By Jen Lahey
There are complex reasons why aboriginal women with HIV/AIDS are not getting adequate care, says a new study that’s due out this month.
“Instead of accessing the care of physicians, they’re using the emergency room more than males,” says Randy Jackson, a researcher at the Canadian Aboriginal AIDS Network (CAAN) in Ottawa.
“At a grassroots level, women put the needs of their dependants over their own. They tend to wait too long for care and have to go to emergency,” Jackson says.
About half of all new HIV cases among Aboriginals in Canada are women, making them one of the fastest growing infectedgroups in the country. Among non-Aboriginals, women make up about a third of new cases.
The Aboriginal Strategy on HIV/AIDS in Canada, authored by Kevin Barlow, CAAN executive director, was released a year and a half ago, with input from over 170 people and agencies.
The report identified nine strategic areas that need to be addressed in order to better prevent and treat HIV/AIDS among Aboriginals, and says more work has to be done on “engaging groups with special needs.” Aboriginal women have been identified as one of these groups.
In last month’s federal budget, the Liberal government allotted an additional $84.4 million to fund research and treatment of HIV/AIDS, but Barlow says it will be at least a month before it’s known how much of this money will go toward initiatives aimed at Aboriginals.
Jackson says poverty, feelings of powerlessness and the fact that aboriginal people tend to become infected at a younger age than other populations, all contribute to the rise in HIV/AIDS among aboriginal women.
The study also found that 17 per cent of aboriginal respondents with HIV/AIDS had attended residential schools, “where we know physical and cultural abuse occurred. This may be a reason why so many, women included, are getting involved in intravenous drug use,” and then are becoming infected with HIV.
Low self-esteem caused by sexual assault may also contribute to behaviour that puts women at a higher risk for contracting HIV.
In addition to intravenous drug use, there is also excessive drinking and unprotected sex, says Barlow.
“There is some evidence that when women go through an assault, they’re more predisposed to contract HIV. Not just from an [HIV] positive attacker, but because of all the psychological ramifications,” says Barlow.
And intravenous drug use not only increases a woman’s risk of contracting HIV, but also makes accessing health-care services more problematic for those who have been infected, says Margaret Aken, executive director of the Saskatchewan-based All Nations Hope AIDS Network.
“One major fear for women who are struggling with an addiction is that if they seek help they will get their kids taken away. This is a real fear for them.”
The study identified other barriers that keep aboriginal women from seeking treatment. Over 30 per cent of the respondents said perceived racism and homophobia among doctors and other health care professionals contributed to keeping them from seeking primary treatment.
In addition, pharmaceutical care is tailored to men: most drugs developed for treating HIV/AIDS are tested on male subjects. Treatment options need to be created that take into account the fact that the number of female HIV/AIDS sufferers are on the rise, Barlow says.
In addition, many aboriginal women who are infected are single parents, says Aken, and that means dealing with a host of other issues, such as how to support the family, when to tell the kids and how to access health care.
“Families need to be supported in their walk on a healing journey,” she says.
Aken says that the spread of HIV/AIDS should also be addressed on a community basis, and thinks the situation could get worse before it gets better.
“Until we start having to deal with the actual cases among our children, that is when the community will understand the issue,” she says.
“AIDS is 100 per cent preventable. This disease is a symptom of many other health and social impacts that the aboriginal community is struggling with.”