Aboriginal women draw attention to HIV plight

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Aboriginal women are at higher risk of contracting HIV and AIDS than Aboriginal men because of gender discrimination, compounded by sexual violence against women, and the lack of gender-specific research into appropriate drugs and treatment.

These findings were set out at the first national conference on women and HIV/AIDS held in Toronto in May. About 500 attended the four-day event, which began May 24 and was organized by the Canadian AIDS Society, the Canadian Aboriginal AIDS Network, the Canadian Treatment Advocates Council and the Community AIDS Treatment Information Exchange. The programs committee consisted of about 50 women of varying backgrounds from women's organizations and AIDS service groups across Canada.

Arlo Yuzicapi Fayant, an Aboriginal AIDS consultant from Regina who spoke at the opening plenary session, said the time had come for women to hold their own conference.

"For years, our particular needs as women, regardless if it's treatment, research, prevention, support, have not really been served in a way that was helping us cope with the epidemic. It's been predominantly very generic or male-oriented, because that seems to be where the disease manifested originally, but over time it became apparent that women were fastly becoming the more infected population."

Delegates explored four major areas of concern. Yuzicapi Fayant said they got "hundreds" of recommendations out of the workshops.

One of the four issues was the question of how to support women who are dealing with sexual violence, sexual exploitation and the spread of HIV in these circumstances.

For example, said Yuzicapi Fayant, "sex trade workers, women in prisons."

Another theme was public policy. Issues included the socio-economic problems that are rampant among people living with AIDS now that AIDS is no longer primarily a disease of single, white males. Women in the sex trade and injection drug users are especially vulnerable, delegates heard. Among Aboriginal women who inject drugs, 58.5 per cent have AIDS.

"Women who use injection drugs may have to trade sex for money or drugs, putting them at risk for HIV infection, said Diane Gobeil-Soirilus, a spokswoman for the Canadian AIDS Society. She also slammed Canadian drug laws and policies, which she said made it difficult to help injection drug users who have HIV.

The third theme delegates focused on was prevention, where it was determined the realities of partner abuse, prostitution and other violence may prevent women either from protecting themselves against infection or from revealing their HIV status.

Finally, delegates discussed treatment strategies. They concluded researchers are neglecting women, who are sometimes affected adversely by a drug regimen designed for men.

"We've been under-represented in terms of research for sure. There's never been any quality research as to how our needs are different; our biophysical requirements for some of the treatments have never been studied adequately," Yuzicapi Fayant said.

Recommendations arising from the conference included a call for effective HIV prevention programs in prisons, more studies of women's treatment issues, and greater inclusion of women in clinical drug trials. The women urged both private and public sector financial support for research and development of an HIV vaccine.

They also want governments and the pharmaceutical industry to move faster on developing microbicides, which they compare in action to spermicides. Microbicides look promising for reducing HIV and other sexually transmitted infections; however, public funding for this initiative is lagging.

"Until there is a vaccine, women need better prevention tools to give them more control over their sexual health," said Sharon Baxter, executive director of the Canadian Aids Society.

Aboriginal people are five times as likely as other Canadians to have AIDS, a bulletin released by the Canadian HIV/AIDS Legal Network states. In addition, Health Canadadata from April reveals the proportion of women among Aboriginal AIDS cases is 22.2 per cent, compared with 7.7 per cent among non-Aboriginal AIDS cases. AIDS has more than doubled among all women since 1994 and is now 16.3 per cent of reported AIDS cases. Among new HIV infections reported in 1999, 24 per cent were women. AIDS manifests with numerous health complications including pneumonia and kidney failure that usually occur several years after a person is diagnosed with an HIV infection.

Jake Linklater, executive director of the Canadian Aboriginal AIDS Network, said the AIDS epidemic among Aboriginal people can't be stemmed as easily as just presenting information about the disease in a culturally appropriate way.

"That's usually the perception of people, Linklater said. "How you present it is one thing, but with Aboriginal folks in Canada, there's one thing called the determinants of health. . . . It comes from housing, economic status, gender, genetics, education. All those determinants seem to highlight HIV infection. It's not the same for a non-Aboriginal person. If you take the average and you weigh it against those social determinants or health determinants, you'll see the person who is more at risk is the Aboriginal person."

Yuzicapi Fayant said these factors are even more critical for Aboriginal women, who usually have less money and less mobility than men and may be dependent on abusive or non-supportive partners.

"Racial discrimination against Aboriginal women is made worse by gender discrimination," she said.