HIV/AIDS The Silent Epidemic Plaguing Canada's Aboriginal Population

The Human Immunodeficiency Virus (HIV) gradually disables the body’s protective immune system by systematically destroying host CD4 cells. If left untreated, HIV gradually progresses to Acquired Immune Deficiency Syndrome (AIDS), which leaves the body vulnerable to opportunistic infections. The virus is primarily transmitted via body fluids such as semen or blood, and is typically spread sexually, via contaminated injections, from mother to child and less frequently via contaminated transfusions/transplants. Thus, the prevalence of HIV/AIDS can be correlated to specific risk factors. In Canada, HIV/AIDS disproportionately affects people of Aboriginal descent, where prevalence rates have grown more than in any other ethnic group during the past decade. Careful consideration is required to better understand whether there is an intra-aboriginal difference in HIV prevalence rates and associated risk factors in rural communities versus urban/off-reserve settings. A structured literature review of PubMed, Medline, Scopus and PsychInfo (using keywords ‘Aboriginal’, ‘HIV’, ‘AIDS’, ‘Canada’, ‘urban and rural’) was used alongside specific inclusion and exclusion criteria. The articles were screened and pooled according to relevance and consisted of qualitative, quantitative and mixed method studies. Epidemiological evidence suggests a higher prevalence of HIV/AIDS amid Aboriginal peoples living in urban regions — particularly women, youth and gay/bisexual men — compared with Aboriginals living in rural communities alongside non-Aboriginals. Related risk factors with high HIV/AIDS prevalence, in both urban and rural settings, include injection drug use (and duration), non-consensual sex, sex-work and living in Vancouver. These results suggest that evidence-based, culturally-appropriate intervention strategies are necessary for HIV/AIDS prevention. Further investigation is needed to establish the qualitative difference in HIV/AIDS prevalence between rural and urban Aboriginal communities. To support these findings, it must be established whether a lack of accessible health services and/or testing services creates selection bias in the data