Advertisement

Canadian Journal of Public Health

, Volume 98, Issue 3, pp 179–182 | Cite as

HIV Risk, Systemic Inequities, and Aboriginal Youth

Widening the Circle for HIV Prevention Programming
  • June Larkin
  • Sarah Flicker
  • Ruth Koleszar-Green
  • Susan Mintz
  • Michelle Dagnino
  • Claudia Mitchell
Article

Abstract

Background

In Canada, Aboriginal people are overrepresented in the HIV epidemic and infected at a younger age than non-Aboriginal people. This paper discusses some of the ways Aboriginal youth in Toronto understand HIV/AIDS risk and the relevance of their comments for HIV prevention education. This research is part of a larger study conducted with Ontario youth through the Gendering Adolescent AIDS Prevention (GAAP) project.

Methods

We conducted 11 GAAP focus groups with Ontario youth. This paper focuses primarily on the four groups of Aboriginal youth. A modified grounded theory approach guided analyses. Data were coded using Nud*ist qualitative data management software.

Findings

Aboriginal youth were more aware of HIV/AIDS and the structural inequities that contribute to risk than their non-Aboriginal counterparts. In addition, they were the only group to talk about colonialism in the context of HIV in their community. Aboriginal youth were, however, more likely to hold a fatalistic view of their future and to blame their own community for high infection rates.

Interpretation

We argue for incorporating structural factors of risk, including the legacy of colonialism, in HIV prevention programs for all youth. This may help to eradicate the stigma and self-blame that negatively impact on Aboriginal youth while allowing other youth populations to distance themselves from the disease.

MeSH terms

Aboriginal adolescent HIV risk prevention colonialism 

Résumé

Contexte

Au Canada, les Autochtones sont surreprésentés dans l’épidémie de VIH, et ils sont infectés à un âge moins avancé que les non-Autochtones. Dans cet article, il est question de la perception du risque de contracter le VIH chez les jeunes Autochtones de Toronto et de la pertinence des commentaires de ces jeunes pour les programmes d’éducation visant à prévenir le VIH. Cette étude s’inscrit dans une étude de plus grande envergure menée auprès des jeunes Ontariens dans le cadre du projet GAAP (Gendering Adolescent AIDS Prevention).

Méthode

Nous avons organisé 11 groupes de discussion GAAP avec des jeunes Ontariens. Dans cet article, nous nous intéressons principalement aux quatre groupes composés de jeunes Autochtones. Nos analyses se sont inspirées d’une approche théorique à base empirique modifiée. Les données ont été codées à l’aide du logiciel de gestion de données qualitatives Nud*ist.

Résultats

Les jeunes Autochtones étaient plus conscientisés que leurs concitoyens non- Autochtones au VIH et au sida, ainsi qu’aux inégalités structurelles qui font augmenter le risque de contracter le virus. De plus, ils ont été les seuls à parler du colonialisme dans le contexte du VIH dans leur communauté. Les jeunes Autochtones étaient cependant plus susceptibles d’envisager l’avenir avec fatalisme et de blâmer leur propre communauté pour les taux d’infection élevés qui y prévalent.

Interprétation

Nous préconisons l’intégration de facteurs de risque structurels, y compris l’héritage du colonialisme, dans les programmes de prévention du VIH, et ce, pour tous les jeunes. Cette mesure pourrait contribuer à éradiquer la stigmatisation et l’auto-accusation dont souffrent les jeunes Autochtones tout en permettant aux autres groupes de jeunes de prendre leurs distances par rapport à la maladie.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    HC. HIV/AIDS among Aboriginal people in Canada: A continuing concern. HIV AIDS Epi Update. Health Canada, 2004.Google Scholar
  2. 2.
    CDCP. HIV/AIDS Epi Update: HIV and AIDS Among Youth in Canada. Ottawa, ON: Centre for Disease Prevention and Control, Health Canada, 2003.Google Scholar
  3. 3.
    UNAIDS. Canada. Epidemiological Facts Sheets on HIV/AIDS and Sexually Transmitted Infections. Switzerland: UNAIDS/WHO Working Group on Global HIV/AIDS, 2004.Google Scholar
  4. 4.
    Albertyn C. Contesting democracy: HIV/AIDS and the achievement of gender equality in South Africa. Feminist Studies 2003;29(3):595–615.Google Scholar
  5. 5.
    Farmer P. Infections and Inequalities: The Modern Plagues. Berkeley, CA: University of California Press, 1999.Google Scholar
  6. 6.
    Flicker S, Skinner H, Read S, Veinot T, McClelland A, Saulnier P, Goldberg E. Falling through the cracks of the big cities: Who is meeting the needs of HIV-positive youth? Can J Public Health 2005;96(4):308–12.PubMedGoogle Scholar
  7. 7.
    Flicker S, Goldberg E, Read S, Veinot T, McClelland A, Saulnier P, et al. HIV-positive youth’s perspectives on the internet and e-health. J Med Internet Res 2004;6(3):e32.CrossRefPubMedCentralPubMedGoogle Scholar
  8. 8.
    Veinot T, Flicker S, Skinner H, McClelland A, Saulnier P, Read S, Goldberg E. “Supposed to make you better but it doesn’t really”: HIVpositive youths’ perceptions of HIV treatment. J Adolesc Health 2006;38(3):261–67.CrossRefPubMedGoogle Scholar
  9. 9.
    Young, TK. Review of research on aboriginal populations in Canada: Relevance to their health needs. Br Med J 2003;327:419–22.CrossRefGoogle Scholar
  10. 10.
    Strauss A, Corbin J. Grounded theory methodology: An overview. In: Lincoln YS, Denzin NK (Eds.), Handbook of Qualitative Research. Thousand Oaks, CA: Sage Publications, 1994.Google Scholar
  11. 11.
    Strauss A, Corbin J. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage Publications, 1990.Google Scholar
  12. 12.
    Taylor SJ, Bogdan R. Introduction to Qualitative Research Methods: A Guidebook and Resource, 3rd, ed. New York, NY: John Wiley & Sons, Inc., 1998.Google Scholar
  13. 13.
    Charmaz K. Grounded theory: Objectivist and constructivist methods. In: Denzin NK, Lincoln YS (Eds.), Handbook of Qualitative Research, 2nd, ed. Thousand Oaks: Sage Publications, Ltd, 2000;509–36.Google Scholar
  14. 14.
    Glaser BG, Strauss, AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, IL: Aldine, 1967.Google Scholar
  15. 15.
    Flicker S. “Ask me no secrets, I’ll tell you no lies”: What happens when a respondent’s story makes no sense. The Qualitative Report 2004;9(3):528–37.Google Scholar
  16. 16.
    Israel BA, Eng E, Schulz AJ, Parker, EA. Methods in Community-Based Participatory Research for Health. San Francisco, CA: Jossey Bass, 2005.Google Scholar
  17. 17.
    Lincoln YS, Guba E. Naturalistic Inquiry. Beverly Hills, CA: Sage, 1985.CrossRefGoogle Scholar
  18. 18.
    Cresswell J. Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Thousand Oaks: Sage Publications, 1998.Google Scholar
  19. 19.
    Miles MB, Huberman, AM. Qualitative Data Analysis: A Sourcebook of New Methods. Beverly Hills: Sage, 1984.Google Scholar
  20. 20.
    Devers, KJ. How will we know “good” qualitative research when we see it? Beginning the dialogue in health services research. Health Serv Res 1999;34(5):1153–88.PubMedCentralPubMedGoogle Scholar
  21. 21.
    Larkin J, Mitchell C, Flicker S, Dagnino M, Koleszar-Green R, Mintz S. HIV risk, prevention education, and youth. Toronto, ON: Report to the Canadian Foundation for AIDS Research (CANFAR), 2004.Google Scholar
  22. 22.
    Patton C. Globalizing AIDS. Minneapolis, MN: University of Minnesota Press, 2002.Google Scholar
  23. 23.
    Patton C. Inventing ‘African AIDS’. In: Parker R, Aggleton P (Eds.), Culture, Society and Sexuality. London, UK: UCL, 1999;387–404.Google Scholar
  24. 24.
    AHS. Access and Utilization of Health Care Services and HIV Testing among British Columbia’s First Nation. Vancouver, BC: Aboriginal HIV/AIDS Society, Healing Our Spirit, 2004.Google Scholar
  25. 25.
    CAAN. HIV Prevention Messages for Canadian Aboriginal Youth. Ottawa: Canadian Aboriginal AIDS Association (CAAN). 2004.Google Scholar
  26. 26.
    An Ethnographic/community based research investigation into why First Nation youth take risks: Recommendations for health care providers, youth and elders on HCV prevention. (poster). Canadian Association for HIV Research Conference (CAHR), Vancouver, BC, 2005.Google Scholar
  27. 27.
    HC. Research on HIV/AIDS in Aboriginal people: A Background Paper. Winnipeg, MB: Health Canada & University of Manitoba, 1998.Google Scholar
  28. 28.
    Matiation S. Canadian HIV/AIDS Policy & Law Newsletter 1999;4(2/3).Google Scholar
  29. 29.
    CAAN. Strengthening Ties — Strengthening Communities. An Aboriginal Strategy on HIV/AIDS in Canada for First Nations, Inuit and Métis People. Ottawa: Canadian Aboriginal AIDS Network (CAAN), 2003.Google Scholar
  30. 30.
    Hackett P. From past to present: Understanding First Nations health patterns in a historical context. Can J Public Health 2005;96(Suppl. 1):S17–S21.PubMedCentralPubMedGoogle Scholar

Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  • June Larkin
    • 1
  • Sarah Flicker
    • 1
    • 2
  • Ruth Koleszar-Green
    • 1
    • 3
  • Susan Mintz
    • 1
    • 4
  • Michelle Dagnino
    • 1
    • 5
  • Claudia Mitchell
    • 6
  1. 1.The Gendering Adolescent AIDS Prevention (GAAP) Project, Undergraduate Coordinator Women and Gender Studies, Women and Gender Studies Institute, New CollegeUniversity of TorontoTorontoCanada
  2. 2.Faculty of Environmental StudiesYork UniversityTorontoCanada
  3. 3.Social WorkRyerson UniversityTorontoCanada
  4. 4.Urban StudiesUniversity of TorontoCanada
  5. 5.Osgoode Law SchoolYork UniversityCanada
  6. 6.The Gendering Adolescent AIDS Prevention (GAAP) Project, Faculty of EducationMcGill UniversityMontrealCanada

Personalised recommendations