title: Navigating identity, territorial stigma, and HIV care services in Vancouver, Canada: A qualitative study.
abstract: This study examines the influence of territorial stigma on access to HIV care and other support services. Qualitative interviews were conducted with thirty people living with HIV (PLHIV) who use drugs recruited from the Dr. Peter Centre (DPC), an HIV care facility located in Vancouver, Canada's West End neighbourhood that operates under a harm reduction approach. Findings demonstrated that territorial stigma can undermine access to critical support services and resources in spatially stigmatized neighbourhoods among PLHIV who use drugs who have relocated elsewhere. Furthermore, PLHIV moving from spatially stigmatized neighbourhoods - in this case, Vancouver's Downtown Eastside - to access HIV care services experienced tension with different groups at the DPC (e.g., men who have sex with me, people who use drugs), as these groups sought to define who constituted a'normative' client. Collectively, these findings demonstrate the urgent need to consider the siting of HIV care services as the epidemic evolves.
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: Alexandra B
authors.initials: AB
authors.lastname: Collins
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
authors.forename: Surita
authors.initials: S
authors.lastname: Parashar
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
authors.forename: Kalysha
authors.initials: K
authors.lastname: Closson
authors.affiliation: Dr. Peter AIDS Foundation, Vancouver, BC, Canada.
authors.forename: Rosalind Baltzer
authors.initials: RB
authors.lastname: Turje
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Carol
authors.initials: C
authors.lastname: Strike
authors.affiliation: BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada. Electronic address: rmcneil@cfenet.ubc.ca.
authors.forename: Ryan
authors.initials: R
authors.lastname: McNeil
mesh_terms: D001955:British Columbia / Q000453:epidemiology; D019033:Delivery of Health Care, Integrated; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D040261:Harm Reduction; D006297:Health Services Accessibility; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012111:Residence Characteristics; D057545:Social Stigma
chemical_list: D013287:Illicit Drugs
keywords: Canada; HIV; Neighbourhoods; Place; Qualitative research; Territorial stigma