Secondly, the interdependent and mutually constitutive relationships are experienced between the different forms of racism intrapersonal, internalized and institutional social identities and a structural inability to access SDOH that bring mostly oppressions. These oppressions become mutually constitutive with her other identities making it almost impossible for her to the access social and health goods at multi-levels of their lives (Logie et al, 20). In their study in Ontario, the experiences of stigma for African women at the micro-level has shown that participants hide their HIV sero-status from their parents and sexual partner for fear of disappointment and rejection due to intense shame and internalized HIV stigma; at the meso-level, the community beliefs and social norms that have expressed African woman as sexually immoral and loose as a symbolic form of HIV related stigma and a participant from Africa was able to surmise her experience at the macro level of the health care system as thus: I was in crisisI had to go see a doctor. When she came in she had three pairs of gloves and yet it wasnt even a problem related to HIV! She kept her distance and could barely touch me. When she finally came closer I said: If you do not remove your gloves you do not touch me! (p.6).
Stigma and discrimination exists as principal drivers that influence the lived experience of the SSA WLHA; invariably fueling and contributing to the continuing and widespr
ead occurrences of HIV in Canada. Womens human rights through their life cycle are an inalienable, integral and indivisible part of universal human rights (UN, 995); and health is a fundamental human right (WHO, 205). Institutionalized, personalized and internalized forms of stigma with any direct and/or indirect system of advancement becomes an indignity and injustice to the lives of people living with the HIV disease, more so, for these African women that are based on socially ascribed hierarchies, her achievements contextually are limited because their social identities limit her. Her status is a function of the sum of their ascribed and achieved actions. Furthermore, elimination of AIDS as a public health threat is being undermined as the achievement of UNAIDS (204) 90-90-90 target that by 2020; 90% of all people living with HIV know their status, 90% of those diagnosed receive antiretroviral treatment, and 90% of those on treatment achieve viral suppression is being compromised by stigma: An ascribed social status. At the end of 204, PHAC, (206), reports that an estimated 80% (73% to 87%) of persons living with HIV were diagnosed, 76% (70% to 82%) of persons diagnosed with HIV were on treatment, and 89% (84% to 93%) of persons on treatment had suppressed viral load. Stigma, possibly, drives this as challenges associated with social determinants of health and access and retention in health services are encumbered (Logie et al, 20; PHAC, 206).