Marginalized Subsistence: Food Security, HIV/AIDS, and Hepatitis C in a Saskatoon Food Desert

Abstract

This thesis examines the ways in which people who access services (PWAS) at the HIV/AIDS service provider AIDS Saskatoon utilize specific survival and subsistence strategies in an urban food desert within Saskatoon, Saskatchewan. Utilizing a community-based, ethnographic approach that is primarily situated within the critical-interpretive theoretical foundation and syndemic framework in medical anthropology, this project aims to contextualize the experiences of marginalized persons who use substances living with, or at risk of, HIV/AIDS and Hepatitis C (HCV) within the formal and informal communities of a low-income urban space. Balancing a plethora of barriers to food security, compounded with experiences of illness, violence, colonialism, substance use, and housing instability, the participants within the current project undertake a number of strategies to survive and acquire food amidst heightened surveillance and control from outside forces. PWAS maintain a sense of agency and autonomy through the use of alternative or “marginalized” subsistence strategies, such as through illicit income generating activities, to meet basic needs when formal interventions and programming are inadequate. PWAS resist overt surveillance and control in their lives, including imposed qualifiers of vulnerability, through specific and direct prioritizing and decision making regarding the intake of consumptive products, through the use of street based economic activities to acquire food, and through participation in moral economic practices around food acquisition. Programming aimed at building a secure status on the food security spectrum can be classified as a harm reduction tactic for PWAS given that it decreases certain risks that come with marginalized subsistence, increases available protective factors, and offers a means of resistance against outside governing bodies. In order to increases the uptake of food programming while building capacity and autonomy in those who access services, food programs centered on choice, dignity, and those which boast low barriers to accessibility, can contribute to positive health and social outcomes for marginalized groups struggling to survive in urban spaces.