HIV / AIDS

A Culturally-Relevant Perspective on This Issue

Introduction

Acquired immune deficiency syndrome (AIDS) is caused by the human immunodeficiency virus HIV, which progressively weakens the immune system, leaving the body susceptible to infections and diseases. HIV/AIDS can be transmitted through unprotected sex, hypodermic needles, blood transfusions, pregnancy, childbirth, and breastfeeding. Among the Aboriginal population in Canada, injection drug use (IDU) is the primary mode of HIV transmission, with just over half of AIDS cases attributable to IDU [1].

Aboriginal people are disproportionately affected by HIV, making up to 12% of all new HIV infections in Canada, despite comprising only 3% of the population [2,3]. HIV/AIDS is affecting Aboriginal people at a younger age than the general population and is a significant burden among Aboriginal women, who represent 45% of positive HIV reports among the Aboriginal population [1]. Further, a disproportionate number of Aboriginal women engage in survival sex [4] and exchange sex for money, drugs, shelter, or other commodities, which increases their risk for HIV infection [5].

The surveillance data on Aboriginal HIV/AIDS rates are incomplete due to a lack of ethnicity reporting [1]. There is a need for improved HIV/AIDS epidemiology and HIV testing data among Aboriginal peoples to better prevent and control the spread of HIV/AIDS.

First Nations

Census data from 2001 report that 73% of Aboriginal AIDS cases occur among First Nations people. Females represent approximately one quarter of First Nations AIDS cases [1]. Economic and social problems that exist among many First Nations communities, such as poverty, violence, and both alcohol and drug use are often associated with higher rates of HIV infection [6].

Métis

The Public Health Agency of Canada 2004 report on Aboriginal AIDS cases states that 7% of Aboriginal AIDS cases occur among Métis community. Females are less likely to be affected, with 8% of Métis AIDS patients being female. AIDS is extremely prevalent among youth and accounts for 36% of Métis AIDS cases.

IDU is a key mode of transmission, with 29% of reported Métis AIDS cases attributed to IDU [1]. The high mobility of Métis people between urban and rural areas may increase the risk of HIV among remote rural communities, making HIV/AIDS prevention and control measures a priority among all Métis communities [7].

Inuit

Inuit people with AIDS make up 4% of the AIDS cases among Aboriginal people and roughly 21% of these cases are female. According to the Aboriginal AIDS Network, heterosexual transmission is the predominant mode of HIV transmission among the Inuit population [8]. However, IDU is also a major transmission mode, accounting for 30% of infections [8]. 

Awareness about HIV/AIDS among Inuit communities is lower than in other Aboriginal and non-Aboriginal populations making prevention and control efforts challenging. Urban Inuit are at greater risk of HIV infection compared to rural Inuit, due to a high prevalence of poverty, violence, and addictions (including IDU) [8].

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