Abstract
BackgroundIndigenous young people are currently highly overrepresented in the HIV epidemic in Canada, especially in the Prairie Provinces, such as Manitoba. Understanding HIV-vulnerability in Indigenous peoples must begin with understanding that social determinants are intersectional and linked to the historical legacy of European colonization. In this paper findings that detail the influence of the intersectional social determinants on Indigenous people who become infected with HIV in their youth are presented.MethodsThe qualitative research design of phenomenology was used as it afforded the opportunity to understand Indigenous young people from their frames of reference and experiences of reality, resulting in a phenomenological understanding of their perspectives and experiences of the early years of living with HIV. A total of 21 Indigenous young people took part open-ended interviews.ResultsThe stories that the Indigenous young people shared revealed their deeply interconnected social worlds, and how social determinants including abuse, trauma, being part of the child welfare system, and housing and food security were connected throughout various stages of their lives. Such stages included childhood, adolescence and young adulthood (the time of HIV infection), and later adulthood for older participants with the social determinants having multiple influences on their health trajectories.ConclusionsThe findings highlight the need for policies and programs that are broadly focused, addressing multiple social determinants together. Overall, there needs to be more emphasis on the multiple social determinants in the life situations of all Indigenous youth. Reducing the health and social disparities in Indigenous youth is key to reducing the number of young Indigenous people diagnosed with HIV. The findings also shed light on the importance of listening to young Indigenous people who have experienced HIV diagnosis and life following diagnosis.
Highlights
Disparities relating to race and ethnicity have been strongly linked to a variety of health inequities for youth [1]
Relating to the broader Canadian context, scholars suggest that an understanding of Human immunodeficiency virus (HIV)-vulnerability in Indigenous peoples must begin with understanding the social determinants that are linked to the historical legacy
Of the 950 reported cases of infection in Indigenous youth (15–29) in Canada between 1998 and 2012, 63% of the cases were due to intravenous drug use (IDU) [3]. 26.4% were due to heterosexual contact, of which 6.7% was men who have sex with men (MSM) and 3.6% MSM/IDU [3]
Summary
Disparities relating to race and ethnicity have been strongly linked to a variety of health inequities for youth [1]. Relating to the broader Canadian context, scholars suggest that an understanding of HIV-vulnerability in Indigenous peoples must begin with understanding the social determinants that are linked to the historical legacy. Understanding HIV-vulnerability in Indigenous peoples must begin with understanding that social determinants are intersectional and linked to the historical legacy of European colonization. In this paper findings that detail the influence of the intersectional social determinants on Indigenous people who become infected with HIV in their youth are presented. An estimated 278 new HIV infections (10.8% of all infections) were reported among Canadian Indigenous peoples – a slight (1.7%) decrease from the figures estimated for 2011 estimate (250 to 450). Of the 950 reported cases of infection in Indigenous youth (15–29) in Canada between 1998 and 2012, 63% of the cases were due to intravenous drug use (IDU) [3]. The broader social determinants that have been found to have health effects on Canadians include ‘Aboriginal status,’ disability, early life, education, employment and working conditions, food insecurity, health services, gender, housing, income and income distribution, race, social exclusion, social safety net, and unemployment and job history [10]
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