feedback and edits. KW and TC contributed to study design, data collection, and provided feedback and edits. All authors approved the final manuscript version. All other CHIWOS Research Team Members who wish to remain anonymous.

Compliance with Ethical Standards

Conflict of interest

All authors declare no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. All participants provided written, voluntary informed consent (or oral consent with a study team member present as a witness for surveys conducted by phone or Skype) at enrolment in the survey phase of the CHIWOS study. Ethical approval for all study procedures was provided by the Research Ethics Boards of Simon Fraser University, University of British Columbia/Providence Health, Women’s College Hospital and McGill University Health Centre.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Factor-Inwentash Faculty of Social WorkUniversity of TorontoTorontoUSA
  2. 2.Women’s College Research InstituteWomen’s College HospitalTorontoUSA
  3. 3.Faculty of Health SciencesSimon Fraser UniversityVancouverUSA
  4. 4.Department of Family MedicineMcGill UniversityMontrealUSA
  5. 5.Chronic Viral Illness ServiceMcGill University Health CentreMontrealUSA
  6. 6.Dalla Lana School of Public HealthUniversity of TorontoTorontoUSA
  7. 7.Department of MedicineUniversity of TorontoTorontoUSA

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