Canada: Aboriginal Youth Resilience to HIV/AIDS (ACRA), 1998-present
A quarter century of HIV/AIDS research suggests that communities cut off from mainstream information sources and health care can be at a disproportionate risk of sexually transmitted infections (STIs) and blood borne viruses (BBVs) including HIV infection. Many of those at risk are young people. First Nations, Métis and Inuit make up roughly 3% of the Canadian population yet represent an estimated 6-12% of new HIV infections. Some 40% of all new infections among First Nations, Métis and Inuit are under 30 years of age.
CIET has been working to address these health inequalities and their implications since 1998. We first collaborated with the Assembly of First Nations in a study on youth resilience to HIV/AIDS in two rural locations in the James Bay region and two urban centres – Montreal and Winnipeg. The results showed that accurate knowledge of HIV/AIDS risks was considerably lower in remote communities.
Building on this experience, and guided by the Alberta Treaty 8 ACRA Elders Advisory Committee, we have been laying the foundation for community-based studies on Aboriginal youth resilience to HIV/AIDS and related diseases with several Alberta Treaty 8 communities in rural Alberta. Beginning in 2007, community-based researchers conducted a baseline study around sexual health, HIV/AIDS, blood-borne-viruses and sexually transmitted infections. The specific objectives of the project were to: identify community strengths through community-led research; help communities implement and evaluate actions to build on youth resilience; and reduce the risk of HIV/AIDS and sexually transmitted diseases. As of May 2010 a pilot phase conducted among 415 youth had been completed and its results socialised as preparation for the full roll-out to the remaing communities whose youth component totals nearly 6000.
In the Tlicho region of the Northwest Territories of Canada, the Tlicho Community Services Agency’s Healing Wind Advisory Committee and CIET facilitated research to support community interventions targeting sexually transmitted infections and HIV/AIDS. As with Treaty 8, the Tlicho recruited and trained community-based researchers who carried out a survey on sexual health attitudes and behaviours in all four Tlicho communities, covering 65% of the population above 9 years of age. A summary report on the Tlicho baseline survey is available from the library, and an article was published in the Summer 2008 edition of Pimatisiwin: A Journal of Indigenous and Aboriginal Community Health.
A nine-minute video entitled “The Partnership” captures the experience of this project: Set in the beautiful Northwest Territories, the video explores how Aboriginal communities are working with health researchers for the community’s benefit. Told through the eyes of Tlicho community-based researchers, “The Partnership” demonstrates that no matter what the issue, the solutions always lie within the community. Link:http://media.extension.ualberta.ca/media/show_item.php?buttonClick=1
Their experience and outcomes derived from the baseline study helped urge the Tlicho in 2009 to create a Community Action Research Team (CART) who operate under the authority of the Tlicho Community Services Agency and are implementing programs to address community wellness, including sexual health. CART are currently working with CIET and the Healing Winds Advisory Committee to design and implement a follow-up study.
Similar work is underway with Inuit living in the Ottawa/Gatineau area. A team of Inuit researchers who are part of the Inuit Community Action Research Team (ICART) developed the urban Inuit questionnaire, based on that used in the ACRA Treaty 8 component with input from a series of cognitive mapping sessions aimed at identifying likely Inuit resilience factors. ICART has an advisory group made up of researchers and representatives from various Inuit organisations such as Inuit Tapiriit Kanatmi, Pauktuutit, Mamisarvik Healing Centre, Sivummut Head Start and Tungasuvvingat Inuit. The instrument has been translated into Inuktitut and, as of May 2010, was being piloted. Data collection, entry and analysis are planned for the second half of 2010. The results will provide training material for the annual Inuit Institute for Research and Planning conducted by CIET each year in November.
This project is supported by an International Collaborative Indigenous Health Research Parrtnership grant from the Canadian Institutes of Health Research (CIHR). Partner countries are Australia and New Zealand. CIET’s Canadian partners on the research team are the Canadian Aboriginal AIDS Network (CAAN) and the Public Health Agency of Canada. The special issue of Pimatisiwin mentioned above also published the research proposal and a sample data sharing agreement for this project.