Email CCSD or Vis-à-vis | CCSD Home Page| Table of Contents (current issue)How many women faced with a man unwilling to wear a condom would just take a deep breath and tell him to go get one? Let's be realistic: Few women set the conditions for sexual activity. A fatal consequence of this comes to light as the incidence of HIV infection among women continues to climb alarmingly.
Capital Health Authority, Public Health Services, launched a "Women and AIDS" initiative four years ago with women's shelters in Edmonton and the surrounding area to integrate HIV prevention into the services of women's shelters.
The project met with initial reluctance from shelter directors and staff, as they were concerned about adding yet another difficult issue to their workload. HIV was seen as the domain of health professionals. The reluctance began to disappear when the topic of HIV was presented within a context of personal power, so that shelter staff could see the link to their work.
Women living in abusive relationships are extremely vulnerable; their fractured self-esteem and limited finances compound the difficulty of leaving a harmful relationship. As long as the thrust of HIV prevention programs remains focused on the use of condoms, women remain dependent upon men to protect their sexual health. HIV then becomes an invisible but deadly form of violence against women.
The subject of HIV raised many unexpected issues for staff. They identified a strong need to explore sexuality issues on a personal level before attempting to talk about HIV with clients. The opportunity to talk about women as sexual beings, as opposed to their roles in society such as wife and mother, was key in the process of discovering personal attitudes and the impact on practice. Once staff members became actively involved in the project, it became clear that HIV educational materials were not useful for women in abusive relationships because the messages implied an equal power base in the relationship. Both staff and residents were keen to create materials with messages that were relevant and supportive.
The value of involving shelter residents in every step of the process cannot be understated. For example, during the creation of a poster, a graphic designer was contracted to develop a prototype but found each sample rejected by residents. The designer was working with new trends and design colours, but the jagged edges of the samples reminded residents of knives and scissors. The prototype was then redesigned under close guidance by shelter residents. A strong sense of ownership resulted from their intimate involvement in the process.
What have we learned? The process of weaving HIV prevention into agencies is crucial to a successful program. Part of this process is taking the time for workers to explore sexuality issues on a personal level. When we did this, not only did we develop some effective HIV education and prevention materials, but we also linked with community agencies to develop a common understanding of women, AIDS and violence, and how we can better serve the needs of women who are HIV+.
Nancy McPherson works with Capital Health Authority, Public Health Services. She can be contacted at:Eastwood Health Centre
7919 - 118 Avenue
Edmonton, AB, T5B 0R5
Tel: (403) 474-8266, fax: 474-5760
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