Navigating Barriers: The Intersectional Impact of COVID-19 on Routine Healthcare Access Among Marginalized Indigenous Women in Vancouver

Résumé fourni par la source

This study investigates the intersectional barriers to routine healthcare access experienced by marginalized Indigenous women, including sex workers and women living with HIV, in Vancouver, Canada during the COVID-19 pandemic. Drawing on data from 142 Indigenous participants in the AESHA and SHAWNA cohorts collected between October 2020 and August 2021, the research employs bivariate and multivariable logistic regression with generalized estimating equations to identify factors linked to difficulties accessing family doctors, nurses, or clinics for routine care. Findings reveal that 27.5% of participants reported challenges in accessing healthcare during the pandemic. Key factors associated with increased difficulty include negative changes in psychological and emotional well-being (AOR: 3.99, 95% CI: 1.33–11.98) and concerns about community safety and violence (AOR: 2.72, 95% CI: 1.06–6.94). This study underscores how the COVID-19 pandemic exacerbated pre-existing structural inequities rooted in colonialism, racism, stigma, and violence, which disproportionately impact Indigenous women with intersecting marginalized identities. There is an urgent need for healthcare systems to implement culturally safe, trauma-informed, and anti-Indigenous racism practices that center Indigenous voices and sovereignty. Enhancing mental health supports and addressing community safety are critical to improving healthcare access and outcomes. The study calls for community-led, Indigenous-led approaches and policy reforms, including the decriminalization of sex work, to dismantle structural barriers and promote health equity among Indigenous women, sex workers and women living with HIV in Canada.

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