‘In the North you can’t be openly gay’: Contextualising sexual practices among sexually and gender diverse persons in Northern Canada

ABSTRACT

Scant research has addressed health and well-being among lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons in the Arctic. The Northwest Territories (NWT) has among Canada’s highest rates of sexually transmitted infections (STIs). LGBTQ persons in NWT are at the nexus of LGBTQ and Arctic health disparities. Yet little is known of their sexual health needs. This qualitative study explored the sexual health needs of LGBTQ persons in the NWT. We conducted semi-structured, in-depth interviews with 51 participants, including 16 LGBTQ youth aged 15–24, 21 LGBTQ adults aged 25 and above, and 14 key informants who worked with LGBTQ persons. Social-ecological approaches to understanding sexual health guided this study. Participants discussed how structural contexts such as heteronormativity in sexual health education and a lack of access to safer sex tools constrained their ability to practice safer sex. Social contexts of intersectional stigma resulted in shame, concealing identities, and fear of accessing safer sex materials. Myriad factors influenced partner communication about safer sex practices, including honesty, consent, and relationship power. Findings suggest the need for comprehensive sexuality education and interventions that address syndemics of substance use, stigma, and low self-esteem to advance sexual health among LGBTQ persons in Northern Canada.     

‘Women are supposed to be the leaders’: intersections of gender,race and colonisation in HIV prevention with Indigenous young people

Focusing on gender, race and colonialism, this paper foregrounds the voices of Indigenous young people, their histories of oppression, their legacies of resistance and the continuing strengths rooted in Indigenous peoples, their cultures and their communities. Exploring the relationship between gender and colonialism, the paper speaks to the lived realities of young people from Indigenous communities across Canada. Over 85 young people participated in six different Indigenous community workshops to create artistic pieces that explored the connections between HIV, individual risk and structural inequalities. In the course of the research, Indigenous young people, and young Indigenous women in particular, talked about how gender intersects with race and colonisation to create experiences that are, at times, especially difficult for them. In this paper, young people discuss the ways in which colonialism has demeaned women's roles and degraded women's sexuality, and how continuing cultural erasure and assimilationist policies impact on their lives and on their bodies.     

‘They can’t report abuse,they can’t move out. They are at the mercy of these men’: exploring connections between intimate partner violence,gender and HIV in South African clinical settings

This qualitative study captured South African female health provider perspectives of intimate partner violence in female patients, gender norms and consequences for patients’ health. Findings indicated female patients’ health behaviours were predicated on sociocultural norms of submission to men’s authority and economic dependence on their partners. Respondents described how men’s preferences and health decision-making in clinics affected their patients’ health. Adverse gender norms and gender inequalities affected women’s opportunities to be healthy, contributing to HIV risk and undermining effective HIV management in this context. Some providers, seeking to deliver a standard of quality healthcare to their female patients, demonstrated a willingness to challenge patriarchal gender relations. Findings enhance understanding of how socially-sanctioned gender norms, intimate partner violence and HIV are synergistic, also reaffirming the need for integrated HIV-intimate partner violence responses in multi-sector national strategic plans. Health providers’ intimate knowledge of the lived experiences of female patients with intimate partner violence and/or HIV deepens understanding of how adverse gender norms generate health risks for women in ways that may inform policy and clinical practice in South Africa and other high-HIV prevalence settings.     

What is the evidence base for integrating health and environmental approaches in the school context to nurture healthier and more environmentally aware young people? A systematic scoping review of global evidence

This scoping review collates empirical and gray literature that examines how schools are acting to nurture healthier and more environmentally aware young people through integrated approaches. Over the last twenty years, integration has been increasing within school contexts. Approaches include teaching and learning, physical environmental adaptations, developing ecologically focused policy, and reorienting wider school culture. We noted a developing discourse around what constitutes evidence in this emerging interdisciplinary field. Developing a better understanding of integrated approaches and an evidence base of what works and how could inform interdisciplinary collaboration and enable a clearer message to be communicated to stakeholders about how the school context can nurture healthier and more environmentally aware young people.