HIV and AIDS infections among Aboriginal people at highest rates in Canada

Stories coming from the International AIDS conference being held in Toronto will hopefully increase awareness and support further prevention programs for the Aboriginal population. But the news about the increased number of HIV/AIDS victims that are Aboriginal is very troubling. Increased knowledge and education are important components of the work that is necessary to make inroads in the battle against the spread of this horrible disease.

From the NAN Health web site ...

Please click on the link to access the NAN AIDS & Healthy Lifestyles website http://aids.nan.on.ca

For information and news or to be added to a mailing list for up to date information on HIV/AIDS please click on the following links.  http://hivandhepatitis.com or http://cdcnpin.org

Contact Gwen Medicine (gmedicin@nan.on.ca) if have any questions, comments or ideas on what you would like to see posted!

Gwen Medicine, HIV / AIDS Coordinator
Tel: (807) 623 8228 or Toll Free: (800) 465 9952, ext 4940
E-mail: gmedicin@nan.on.ca
710 Victoria Avenue East
Thunder Bay, ON P7C 5P7 
Fax: (807) 623 7730

The 2006 World AIDS Conference is being held August 14 - 17, 2006 in Toronto!  For more information please visist www.aids2006.org

from CBC online News at http://www.cbc.ca/news/background/aids/aboriginals.html

Aboriginals: Canada's most vulnerable population - Last Updated August 15, 2006

Canada's First Nations people are disproportionately becoming infected with HIV and AIDS.

"Aboriginal people now total 16.4 per cent of all AIDS cases," said Chief Angus Toulouse, Ontario Regional Chief-Chair of the Assembly of First Nations, during a news conference at the 16th International AIDS Conference in Toronto.

"This is a 500-per-cent increase over the past 20 years, compared to a 24 per cent decrease in the general Canadian-born population."

Aboriginals make up just three per cent of the country's population, but the infection rate for First Nations people is nine per cent, according to the Public Health Agency of Canada.

And the numbers have been rising rapidly.

 Kevin Barlow, executive director of the Canadian Aboriginal AIDS Network, tells the AIDS conference about the unique challenges facing Canada's aboriginals in the fight against the disease. (Robin Rowland/CBC)

"I've had a lot of friends die (from AIDS)," says Kevin Barlow, executive director of the Canadian Aboriginal AIDS Network and a speaker at the Toronto AIDS conference.

"I've seen so many die that in some ways, there are times when I have to numb myself to that kind of loss. But I also draw upon their strength because every person that has touched my life who has been HIV-positive, their spirit teaches me that I must do more."

It's hard to analyze the figures for aboriginal people exclusively, because ethnicity isn't always reported when cases or test results are recorded. But, looking at the cases where the cultural background of the infected person is known reveals some unsettling patterns.

In 2005, aboriginals represented an estimated 200 to 400 new HIV infections that year, according to Canada's public health agency. At the end of 2005, there was an estimated 3,600 to 5,100 First Nations People living with the disease.

Before 1993, aboriginals represented about two per cent of AIDS cases Canada reported to the Centre for Infectious Disease Prevention and Control (CIDPC) where ethnicity was known. By 2003, the number had climbed to 14.4 per cent.

Barlow told CBC News he believes that the problem is much larger than the numbers suggest.

"We also know that aboriginal people are not getting tested," he said. "They're not getting the information as much as we would like them to. Given those kind of dynamics, and the marginalization of some of our people, that creates the formula for the virus to be spreading a little more rapidly than we would like."

That's why he is pushing to create an international HIV/AIDS secretariat to bring a higher profile to the issues of aboriginals and other indigenous people.

"So that in these future conferences, there will be a bigger indigenous presence. It's sad that at this conference there was only one workshop that was indigenous-led."

Epidemic hits women, children and intravenous drug users hardest

Injection drug use is the most common way aboriginals in Canada come in contact with the HIV virus.

It's a trend that has been getting worse over time. Before 1993, 11 per cent of all aboriginal AIDS cases stemmed from injection drug use. By 2003, this rose to 51.7 per cent.

The pattern is even more apparent when looking at HIV infections for the period between 1998 and 2004: 59.4 per cent of aboriginal HIV infections stemmed from injection drug use, compared with 27.5 per cent of cases for the non-aboriginal population.

And the proportion of women with HIV and AIDS is greater when comparing the aboriginal and general Canadian populations. Women represent nearly half (45 per cent) of all positive HIV reports in the aboriginal population, while for the non-aboriginal population the figure is about 20 per cent.

Root causes

The HIV virus and AIDS is a relatively new phenomenon for aboriginals in Canada, speeding the pace at which it has been spreading in the community, Barlow says.

While most AIDS organizations have been around for more about 25 years, he says most aboriginal AIDS agencies have been in existence for just 10 or 12 years years — and as little as four in some cases.

"When we finally mobilized around HIV/AIDS we hit a lot of roadblocks," he said. "One, we didn't have the data that we needed. Second, the dollars were pretty much committed. There were no new dollars for aboriginal people to get into the sectors and start doing some work."

As the frontline response tried to catch up to the AIDS epidemic, he says, the disease kept shifting its spreading pattern within the aboriginal community. From homosexual men, to women, to sex trade workers and the prison population — its changing shape made it hard for AIDS workers to focus their response, he says.

"We have had to do more work in the last 10 years than many of these other groups because our population shifted so quickly … and that has created pressures in itself because the resources haven't grown the way we would have liked," says Barlow.

Plus, poverty, lower education levels, poor housing, and the leftover scars from the residential school years have resulted in more high-risk activities, such as higher intravenous drug use in the aboriginal community, he says.

"These types of lifelong traumas don't just go away. And sadly, some people turn to negative coping patterns, which include addiction," he says.

Mounting a response

The Canadian government hasn't responded adequately, Toulouse says.

"A $5.1 billion commitment was made at the First Ministers Meeting in Kelowna last November to eliminate poverty among the First Nations over the next 10 years," he says. "This included $1.3 billion in new health investments. So far none of this has been approved by the Conservative government."

The Assembly of First Nations estimates that the health-funding shortfall will reach close to $2 billion over the next five years, he says, most likely resulting in cutbacks to HIV/AIDS prevention and promotion programs.

"I would say there would still be a stigma (about HIV and AIDS) in the aboriginal community, because of the lack of resources that aren't there to provide the education and awareness to the youth, and also to the general First Nations population as a whole," Toulouse says.

To stop the rising numbers of HIV-infected aboriginal people, more resources need to be directed towards the front lines, says Barlow.

"Since the Conservative government took (office), four aboriginal AIDS organizations have closed their doors. Two of them have reopened, because the funding finaly started flowing. But two of them remain closed in Manitoba. So here we are listed in the federal initiative as a target population, but yet our service agencies are closing down."

He says even the existing organizations are overwhelmed — some have just two or three workers to serve an entire province.

It's only been recently that the federal government has allotted money to deal with AIDS, of which portions are earmarked for aboriginals, he says. Despite losing loved ones to the disease himself, Barlow says he's optimistic about the future.

"I must continue to make sure there are more people in our communities that don't get infected.

"And when there are people living [with] HIV, that we support them and we stand by them. That's the aboriginal way. We don't have the luxury of throwing away any of our people because we've had so much loss."

Aboriginal prevention strategies needed to curb AIDS epidemic - Last Updated Tue, 15 Aug 2006

Indigenous people worldwide are so disproportionately affected by the HIV epidemic that their survival is at risk, the International AIDS Conference in Toronto heard Tuesday.

Yvonne Davis (Robin Rowland/CBC) Yvonne Davis (Robin Rowland/CBC)

To suggest the possibility of a population collapse is not being alarmist, said Clive Aspin of the National Institute of Research Excellence in Maori Research and Development at the University of Auckland in New Zealand.

In New Zealand and Canada, indigenous people are over-represented in the HIV epidemic. Although men who have sex with men are the main group affected among non-aboriginals, heterosexual transmission is higher among indigenous people in both countries. 

In Canada, aboriginals accounted for an estimated 7.5 per cent of HIV infections at the end of 2005, and 9 per cent of all new HIV infections in 2005 — an estimated overall infection rate that is three times higher than for non-aboriginals.

The problem is likely more alarming than the estimates suggest, given that Ontario does not collect data on ethnicity, Aspin noted.

Indigenous prevention strategies

Before the arrival of colonizers, indigenous people in New Zealand were healthier and had longer life expectancies than Europeans, Aspin said.

In the past, Western textbooks have portrayed indigenous people as weak and uncivilized, and when researchers saw differences they didn't understand, they would make up an explanation without considering indigenous perspectives.

Today, indigenous people "want research that produces benefits for us," he said to applause from the audience.

Kevin Barlow (Robin Rowland/CBC) Kevin Barlow (Robin Rowland/CBC)

The research must include people infected by HIV, and prevention strategies should widen their focus from the individual to the community of family and friends who support those who are HIV positive.

Reducing the HIV epidemic among indigenous people needs research into indigenous prevention methods, said Yvonne Davis, president of the board of directors at the National Native American AIDS Prevention Center and a consultant to the University of New Mexico's Center for Health Promotion and Disease Prevention.

"Indigenous people have shown remarkable resiliency in the face of extreme adversity and dispossession of land," Aspin told a symposium at the conference.

"If our ancestors could do it, so can we."

++++++++++++++++

AIDS hidden among the Inuit, says health worker - Last Updated: Monday, August 14, 2006

A woman who works for better sexual health among the Inuit says AIDS is more prevalent in Nunavut's scattered communities than people know.

A new report by the Public Health Agency of Canada shows that aboriginal people account for nearly a quarter of new HIV cases in Canada.

"There's a hidden epidemic among Inuit communities, for sure," said Aideen Reynolds of the Pauktuutit Inuit Women of Canada.

The numbers, released in a report titled HIV and AIDS in Canada, show 22.7 per cent of positive HIV tests done in Canada last year came from aboriginal Canadians.

However, it shows no reported cases coming from Nunavut.

While the numbers don't distinguish between First Nations, Inuit and Métis groups, Reynolds says she's certain the disease is spreading among Inuit.
 
She believes many don't get tested because of the lack of anonymity in small communities. Some may go to Montreal or Ottawa for a test, but she never gets to see those numbers.

"But at some point, if people start being tested and testing positive we do think there will be an explosion," she said.

Reynolds hopes this week's international AIDS conference in Toronto will open the eyes of all governments to a problem that remains hidden in many northern communities.

"The more education we have, the more awareness we have, if we can nip it in the bud, that's a lot better than having to deal with something coming at us with full force as it is going on in other countries," said Pitsyulala Layta, who co-ordinates HIV programs in the North for Pauktuutit.

Reynolds says right now strategies don't appear to be working, and she calls them short-term and poorly funded.

She said what really needs to happen is a change of attitude about sexual health among the Inuit.