From the early days of the HIV epidemic, Indigenous peoples were identified as a population group that experiences social and economic determinants—including colonialism and racism—that increase exposure to HIV. There are now substantial disparities in HIV rates between Indigenous and non-Indigenous peoples in some countries. We conducted a comprehensive literature review to assess the evidence on HIV-related behaviors and determinants in four countries—Australia, Canada, New Zealand and the United States—in which Indigenous peoples share important features of colonization and marginalization. We identified 107 articles over more than 20 years. The review highlights the determinants of HIV-related behaviors including domestic violence, stigma and discrimination, and injecting drug use. Many of the factors associated with HIV risk also contribute to mistrust of health services, which in turn contributes to poor HIV and health outcomes among Indigenous peoples.

ObjectivesCompared to other young Canadians, youth in the Northwest Territories (NWT) suffer disproportionately from negative sexual health outcomes, including high rates of sexually transmitted infections and unintended pregnancies. This study aimed to identify the self-perceived barriers and facilitators to positive, empowered, and safer sexual health that impact female youth in the NWT.Study design and methodsA total of 12 females aged 15–19 who live in the NWT were recruited through purposive sampling to participate in semi-structured, face-to-face interviews. Inductive coding and thematic analysis of transcribed data occurred using Atlas.ti.ResultsOverall 4 main themes influenced the sexual health of these women: sexual health knowledge, relationships with the self and others, access to quality sexual health resources, and alcohol use/abuse.ConclusionRecommendations for future action include improving the content and delivery of sexual health education, enhancing parent–adolescent sexual health communication, providing workshops to empower young women to assert themselves within relationships, and supporting an environment that normalizes youth sexuality.

This report found highly elevated overdose death rates and levels of premature mortality among First Nations Canadians in British Columbia compared to the general population. While previously unidentified, these findings are consistent with the poorer population health profile of First Nations Canadians. Although further research is needed to identify the causes of the elevated death rates, our findings support increased availability of evidence-based overdose prevention measures.

ObjectivesThe number of children in care of the state continues to grow in BC, Canada with a historical legacy of child apprehension among criminalized and marginalized populations, particularly women of Aboriginal ancestry and sex workers. However, there is a paucity of research investigating child apprehension experiences among marginalized mothers. The objective of the current analysis is to examine the prevalence and correlates of child apprehensions among female sex workers in Vancouver, Canada.MethodsAnalyses were drawn from the AESHA (An Evaluation of Sex Workers Health Access, 2010-present), a prospective cohort of street and off-street SWs, through outreach and semi-annual visits to the research office. Bivariate and multivariate logistic regression were used to examine correlates of child apprehension.ResultsOf a total of 510 SWs, 350 women who had given birth to at least one child were included in the analyses (median age = 37 yrs: IQR: 31–44 yrs). The prevalence of child apprehension among mothers was 38.3%, with 37.4% reporting having been apprehended themselves by child welfare services. In multivariable analysis, servicing clients in outdoor public spaces (versus formal sex work establishments or informal indoor settings) (adjusted odds ratio, (aOR) = 2.73; 95%CI 1.27–5.90), history of injecting drugs (aOR = 2.53; 95%CI 1.42–4.49), Aboriginal ancestry (aOR = 1.66; 95%CI 1.01–2.74) were associated with increased odds of child apprehension.Discussion/ConclusionsChild apprehension rates are high, particularly among the most marginalized sex workers, including sex workers who use drugs and sex workers of Aboriginal ancestry. Structural reforms to child protection are urgently needed, that support family-based care address the historical legacy of colonization affecting Aboriginal peoples.