Aboriginals using injection drugs are twice as likely to contract HIV than non-aboriginals, despite access to the same harm-reduction resources, a new study suggests.
The BC Centre for Excellence in HIV/AIDS 2007 study found that native people living in Vancouver and using injection drugs are more susceptible to HIV.
Aboriginal participants were more likely to be women, young, reside in downtown Eastside Vancouver, be involved in the sex-trade, inject cocaine daily and have unsafe sex, according to the study.
As with prison populations, aboriginals are over represented when it comes to HIV infection.
That says harm-reduction programs aren’t working for minorities, said Patricia Bacon, Blood Ties Four Directions Centre executive director.
“When it comes to HIV prevention with regards to the aboriginal population, we’re still missing the mark and delivering programs that aren’t working,” said Bacon.
“On a national level, aboriginal people are overly represented for HIV transmissions.”
Similar situations and numbers are probably found in other urban areas with a large aboriginal population, said Lucy Barney, study co-author and nursing consultant.
“We feel safe with each other, and drugs are introduced quite quickly at a young age,” she said.
“Many of our people aren’t employed or don’t have an education.”
This is where coping mechanisms, like drugs and alcohol, come in, she added.
But the perception of addictions is misguided, she said.
“Addiction is being thought of as a criminal action when it’s a health matter, or an illness,” said Barney.
One-third of all new HIV infections outside of sub-Sahara Africa can be attributed to injection drug use, according to the United Nations.
In North America, one in four HIV infections is caused by injecting drugs.
Nearly 58,000 men and women are HIV positive, according to the study.
Aboriginal people make about 40 per cent of Blood Ties’ clients, said Bacon.
But there are no numbers to show how many people inject drugs in the territory.
“All we know is who comes to the needle exchange,” she said.
Despite having access to the same harm-reduction and needle-exchange programs and resources in Vancouver, or elsewhere, aboriginals are still infected at a higher rate.
“That has to make us question what messages we’re sending about access to harm reduction that’s not resonating with aboriginal people,” said Bacon.
“Obviously there are barriers in the Downtown Eastside, or even downtown Whitehorse, that need to be looked at critically.”
Blood Ties is holding a two-day conference on harm reduction for northerners.
Delegates will hear health and policy experts speak on issues related to First Nations and harm reduction in the Yukon.
Aboriginal-run organizations, like Canadian Aboriginal AIDS Network, appear to have more success than non-aboriginal programs, said Bacon.
But one problem affects all HIV/AIDS organizations running targeted harm reduction projects, she added.
“We tend to fund projects on a year-by-year basis,” said Bacon.
That leaves little opportunity to study a program’s long-term success.
A project receives one year’s worth of funding set aside for the aboriginal population, then the money runs out and there’s only new money for another project, said Bacon.
“The funders say, ‘If you’ve got a new project, we’ll fund it, but not your old one,’” said Bacon.
“You don’t have enough time to implement programs and run them long term, and fine tuning and tweaking and looking at long-term results.”
Organizations need stable funding to research best practices, she added.
The study followed two groups of injection drug users in Vancouver, one since1996 and the second since 2003, and compared rates of HIV infections.
By the end of the study period, 18.5 per cent of aboriginal participants reported HIV infection compared to 9.5 per cent for non-aboriginals.
Just under 2,500 people participated in the study, 23.4 per cent of which self-identified as aboriginal — Métis, First Nation or Inuit.
Aboriginal people tend to have a lower life expectancy, higher rates of chronic diseases and lower access to health care and prevention services, says the report.
Because of the higher infection rate among aboriginals, a culturally targeted and evidence-based response to HIV/AIDS is needed to reverse the trend, said the researchers.
Too many resources are spent on law enforcement, which has had limited success in stemming drug trafficking and lowering use, said researchers.
The effect of ineffective drug policy is felt harder in aboriginal communities.
Drug and alcohol awareness starts at home so there should be more educational and training resources for parents, said Barney.
Organizations like Blood Ties need more support, too.
Addictions support is only a stopgap measure because the problem is more deeply rooted, said Barney.
“If you need an education, you need housing and you need an income,” she said.
While representing three per cent of the Canadian population, aboriginals make up more than 20 per cent of people in jail.
Many of those incarcerated are there because of drug-related offences.
A health and social approach, with mix of traditional culture, to addictions is more appropriate, said Barney.
Similar programs have yet to see significant results, said Bacon.
“We don’t know yet what a culturally meaningful program looks like,” said Bacon.
“It’s difficult to get people to talk about injection drugs.”