Publications

PrEP prevents HIV very effectively, yet uptake, adherence and persistence remain uneven. This study examines the political and economic conditions behind that gap in Ontario, Canada. Between July and October 2021, researchers held six focus groups and three interviews with 20 stakeholders, including clinicians, community organization staff and government staff, then analyzed transcripts using reflexive thematic analysis informed by a critique of neoliberalism. Participants described funding structures that prioritize profit and push patients and providers to act as individual entrepreneurs, compounding inequities for marginalized people. Suggested paths forward included stronger institutional and government support, community collaboration, and moving beyond risk-based health frameworks.

Precarious work is rarely examined through a queer lens, a gap this narrative inquiry addresses. Twenty gay, bisexual, and queer men shared employment stories, analyzed using Polkinghorne's narrative analysis and framed by a political economy of queer struggle. Their accounts form a three-part arc. Early devaluation of LGBTQ+ identities and adverse life experiences disrupted career planning and postsecondary education. Entering the labour market, participants faced restricted opportunities because of safety concerns and learned to navigate white, cisgender, straight, Canadian ideals prized by employers. Once employed, they lacked protections against hostile treatment, fearing job loss, leaving them susceptible to exploitative labour markets.

Les personnes de la diversité sexuelle et de genre (DSG) rapportent une consommation accrue de méthamphétamine en contexte sexuel, mais peinent à donner un sens à leurs expériences et à se faire entendre dans les services. Cette étude participative documente l'implication de pairs-chercheurs à toutes les étapes du processus, par journal de bord et notes de réunions analysés selon le cadre de l'injustice épistémique. Leurs savoirs situés ont enrichi l'analyse, orienté la diffusion vers la transformation des services et favorisé la confiance avec la population. Ces liens génèrent toutefois des attentes exigeantes, et l'engagement de l'équipe peut sembler manquer d'objectivité.

Dietitians supporting gender-diverse clients may need knowledge that training aimed at cisgender patients never covers. This qualitative mini review systematically searched for and synthesised studies on gender-diverse people's own experiences with nutrition, eating disorders, and eating-related health services, ultimately including 14 papers, 11 about disordered eating and three about nutritional needs, knowledge, and food insecurity. Themes included restricting food to suppress secondary sex characteristics or meet social expectations, the effect of gender-affirming care on disordered eating, and negative encounters with nutrition and eating disorder services. Recommendations centre trans literacy among clinicians, safer treatment spaces, and dual competence in eating disorders and gender-affirming care.

People living with HIV who use drugs are hospitalized more often than the general population and frequently describe poor treatment on the ward. To understand why, researchers interviewed 26 hospital-based providers in Toronto and Ottawa, including physicians, registered nurses, social workers, pharmacists, a dietitian and a nurse practitioner, analysing the transcripts through structuration theory. Most providers said their hospitals offer no explicit rules guiding care for patients who use drugs, and many considered this work beyond their scope of practice. In that vacuum, implicit rules and improvised actions take over, which the authors argue can undermine equitable care for this group.