Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.

Reuters NewMedia - August 25, 2009
Rod Nickel

* Drug use bigger cause of infection than unsafe sex

WINNIPEG, Manitoba, Aug 25 (Reuters) - AIDS is spreading faster among Canada's aboriginal people than in the general population, and a strong cultural stigma and links to rising drug use make the problem difficult to solve.

One health official compared it last week to the AIDS epidemic in Africa and warned that up to 30 percent of the aboriginal population in the western province of Saskatchewan could die of AIDS within a decade.

Saskatchewan's top health official dismissed that prediction, but said the rapid spread of AIDS in the native population is a growing concern.

Many aboriginals, a broad term that includes Indians, Inuit and Metis, live in poverty and suffer poorer health than most other Canadians. They make up about 3.3 percent of the population, living mainly in western cities, the North and on rural reserves.

Despite their relatively small population, aboriginals accounted for almost one-quarter of Canada's reported AIDS cases in 2006 for which ethnicity was known, double the rate six years earlier, according to the Public Health Agency of Canada.

Intravenous drug use, especially among women, is the cause of more than half the infections with the human immunodeficiency virus (HIV), which leads to AIDS. Canadian non-aboriginal infections are mostly linked to unsafe sex.

Aboriginals with HIV infections also tend to be younger than other infected Canadians and more often women.

"(It's) partly because of the vulnerabilities of that group -- (especially) if they're addicted and dependent on the sex trade for their income," said Dr. Moira McKinnon, chief medical health officer for Saskatchewan.

INFECTION RATE ON RISE

The rate of HIV infection in Saskatchewan has risen rapidly among natives, McKinnon said. The province of 1 million people, had 174 new HIV cases last year, up 40 percent from 2007. Sixty-five percent of the new cases were aboriginals.

An estimated 73,000 Canadians were infected with HIV as of 2007, according to the United Nations AIDS agency. Worldwide, 33 million people had the HIV virus as of 2007, with almost one-third in southern Africa.

The spread of the AIDS virus in Canada is most acute among young aboriginal people who have moved from rural reserves to cities, said Ken Clement, chief executive of the Canadian Aboriginal AIDS Network.

Rates of diabetes and tuberculosis are also higher among aboriginals than in the general population, causing HIV infection to become fatal more quickly, Clement said.

Some aboriginals, once infected, are reluctant to use HIV drugs. "It's scary and a real concern," Clement said. "HIV becomes another layer of their disease."

A strong stigma about AIDS within aboriginal circles can also discourage testing and treatment, said Art Zoccole, a gay aboriginal man who is infected with HIV.

"Once you get outside the urban centers, I find the stigma still exists," said Zoccole, 57, who lives in Toronto. "The reason is the lack of information."

It all adds up to a problem without a one-size-fits-all solution, said Phat Ha, public health policy analyst for the Assembly of First Nations (AFN). Most government attempts to control the spread of AIDS center on safe sex, he said .

"There's a large portion (of the population) that's not being addressed, in particular the injection junkies," Ha said.

Saskatchewan will soon take steps to increase access to testing and anti-viral drugs, McKinnon said. She hopes to see the trend to rising HIV cases reversed as quickly as it arose.

"I'm optimistic that within a couple of years, we'll see those figures go down," she said. (Editing by Rob Wilson)

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