Social issues complicate health care access

Aboriginal people in B.C. need access to information about HIV and AIDS, and they need the basics of food, water and shelter in order to reduce the rate that they are contracting the fatal disease.
Dr. Perry Kendall, the B.C provincial health officer, released a report in June, entitled Pathways to Health and Healing: 2nd Report of Health and Well-being of Aboriginal People in British Columbia. It revealed an increase in the number of Aboriginal people afflicted with HIV and AIDS, up from the previous 2001 numbers.
In 2002, the rate of HIV/AIDS in Aboriginal people was 1.5 per 10,000 people. The rate for non-Aboriginals was 0.2 per 10,000.
In 2007, the rate for Aboriginals increased to 1.9 in 10,000 and the rate for non-Aboriginals remained at 0.2 per 10,000.
Local experts in the field of HIV and AIDS are convinced that because the basic needs of Aboriginal people are not being met, it enables the virus to spread within the community.
Michelle George is the executive director of Healing Our Spirit: BC Aboriginal HIV/AIDS Society. She said HIV and AIDS within the Aboriginal community is very complex and that there are currently not enough resources to address all of the issues contributing to higher rates of infection.
"There are large pockets of people who are marginalized [and] who aren't getting the information soon enough," said George, who has worked in the HIV/AIDS field for 14 years.
George said leaders in B.C. must be compassionate to the barriers that many Aboriginal people face on a daily basis. She said many Aboriginals in B.C. live in secluded communities, which can make getting information more difficult.
"If you have ever lived in a small First Nations community, it is your grandma or your aunty who works in the health centre. How do you tell your grandmother or your aunt that you need condoms or you want information about HIV?" said George. She explained that there are layers of challenges that must be dealt with in order for the spread of HIV and AIDS to slow down.
Healing Our Spirit is located in Vancouver. The centre facilitates many programs that help mentor Aboriginal people who may be at risk of contracting HIV, and educates community members on preventative steps to protect themselves from the virus that attacks the immune system.
According to the government of British Columbia's Web site, there were 198 bands counted as of September 2006. George said that there is currently not enough staff to reach such a large population spread out across the province.
George is hopeful that Kendall's report will produce some positive results in helping to raise awareness around the issue.
Kendall said Aboriginal health is an area that will be evaluated every five years.
"Aboriginal people are a group with special status in Canada, and they are a group facing very specific health challenges."
Kendall said the report is beneficial because it profiles best practices, plus highlights where there are opportunities for improvement.
Irene Day is the director of operations at the British Columbia Centre for Excellence in HIV/AIDS and she has a few suggestions on improvements that she feels must be made in order to help those who are infected take care of themselves and decrease that chance of infecting others.
Day explained that antiretroviral medication is available for people living with HIV/AIDS, but there are a variety of other factors that keep some from taking their medication on a regular basis.
"If I am a drug addict and I can't think of anything else than getting my next fix, why would I think about taking my antiretroviral medications? It wouldn't be my priority," said Day. Addiction is but one reason why the virus continues to spread, she said. There are others.
She used the Downtown Eastside of Vancouver, one of the poorest postal codes in Canada, as an example. With so many people dealing with other threatening conditions like no housing and no food, it is an incredible challenge for those infected with HIV to make their health a priority.
"For some medications you have to take food with it. Well, if you don't have any food or if you have to take medication on a regular timeframe and you have no place to live, it makes it difficult," explained Day.
"We know that there are people that don't have housing. We know there are people who are addicted. We know there are people who aren't getting regular meals, so all of these factors play a role in being able to address your HIV status," she said.
Day works alongside Dr. Julio Montaner who is the director of the British Columbia Centre for Excellence in HIV/AIDS. Montaner has more than 20 years experience in HIV/AIDS research and was a part of the medical team that discovered the effectiveness of combining antiretroviral drugs, a therapy called Highly Active Antiretroviral Therapy (HAART).
One of the missions of the centre is to increase access to HAART. Day said this is something they can't do alone.
Both Day and George agree that there is a stigma attached to HIV/AIDS that is slowing down the progress to significantly reduce the fatalities of HIV/AIDS.
"If we work in collaboration to address issues such as homelessness, mental illness, and addiction, people who medically need to be on HAART will be able to access HAART, and we can significantly reduce the incidents of HIV," said Day. "We could change the way the disease impacts people."