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AJPH First Look, published online ahead of print Jan 30, 2008
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©
American Journal of Public Health, 10.2105/AJPH.2007.114595

Research and Practice

Burden of HIV Infection Among Aboriginal Injection Drug Users in Canada

Evan Wood 1*, Julio S.G. Montaner 1, Kathy Li 2, Ruth Zhang 2, Lucy Barney 3, Steffanie A. Strathdee 4, Mark W. Tyndall 2, Thomas Kerr 2

1 University of British Columbia
2 BC Centre for Excellence in HIV/AIDS
3 BC Centre for Disease Control
4 University of California, San Diego

* To whom correspondence should be addressed. E-mail: uhri.cfe{at}gmail.com.


  Abstract

Objectives. We sought to examine whether there were differential rates of HIV incidence among Aboriginal and non-Aboriginal injection drug users in Canada.

Methods. Data were derived from 2 prospective cohort studies of injection drug users in Vancouver, British Columbia. Using the Kaplan–Meier method and Cox proportional hazards regression, we compared HIV incidence among Aboriginal and non-Aboriginal participants.

Results. Overall, 2496 individuals were recruited between May 1996 and December 2005. Compared with that of non-Aboriginal persons, the baseline HIV prevalence was higher among Aboriginal persons (16.0% vs 25.1%; P<.001). Among participants who were HIV negative at baseline, the cumulative HIV incidence at 48 months was higher among Aboriginal persons (18.5% vs 9.5%; P <.001). In multivariate analyses, Aboriginal ethnicity was independently associated with elevated HIV incidence (relative hazard=1.59; 95% confidence interval=1.12, 2.26; P =.009).

Conclusions. Aboriginal persons in Vancouver had a significantly elevated burden of HIV infection, which calls for a culturally sensitive and evidence-based response. Policymakers in other settings with at-risk Aboriginal populations should seek to avert similar public health emergencies by being proactive with evidence-based HIV-prevention programs.

Key Words: HIV/AIDS, Native Americans, Drugs, Urban Health




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