AIDS advocates call for support as epidemic grows in aboriginal communities

As the number of aboriginal people living with HIV and AIDS in Canada grows, efforts to address the situation should consider the social factors, such as poverty, behind the epidemic, advocates say.

But for much-needed progress to be made, the stigma and discrimination borne by aboriginal people with AIDS must end, according to the Canadian Aboriginal AIDS Network. That’s why the network is calling on First Nations, Métis, and Inuit leaders ahead of Valentine’s Day, and asking them to speak out on the issue in public.

"A lot of us take it for granted. If we’re healthy and living with friends and family and loved ones around us, we think that everything’s all right in the world," Kevin Barlow, the network’s executive director, told the Georgia Straight by phone from Ottawa. "In reality a lot of aboriginal people who are living with HIV and AIDS talk about the isolation and the rejection they experience."

Hearing leaders denounce discrimination and then endorse AIDS prevention, harm-reduction, and treatment programs, he said, will help create more supportive environments in aboriginal communities and encourage those at risk of or living with human immunodeficiency virus or acquired immune deficiency syndrome to get tested or seek assistance.

"When the awareness level is low, then you have higher levels of stigma and discrimination," Barlow said. "When you can inform and educate people, then you bring the stigma and discrimination levels down a bit, because people are more informed and they’re not afraid."

Statistics show aboriginal people—who compose 3.8 percent of Canada’s population, according to the 2006 census—are overrepresented among cases of HIV and AIDS in Canada, and the percentages continue to rise.

According to statistics published by the Public Health Agency of Canada, aboriginal persons made up 3.1 percent of reported AIDS cases with information on ethnicity from 1979 to 2003, and 23.4 percent of positive HIV-test reports from 1998 to 2003. In 2003, 13.4 percent of reported AIDS cases involved aboriginal persons, up from 1.2 percent before 1993. Aboriginal persons composed 25.3 percent of positive HIV-test reports in 2003, up from 18.8 percent in 1998.

Women and youth are also disproportionately represented among new infections in the aboriginal population, compared to the non-aboriginal population.

"Infection rates are far worse here amongst aboriginal people than they are among some Third World developing countries," Shawn Atleo, regional chief of the British Columbia Assembly of First Nations, told the Straight. "This should be a general public concern, not just an aboriginal-health issue."

Atleo said he’s willing to speak publicly to fight the stigma and discrimination that still surround AIDS and to support the work of people in the field.

"This is very personal, I think, for everyone in our community. You don’t have to go far," he said. "I lost one of my childhood friends to the disease, from Ahousaht, west coast of Vancouver Island—not on the Downtown Eastside. This is in our communities everywhere."

Ken Clement, president of the Canadian Aboriginal AIDS Network and executive director of the Vancouver-based Healing Our Spirit BC Aboriginal HIV/AIDS Society, said financial, human, and technical resources are needed in communities across the province to support aboriginal people living with the disease. Indeed, he said, the lack of resources in rural communities can lead people with AIDS to seek out services in Vancouver.

"If we don’t have those resources I talked about, it’s almost pointless to speak of our future as a nation if we don’t have the people," Clement said. "It’s kind of ironical that we talk about treaty process, but if we have our communities infected and affected by HIV and other health issues, then it seems to be a lost cause."

Both Barlow and Clement maintained social factors—such as poverty, lack of education and housing, foster care, and residential-school wounds—are driving the AIDS epidemic in aboriginal communities.

"When people are below poverty levels and they can’t get gainful employment and they’re struggling with mental-health challenges or these childhood wounds that come from things that they have no control over, it creates a very different dynamic for people," Barlow said.

Dirty needles are responsible for most new HIV infections among aboriginal people, he noted, adding that means there is much harm-reduction work to be done.

A study by the B.C. Centre for Excellence in HIV/AIDS, to be published in the March issue of the American Journal of Public Health, found aboriginal people in Vancouver who inject drugs are much more likely to have or to be infected with HIV than non-aboriginal injection-drug users.

Entering the study period, 25.1 percent of aboriginal participants were HIV-positive, compared to 16 percent of non-aboriginal subjects. Four years later, 18.5 percent of aboriginal participants reported new HIV infections, while only 9.5 percent of non-aboriginal persons did.

"Our findings demand a culturally appropriate and evidence-based response to the HIV epidemic among Aboriginal injection drug users," the study’s authors wrote, according to a draft.