For years, researchers and advocacy groups have demanded immediate, hard action to combat the spread of HIV/AIDS through aboriginal populations.
Nevertheless, the incidence of Acquired Immune Deficiency Syndrome and Human Immunodeficiency Virus in First Nations, Metis and Inuit communities continues to rise, according to Health Canada.
“We used to say that there was one aboriginal person infected per day with HIV,” said Art Zoccole, executive director of 2 Spirits, a Toronto-based organization for gay and lesbian aboriginal people with HIV/AIDS.
“Now you can see it’s gone higher than that — it’s more like one and a half aboriginal people per day,” said Zoccole from Toronto.
Before 1993, 1.2 per cent of reported AIDS cases were among aboriginal people; by 2003, it increased to 13.4 per cent, according to numbers from Health Canada.
And, in 1998, 18.8 per cent of positive HIV test reports were from aboriginal peoples. ‘
By 2003 that had increased to 25.3 per cent.
The threat to Canada’s aboriginal communities has been compared to the epidemic in Africa.
In 2005, Dr. Patricia Spittal, who works with the BC Centre for Excellence in HIV/AIDS, released preliminary statistics from a study of aboriginal intravenous drug users in Vancouver.
“If not addressed aggressively in small reserves and rural areas, it is believed that the virus can potentially wipe out whole communities, as demonstrated in the early phases of the epidemic in sub-Saharan Africa,” Spittal told the Globe and Mail in May 2005.
HIV is spread through unprotected sex, sharing needles or equipment for injecting drugs, using non-sterilized needles for tattooing or piercing and through occupational exposure in health-care settings.
As well, infected mothers can pass it on to their newborns.
There are treatments to hinder the progress of AIDS, like antiretroviral drugs that suppress HIV reproduction, but there is no known cure or vaccine.
In terms of AIDS/HIV infection, aboriginal populations differ from non-aboriginal populations in three distinct ways.
First, females are at a higher risk.
Women make up half of all positive test reports from aboriginals, compared to 20 per cent of reports in non-aboriginal populations.
Second, the disease hits younger people in aboriginal communities.
One-quarter of aboriginal AIDS diagnoses are from people under the age of 30, as compared to 16 per cent across Canada, said Randy Jackson, Canadian Aboriginal AIDS Network research manager in an interview from Ottawa.
And third, aboriginals are more likely to have contracted the disease through intravenous drug use.
“Perhaps the most significant contrast one can point to is that the aboriginal population is about 5.5 times more likely to have contracted HIV through injection-drug use than the general population,” said Jackson.
Before 1993, 10.9 per cent of reported AIDS cases among aboriginal people were attributed to injection-drug use.
By 2003, the figure increased to 58.3 per cent, according to numbers from Health Canada.
Social circumstances, like poverty, lack of education, and the dark legacy of residential schools, contribute to the growing epidemic, said Jackson.
“You’re poor, you have no money and you make different priorities in your life — it doesn’t cause, but it would facilitate activities that lead to infection.”
“I call it aboriginal reality. Social-economic conditions, like residential school, the loss of parenting, unemployment — and the list goes on and on,” said Zoccole.
“That’s our reality and that puts aboriginal people at risk for HIV infection through unsafe sex practices and through injection drugs.”
And aboriginal communities face special obstacles to getting tested and getting treatment.
First is the stigma carried by a disease like HIV/AIDS.
News travels fast, especially through small communities, which makes people shy away from testing.
“There are issues of confidentiality in small communities; if you are known to be HIV positive, for example, that information can travel very quickly through a small community and that raises issues of stigma,” said Richard Elliott, deputy director of the Canadian HIV/AIDS Legal Network.
“One problem we have here is that people aren’t being tested because there’s so much stigma — they’re afraid to be ostracized from their families and communities,” said a spokesperson for All Nations Hope, a Regina-based aboriginal AIDS organization.
Second, it’s common for aboriginal communities, like reservations, to fall through jurisdictional cracks in the healthcare system.
They often get bounced between various levels of government.
Third, it’s harder to access necessary testing and follow-up care in small communities.
“People needing to travel for testing creates an additional barrier to people finding out their HIV status,” said Elliott.
And fourth, like in many other communities, misinformation and homophobia are roadblocks to discussion, said Zoccole.
“Some aboriginals think AIDS is a gay, white-man’s disease,” he said. “They think ‘It’s not going to happen to us.’”
So, to be effective, education must be geared toward aboriginals.
And the approach must incorporate traditional healing, spiritually and physically.
“Even though people might be on the anti-retrovirals the aboriginal component of their life — the physical, the emotional and the spiritual — is very important when addressing HIV and AIDS,” said Zoccole.
In the Yukon
Between 1985 and 2005, there were 58,929 positive HIV tests in Canada — 45 in the Yukon, according to a Public Health Agency of Canada report called HIV and AIDS in Canada.
But that’s not even the tip of the iceberg, said Patricia Bacon, executive director of Blood Ties Four Directions, a Whitehorse-based organization mandated to support and educate Yukoners on HIV/AIDS and hepatitis C.
Because of the stigma, many opt to go Outside for testing.
“The thinking that anybody can get HIV is both true and not true,” said Bacon.
“Social determinants of health make (aboriginal) populations more vulnerable to problematic behaviours, like drinking and drug use,” said Bacon.
Blood Ties doesn’t receive the funding to execute extensive outreach work in smaller communities, said Bacon.
But, for the first time in many years, the organization will have the funding to visit each Yukon community to give workshops on prevention of blood-borne diseases, like HIV and hepatitis C between now and March 2007.
The organization receives core funding of $125,000 a year through Ottawa’s AIDS Community Action Program, and $167,000 a year from Yukon Health and Social Services.