Systemic inequities and sources of resilience: challenges faced by Indigenous women living with HIV during COVID-19 in the Canadian prairies

This study explored the challenges faced by, and resilience of First Nations, Métis, and Inuit women living with HIV in Manitoba and Saskatchewan during the COVID-19 pandemic. Through a decolonizing, community-based research approach, guided by a Community Guiding Circle (CGC), interviews were conducted with 45 Indigenous women living with HIV. Participants were recruited via community outreach, peer networks, and social media. Data collection and analysis utilized Indigenous storywork and inductive thematic analysis. The study revealed significant barriers related to housing instability, childcare, and access to healthcare, all exacerbated by systemic inequities rooted in colonialism, patriarchy, and capitalism. Despite these challenges, Indigenous cultural practices, ceremonies, community support, and family ties emerged as crucial sources of resilience, though often disrupted during the pandemic. The findings underscore the urgent need for culturally safe, women-centered care models that integrate Indigenous knowledge and practices. For health and social care practitioners, this research emphasizes the importance of advocating for systemic change to address the unique needs of Indigenous women living with HIV and calls for the development and implementation of culturally safe health and social care tailored to their unique needs and resilience.