Through the Systems Navigation Access and Partnership (SNAP) Project, Community Health Centre (CHC) grantees are working to advance systems navigation efforts to improve access and health across Canada. This blog explores the work of Toronto based CHC, Women’s Health in Women’s Hand and the impact the funding has had in their community.

1 – Tell us a bit about your CHC, catchment area and community that you serve

Women’s Health in Women’s Hands Community Health Centre

Our Mandate:

 Women’s Health in Women’s Hands (WHIWH CHC) Community Health Centre provides racialized women, trans and non-binary clients from the African, Black, Caribbean, Latin American and South Asian communities in Toronto and surrounding municipalities with culturally safe, relevant, and responsive primary healthcare. We are changemakers engaged in knowledge transfer and exchange, research, capacity building and advocacy within and across multiple systems.

Our Commitment:

As the only centre of its kind in North America, WHIWH CHC aims to empower racialized women, trans and non-binary people, and improve their health outcomes. Working together as a multidisciplinary team to provide quality holistic health care, we are committed to working from a trauma-informed, intersectional feminist, pro-choice, anti-racist, anti-oppressive, sex-positive, harm reduction, and multilingual participatory framework in addressing the issue of access to healthcare for our mandated priority populations.

To learn more visit: https://www.whiwh.com/our-commitment

2- Tell us about your SNAP project 

The SNAP (System Navigation Access and Partnership) project, is a project focused on supporting African Caribbean and Black young women living with HIV with system navigation to increase timely appropriate care and support for young HIV positive women age 16-29 to by providing essential support to navigate the healthcare system, access mental health services, and build a strong support network.

3-Why was it important to engage with young, racialized women living with HIV

There are disproportionately high rates of HIV infection among Young African, Caribbean and Black women in Canada, including those in Toronto, they face higher risk of HIV acquisition compared to other populations. Young women in this demographic face disproportionately high rates of HIV infection, and many struggles to transition from pediatric to adult care. SNAP project focus is to close the gap, link them to care, ensure they get treatment and retained in care and also integrate other socio-economic supports focusing on holistic care for better health outcomes/and not the disease only.

WHIWH has developed a unique HIV service delivery model which integrates all of the determinants of health that are relevant to racialized women living with and at risk of HIV. Our HIV System navigation program has been a successful strategy in linking women to the different stages of the HIV care cascade i.e. Education and HIV testing, linkage to and retention in treatment, support and care. However, there are unique challenges faced by young women living with HIV (YWLWH) in accessing and engaging in HIV care. Through the project, we have extended the Peer Navigator strategy to support Young Women living with HIV (ages 16-29). Peer Navigators provide tailored support, guidance, advocacy to support young women within the GTA.

4- What has the impact of your SNAP project been

Through systems’ navigation, we have improved the health and wellbeing of Young women living with HIV by:

1. a) Reducing barriers to care including reducing HIV-related stigma and discrimination/racism/sexism/homophobia, cultural and language barriers, complexities of navigating healthcare systems, social isolation, limited knowledge on HIV management etc.
2. b) Fostering, a supportive peer-led environment to enhance linkage to HIV care services
3. c) Increasing retention in care through ongoing peer support and navigation; and
4. d) Enhancing emotional and social support networks for overall wellbeing and quality of life.
5. e) Increased knowledge and awareness among young women living with HIV, enhanced self-advocacy. sense of belonging, empowerment, and social support among participants, leading to improved mental well-being and adherence to HIV treatment

5-What have been the challenges around your respective SNAP project

While the project has seen considerable success, we have encountered several challenges along the way:

Geographic Distance: Some young women reside far from our center or even outside of Toronto, which can hinder their ability to participate in on-site activities. To mitigate this challenge, we proactively reach out to these women via phone calls for follow-up discussions. Additionally, we offer transportation assistance to ensure they can attend in-person appointments and access the support they need.

Internalized and Societal Stigma: Stigma surrounding HIV, both internalized by individuals and perpetuated by societal attitudes, poses a significant challenge to the healing journey of our clients. Overcoming this stigma requires ongoing education, advocacy, and the creation of safe and supportive spaces where individuals feel empowered to seek help and support without fear of judgment.

HIV Non-Disclosure Laws: The legal framework around HIV non-disclosure in Canada adds another layer of complexity to our clients and staff. Navigating these laws while supporting clients requires careful consideration and legal expertise to ensure the rights and well-being of our clients are protected.

Housing Crisis: The ongoing housing crisis in our community presents a significant barrier to supporting clients in securing stable housing. Majority of our clients have reported having bad experiences of discrimination and poor treatment while in temporary housing/ shelters once people find out their HIV status. Without stable housing, individuals may struggle to prioritize their health and well-being, making it essential for us to continue to advocate for affordable housing options and provide assistance in navigating housing resources.

Limited Access to Afro-Centric Mental Health Services: The availability of afro-centric or culturally relevant mental health support services in the community is limited, resulting in long waitlists and inadequate access to culturally appropriate care for our clients. Addressing this challenge requires collaboration with mental health service providers to expand culturally competent care options and reduce barriers to access for marginalized populations.

Despite these challenges, WHIWH CHC has demonstrated resilience and determination in finding solutions and adapting its approach to meet the evolving needs of its clients.

6-What impact do you hope your evaluation and increased support will leave for clients in the long term

The SNAP project at WHIWH CHC is designed to have a profound and lasting impact on the lives of young, racialized women living with HIV. By addressing critical areas such as retention in care, food security, stigma, and community engagement, the project aims to:

Improved Health Outcomes

• Enhanced access to care: By removing logistical barriers and providing consistent support, the project helps women maintain continuous care, leading to better overall health outcomes.
• Improved nutritional status: Addressing food insecurity is fundamental to overall health. By providing access to nutritious food, the project contributes to improved physical and mental well-being.
• Reduced stigma and discrimination: Through psycho-social and educational support, women can develop coping strategies to manage internalized and societal stigma, leading to increased self-esteem and resilience.

Increased Empowerment and Self-Sufficiency

• Stronger social support networks: The creation of a supportive community through the SNAP project fosters a sense of belonging and empowers women to navigate challenges together.
• Developed leadership skills: Participation in social activities and peer leadership roles can enhance women’s confidence and ability to advocate for themselves and their community.
• Increased knowledge and skills: Education on HIV, sexual reproductive health, and mental health empowers women to make informed decisions about their health and well-being.

Positive Community Impact

• Reduced HIV transmission: By promoting education and prevention strategies through social media and outreach events, the project contributes to reducing HIV transmission rates among young women.
• Increased community awareness: The project raises awareness about the challenges faced by young, racialized women living with HIV, fostering empathy and support within the community.
• Stronger partnerships: Collaboration with community organizations and stakeholders strengthens the network of support for young women, leading to more comprehensive and effective services.

7-How do you hope to continue to sustain your SNAP project? Would more funding allow for your project to continue?

Advocate for Increased Funding and Resources: We urge stakeholders at all levels to prioritize and allocate adequate funding and resources to support programs aimed at improving the health and well-being of young women living with HIV. Increased investment in comprehensive healthcare services, including mental health support, harm reduction supports, employment supports and housing assistance, is crucial to addressing the complex needs of this population effectively.

Promote Community Engagement and Support: We call upon community leaders, organizations, and individuals to actively engage in initiatives that foster supportive and inclusive environments for young women living with HIV. By building strong community networks and support systems, we can reduce isolation, provide mutual aid, and empower individuals to navigate challenges more effectively.

Address HIV-Related Stigma and Barriers to Care: It is imperative to confront and dismantle the stigma and discrimination that continue to hinder access to care and support for individuals living with HIV. Through targeted education, awareness-raising campaigns, and advocacy efforts, we can challenge misconceptions, promote empathy, and create environments that are free from judgment and discrimination.

Advocating for Policy Changes to Address Social Determinants of Health: We advocate for policy changes that address the underlying social determinants of health contributing to health disparities among young women living with HIV. This includes advocating for affordable housing, employment opportunities, comprehensive sexuality education, and access to quality healthcare services for all individuals, regardless of their HIV status.

WHIWH CHC envisions a future where all racialized women, trans, and non-binary individuals have access to quality healthcare and the support they need to thrive. By continuing to provide essential services like SNAP, advocating for policy changes, and building strong community partnerships, the center is working towards a healthier and more equitable future for all.