Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada.
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Health Soc Care Community. 2022 Jan;30(1):e138-e147. doi: 10.1111/hsc.13420. Epub 2021 May 12.
Globally, people living with HIV (PLWH) are disproportionately affected by food insecurity. Yet there is limited understanding of the impacts of food insecurity among cisgender and transgender women living with HIV (WLWH) in high-income countries. Thus, it is critical to examine the lived experiences of WLWH and food insecurity to inform policy and service provision. As part of the community-based SHAWNA (Sexual Health and HIV/AIDS: Women's Longitudinal Needs Assessment) study, we conducted 64 semistructured qualitative interviews with WLWH in Vancouver, Canada (2015-2017). Drawing on a socio-ecological framework, this analysis explores the lived experiences of navigating food security and health among WLWH in Metro Vancouver. Our findings indicate that WLWH relied heavily on food banks and other food-related supportive services. Despite the abundance of programs, access to nutritious foods remained difficult, and women often relied on processed foods that were more affordable and readily available. For many, food insecurity was exacerbated by unresponsive food services regulations that did not reflect the actual needs of food service users in terms of opening hours and locations, and a lack of nutritious food. Additionally, the absence of trauma-aware, women-centred and culturally responsive services, as well as, spatial and material barriers related to the recent loss of funding for HIV-specific support services, impeded food security among WLWH. Our findings emphasise that recognizing and addressing the social and structural disparities that exist for WLWH in high-income setting are essential for addressing food insecurity and ultimately optimal health among this population.
在全球范围内，艾滋病毒感染者（PLWH）受到粮食不安全的影响不成比例。然而，对于高收入国家的跨性别和 transgender 女性艾滋病毒感染者（WLWH）中粮食不安全的影响，人们的理解有限。因此，了解 WLWH 和粮食不安全的实际情况对于为政策和服务提供信息至关重要。作为基于社区的 SHAWNA（性健康和艾滋病毒/艾滋病：妇女的纵向需求评估）研究的一部分，我们在加拿大温哥华对 64 名 WLWH 进行了半结构化定性访谈（2015-2017 年）。本分析借鉴社会生态框架，探讨了温哥华大都市区 WLWH 中粮食安全和健康问题的实际情况。研究结果表明，WLWH 严重依赖食品银行和其他与食品相关的支持性服务。尽管有大量的项目，但获得营养食品仍然很困难，而且女性经常依赖更便宜和更容易获得的加工食品。对许多人来说，粮食不安全的情况因不响应的粮食服务法规而加剧，这些法规在营业时间和地点方面没有反映粮食服务用户的实际需求，也缺乏营养食品。此外，还缺乏对创伤的认识、以妇女为中心和文化上的回应性服务，以及与最近丧失艾滋病毒特定支持服务资金有关的空间和物质障碍，这也妨碍了 WLWH 的粮食安全。研究结果强调，认识和解决高收入环境中 WLWH 存在的社会和结构性差距，对于解决粮食不安全问题以及最终实现这一人群的最佳健康至关重要。
