Abstract / Summary
In 2023 Canadian surveillance data, injection drug use accounted for 13.6% of new HIV diagnoses among males and 28.4% among females in exposure-category data. This study identified the presence of intersectionality language among health policies that affect access to HIV related services for people who use drugs (PWUDs) in Ontario. Guided by two theories, we conducted a health policy content analysis of federal and provincial policies. Five intersectionality dimensions- gender, race/ethnicity, social class/income, sexual orientation, and immigration were considered. Two people independently reviewed and collated the content of publicly available documents. Data were coded and quantified numerically using an adapted 5-point Likert scale, with language ranging from weakest, weak, generic, strong, and strongest. The coded data were analyzed and visualized using a qualitative heatmap, with “traffic light” colors. Fifteen policy documents published from 2016 to 2024 were included. Language related to sexual orientation and immigration is the weakest in most policies, while race and income are the most identified. The vague language is more common in Acts compared to strategic plans and guidelines. Acts that focus on a specific intersectionality dimension are silent on others. The HIV/AIDS targeted strategic documents have “strong to strongest” language on all the intersectionality dimensions. Consideration of intersectionality has great potential in advancing equitable policy actions. Findings are pivotal to achieving Ontario’s HIV/AIDS target of 2030 by ensuring an intersectional approach in health policy development, which will consider the intersecting challenges PWUDs face in accessing services and implement strategies to address them.