March 19, 2019
Reflections on National Native HIV/AIDS Awareness Day: Examining Inequities in the Global Response to HIV/AIDS
By Trevor Stratton, Coordinator for the International Indigenous Working Group on HIV & AIDS for the Canadian Aboriginal AIDS Network
Growing up as a member of the Mississaugas of the Credit First Nation near Toronto, Canada, I was a first-hand witness to how the disparities in HIV/AIDS health care impact Indigenous communities. My story, unfortunately, was not an uncommon one: I learned in 1990 that I was HIV positive, and years later that it had progressed to AIDS. I was forced to face my own fears and stigma associated with acquiring HIV during the height of the epidemic. Thankfully, through the support of the Canadian Aboriginal AIDS Network (CAAN), I realized that I didn’t need to confront this journey alone and I could still live a normal, healthy and purposeful life. That’s when I decided to take action and join forces with CAAN to provide support to others living with HIV/AIDS and advocate for equitable and culturally-sensitive care for this resilient yet underserved population.
When population size is taken into account, the Indigenous population ranks fourth in the US, among ethnicities, in rates of HIV/AIDS. To understand the complexities associated with HIV in the Indigenous population, it’s necessary to consider the Indigenous Peoples’ long history of mistrust towards health and social services stemming from colonialism, displacement, systemic violence and racism, which continue to this day. With about 560 federally-recognized Indigenous tribes who speak more than 170 languages, cultural diversity presents a challenge in HIV prevention. Continued downward pressure on the determinants of Indigenous health has resulted in poverty, multi-generational trauma and high rates of alcohol and drug use contributing to the prevalent rates of HIV in our communities. Aggravating the problem, stigma and racism continue to restrict Indigenous Peoples’ essential access to culturally-appropriate treatment, care and support.
I am proud to be a member of the Conference Coordinating Committee for the 23rd International AIDS Conference (AIDS 2020), enabling the voice of diverse Indigenous communities to be heard. AIDS 2020 is the largest gathering in the world for HIV/AIDS professionals and will take place in San Francisco and Oakland in July 2020.
Indigenous healthcare needs to be front and center in the national conversation, yet to this day it remains painfully ignored. The conference represents an opportunity to stand together with the Indigenous Peoples as a community in the fight against the epidemic. There, we will address the obstacles to reducing HIV disparities and enhancing the health and well-being of Indigenous Peoples. We will explore ways to improve access to HIV services, provide comprehensive prevention information and resources and offer health care services delivered by members of the Indigenous community. We will work to prioritize the accurate representation of Indigenous Peoples in epidemiological data and clinical research. At the core of the HIV response is the right to healthcare for every person, including our Indigenous communities.
All narratives, expertise and experiences must be considered as we move closer to zero new HIV/AIDS cases and ultimately, a cure. In fact, AIDS 2020 is being held on sacred Indigenous lands. During the conference we will welcome delegates to a ceremony honoring the land, an added opportunity to shine a bright light on the Indigenous experience with HIV/AIDS and our role in ending the epidemic. We know how far we have come, and after AIDS 2020, we will have a better understanding of where we still need to go.
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