Ontario Policy Analysis Examines Intersectionality in HIV Guidelines for Drug Users

A health policy content analysis of fifteen federal and provincial policy documents published between 2016 and 2024 revealed that language addressing sexual orientation and immigration is the weakest across most policies affecting access to HIV-related services for people who use drugs in Ontario, while race and income are the dimensions most frequently identified. While legislative Acts commonly contained vague language or remained silent on other dimensions when focusing on a specific factor, strategic documents specifically targeted at HIV and AIDS incorporated strong to strongest language across all evaluated intersectionality dimensions.

The analysis addressed health policies influencing service access for people who use drugs within the context of recent epidemiology. In 2023 Canadian surveillance data, injection drug use accounted for 13.6 percent of new HIV diagnoses among males and 28.4 percent of new diagnoses among females in exposure-category data. To evaluate how institutional frameworks address these populations, the investigation identified the presence and depth of intersectionality terminology within relevant provincial and federal policy materials.

Guided by two theories, the researchers evaluated publicly available health policy documents across five distinct intersectionality dimensions: gender, race or ethnicity, social class or income, sexual orientation, and immigration. The review process involved two reviewers who independently evaluated and collated the text from eligible documents to map how overlapping social factors and structural barriers are recognized in policy texts.

The extracted data were coded and quantified numerically through an adapted five-point Likert scale, classifying policy language across five standardized tiers: weakest, weak, generic, strong, and strongest. Following the numerical coding, the data were analyzed and visualized using a qualitative heatmap formatted with traffic light colors to compare how different types of policy instruments addressed each dimension.

Across the fifteen analyzed documents, clear structural differences emerged between instrument types, with vague terminology occurring more frequently in legislative Acts than in strategic plans and operational guidelines. The authors concluded that incorporating an intersectional approach into health policy development is pivotal to achieving Ontario’s 2030 HIV and AIDS targets, offering significant potential to advance equitable policy actions by addressing the intersecting challenges people who use drugs experience when accessing health services.

Subject of Research: Intersectionality in Ontario HIV-related health policy documents

Article Title: Intersectionality in HIV-related policy documents affecting people who use drugs in Ontario, Canada: a policy document analysis

Article References: Namyalo, P. K., Mosleh, K., Schwalm, J., & O’Shea, T. (2026). Intersectionality in HIV-related policy documents affecting people who use drugs in Ontario, Canada: a policy document analysis. AIDS Research and Therapy. https://doi.org/10.1186/s12981-026-00948-4

Image Credits: AI Generated

DOI: 10.1186/s12981-026-00948-4

Keywords: HIV policy, Ontario, intersectionality, people who use drugs, health policy analysis, public health, health equity, Canadian healthcare, HIV-related, policy, documents, affecting