Table 1.

Key recommendations to inform a National Action Plan to advance the sexual and reproductive health of women living with HIV in Canada.

1. Meaningfully engage women living with HIV across research, policy, and practice aimed at advancing the sexual and reproductive health and rights by, with, and for all women living with HIV.

Recognize and implement essential expertise of women living with HIV at all levels within programming, policy, and whenever decisions are made. Meaningful engagement avoids tokenism, provides sufficient training and compensation, and recognizes women’s right to self-determination in their own sexual and reproductive health. Embedding peer support into services for women living with HIV and providing adequate compensation and support to peer leaders for their time and expertise is one example of meaningful engagement.

Respond to the diversity of women’s individual priorities, experiences, and identities, and meet women where they are at by addressing specific needs of communities facing intersecting systemic and structural inequities related to colonization, racism, and gender (e.g. Indigenous, African, Caribbean, Black, and trans women living with HIV).

Ground all efforts aimed at advancing sexual and reproductive health and rights of women living with HIV within an anti-oppressive framework, a which includes acknowledgement and active disruption of patterns and experiences of systemic, institutional, and lateral violence. b

2. Centre Indigenous women’s priorities, voices, and perspectives in all efforts to advance sexual and reproductive health and rights of women living with HIV.

Integrate the Truth and Reconciliation Commission Calls to Action (e.g. those related to health, justice, family, and community welfare) into the National Action Plan to support enabling environments by, with, and for Indigenous women living with HIV, with attention to redressing health inequities shaped by experiences of historical and ongoing colonization.

Acknowledge and honour strengths Indigenous women living with HIV draw from traditional ways of knowing, healing, and medicines. Create environments that enable access to a range of culturally safe and relevant support and services.

3. Use language and terminologies that are actively destigmatizing, inclusive, and reflective of strengths and experience of women living with HIV when discussing sexual and reproductive health and rights of women living with HIV.

Choose careful, intentional, respectful, and non-stigmatizing written, verbal, and body language. Language can be a source of power, connection, inclusion, healing, and affirmation when chosen carefully; failing to do so risks (re)producing language and guidance that is limiting, universalizing and/or otherwise insufficiently inclusive of the diversity of women’s experience. Adopting open and non-judgmental body language is important to facilitate respect.

Recognize what is considered appropriate or affirming in language may change over time and in different contexts. Understanding this, investing time in staying up-to-date, and entering conversations with a sense of humility and willingness to change are essential in choosing language that creates enabling environments.

4. Strengthen and expand Knowledge Translation (KT) initiatives to support access to and uptake of relevant and contemporary sexual and reproductive health and rights information for all stakeholders.

Ensure that women living with HIV have access to and understand their rights, and available resources and supports. KT outputs should be used to support and build capacity for self and community advocacy.

Support access to up-to-date information for all stakeholders to create environments that enable autonomy, choice, and informed decision-making of women living with HIV. Invest in developing targeted KT strategies that appeal to diverse audiences through diverse mediums, improving use, applicability, and uptake.

5. Catalyse the reciprocal relationship between evidence and action such that action on sexual and reproductive health and rights is guided by research evidence, and research is guided by what is needed for effective action.

Create and support the interdisciplinary collaborations across stakeholder groups that are necessary to create a system that integrates and adapts to the priorities of women living with HIV and emerging actionable and community driven research. Commit to providing infrastructure support and funding to sustain and nurture these collaborations.

Ensure that the diverse expertise of all women living with HIV is integrated and honoured throughout the process.

^aWe define an anti-oppressive framework as an approach that actively challenges systems of oppression in which we operate and critically analyses roles within these systems.^66–68

^bLateral violence is defined as: violence against one’s peers rather than one’s adversaries, which results from and is rooted in systemic cycles of abuse and oppression trauma, racism, and discrimination. ⁷¹