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International focus on reducing onward HIV transmission emphasizes the need for routine HIV testing and early uptake of antiretroviral treatment (ART). Strategic targets have been set for 2020 to achieve the goal of 90% of people infected with HIV diagnosed, 90% of identified cases on treatment, and 90% of persons on treatment virally suppressed (90–90–90). It is vital to understand the complexity of factors influencing a person's treatment decisions over time and the context which may enable better adherence. In this paper we present findings from the review of published and gray literature (2003–2013) on the documented factors associated with treatment initiation and adherence in the general adult population of Australia, Canada, and the UK. A framework developed by Begley, McLaws, Ross, and Gold [2008. Cognitive and behavioural correlates of non-adherence to HIV anti-retroviral therapy: Theoretical and practical insight for clinical psychology and health psychology.Clinical Psychologist, 12(1), 9–17] in Australia was adapted to summarize the findings. A systematic database search using keywords and a set of inclusion criteria yielded 17 studies (Australia = 6; Canada = 8; UK = 3). In addition 11 reports were included in the review. We found that a person's abilities and motivations (intrapersonal factors, reported in 7 studies) to start and continue ART are influenced by a host of interconnected factors spanning relationship (interpersonal, 3 studies) and broader structural (extrapersonal, 15 studies) factors that are situated within social determinants of health. People therefore evaluate various costs and benefits of starting and staying on treatment, in which biomedical concerns play an important yet often subsidiary role. In this review the economic barriers to care were found to be significant and under-reported, highlighting the persistent health inequities in terms of access to services. Our understanding of the context around people's use of ART remains poor. Qualitative social research within HIV-positive communities is urgently needed to capture people's lived experiences and may address some of this deficit in understanding. [ABSTRACT FROM AUTHOR]

Canada and the United Kingdom have pedigrees in offering asylum; however, research in both countries has demonstrated widespread poverty amongst asylum seekers and a high risk of homelessness. Focusing on case examples drawn from 60 in-depth interviews with refugees in Toronto and London, this paper shows how national and local structures shape pathways to homelessness, and how refugees interpret their homlessness in the context of their flight from persecution, reception, and settlement. [ABSTRACT FROM AUTHOR]

For sixty years, the phrase ‘North Atlantic triangle’ has been employed by Canadian scholars to describe the relations of Canada, Britain and the USA. That image was a product of its time and its originator's perspective, with particular relevance to an understanding of Canada's international relations in the Second World War and its aftermath. This paper weighs the evidence for and against the existence of a triangular relationship in the 1940s and it concludes that the geometric form conveyed an incomplete understanding at the time and it has even less relevance since then. [ABSTRACT FROM AUTHOR]