Elevated rates of HIV infection among young Aboriginal injection drug users in a Canadian setting.

Cari L Miller,Kathy Li,Evan Wood,Martin T Schechter,Steffanie A Strathdee,Thomas Kerr,Patricia M Spittal

doi:10.1186/1477-7517-3-9

Cari L Miller, Kathy Li + Show 5 more

Open Access

https://doi.org/10.1186/1477-7517-3-9

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Abstract

ObjectivesRecent reports have suggested that Aboriginal and American Indian people are at elevated risk of HIV infection. We undertook the present study to compare socio-demographic and risk variables between Aboriginal and non-Aboriginal young (aged 13 – 24 years) injection drug users (IDUs) and characterize the burden of HIV infection among young Aboriginal IDUs.MethodsWe compared socio-demographic and risk variables between Aboriginal and non-Aboriginal young IDUs. Data were collected through the Vancouver Injection Drug Users Study (VIDUS). Semi-annually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for HIV and Hepatitis C (HCV).ResultsTo date over 1500 Vancouver IDU have been enrolled and followed, among whom 291 were aged 24 years and younger. Of the 291 young injectors, 80 (27%) were Aboriginal. In comparison to non-Aboriginal youth, Aboriginal youth were more likely to test seropositive for either HIV (20% vs 7%, p=< 0.001) or Hepatitis C virus (HCV) (66% vs 38%, p =< 0.001), be involved in sex work and live in the city's IDU epi-centre at baseline. After 48 months of follow-up, Aboriginal youth experienced significantly higher HIV seroconversion rates than non-Aboriginal youth, 27.8 per ppy (95% CI: 13.4–42.2) vs. 7.0 per ppy (95% CI: 2.3–11.8) respectively (log-rank p = 0.005) and the incidence density over the entire follow-up period was 12.6 per 100 pyrs (CI: 6.49–21.96) and 3.9 per 100 pyrs (CI: 1.8–7.3) respectively.InterpretationThese findings demonstrate that culturally relevant, evidence based prevention programs are urgently required to prevent HIV infection among Aboriginal youth.

Highlights

In Canada and the United States, the respective Centres for Disease Control have been alerted to the fact that persons of Aboriginal and American Indian descent may be at elevated risk for HIV/AIDS [1,2,3], though little data is presently available to inform prevention efforts
In the Vancouver Injection Drug Users Study (VIDUS), Aboriginal people account for approximately 25% of the 1500 injection drug users (IDUs) enrolled[7]
Between May 1996 and May 2003, 1548 participants were recruited into the VIDUS study among whom there were 291 (19%) participants aged ≤24 years

Summary

Introduction

In Canada and the United States, the respective Centres for Disease Control have been alerted to the fact that persons of Aboriginal and American Indian descent may be at elevated risk for HIV/AIDS [1,2,3], though little data is presently available to inform prevention efforts. Aboriginal people in Canada are overrepresented among marginalized groups at risk for HIV/AIDS such as injection drug users (IDU) and street youth, in the western provinces where a relatively higher proportion of Aboriginal people reside [2,6]. In the Vancouver Injection Drug Users Study (VIDUS), Aboriginal people account for approximately 25% of the 1500 IDU enrolled[7]. Aboriginal service providers have suggested that injection drug use may be one of the ways in which Aboriginal people cope with the complex effects of discrimination, poverty and cultural dislocation, including the multigenerational effects of the residential school system [8]

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