Increasing the Accessibility and Acceptability of HIV Counseling and Testing among Aboriginal Women in Ottawa

Abstract

Background: In Canada, Aboriginal women are disproportionately impacted by HIV and are tested later in disease progression, resulting in poorer health outcomes and increasing the risk of onward transmission. Methods: Using purposive sampling, 13 self-identified Aboriginal women participated in in-depth, qualitative interviews exploring women’s experiences with HIV testing and their ideas for improving the process. Thematic analysis was conducted in conjunction with constant comparison to identify emergent themes and to direct future interviews and analyses. Results: Women identified several barriers to HIV testing converging on the subjects of insufficient knowledge of HIV and HIV transmission, lack of perceived relevance of HIV testing, unwillingness or inability to confront the need for testing, and judgment from self and others regarding engagement in HIV-related risk-behaviours. The women also described their acceptable and unacceptable testing experiences, presented recommendations for increasing HIV testing uptake, and suggested ways to create the ideal testing experience. The findings demonstrate a clear need for stronger engagement of Aboriginal women surrounding their HIV-related testing needs and increased access to educational opportunities, culturally appropriate care, and initiatives aimed at reducing societal stigma around HIV.