High prevalence of HIV infection among homeless and street-involved Aboriginal youth in a Canadian setting

Abstract

Aboriginal people experience a disproportionate burden of HIV infection among the adult population in Canada; however, less is known regarding the prevalence and characteristics of HIV positivity among drug-using and street-involved Aboriginal youth. We examined HIV seroprevalence and risk factors among a cohort of 529 street-involved youth in Vancouver, Canada. At baseline, 15 (2.8%) were HIV positive, of whom 7 (46.7%) were Aboriginal. Aboriginal ethnicity was a significant correlate of HIV infection (odds ratio = 2.87, 95%CI: 1.02 – 8.09). Of the HIV positive participants, 2 (28.6%) Aboriginals and 6 (75.0%) non-Aboriginals reported injection drug use; furthermore, hepatitis C co-infection was significantly less common among Aboriginal participants (p = 0.041). These findings suggest that factors other than injection drug use may promote HIV transmission among street-involved Aboriginal youth, and provide further evidence that culturally appropriate and evidence-based interventions for HIV prevention among Aboriginal young people are urgently required.

Housing Instability among People Who Inject Drugs: Results from the Australian Needle and Syringe Program Survey

“…74 Strong relationships between drug use, homelessness, and risky injecting practices are evident among Canada's Indigenous peoples and are thought to account, at least in part, for the elevated HIV prevalence and incidence observed among Aboriginal PWID in this setting. 53,72,75,76 Similarly, ANSPS data collected between 1998 and 2008 and stratified by Indigenous Australian origin documented significantly higher rates of both anti-HCV and key injecting risk behaviors among these participants relative to their non-Indigenous counterparts. 77 Although housing information was not available for this (previous) analysis, the consistency between the present results and those derived from other settings which demonstrate strong associations between housing and risk among Indigenous peoples suggests that the elevated HCV prevalence and injecting risk behaviors previously documented among Aboriginal ANSPS participants 77 is likely to be at least partially accounted for by housing inequities experienced by Indigenous and non-Indigenous ANSPS participants.…”

HIV Incidence and Prevalence Among Aboriginal Peoples in Canada

“…3). Prevalence estimates were generally found to be high among Aboriginal peoples who use drugs and ranged from 0.8 to 38.0% [16,54] compared with 2.0 to 21.2% among non-Aboriginal peoples who use drugs in these studies [17,30] (Fig. 3a).…”

Homelessness & Health in Canada

“…Studies have consistently reported that Aboriginal youth demonstrate more sexual risk behaviours and higher prevalence rates of stis and hiv. In Vancouver, Aboriginal homeless youth were nearly three times more likely to be hiv positive than non-Aboriginal youth (Marshall et al 2008). In Toronto, a higher proportion of Aboriginal youth (5.0%) and black youth (4.3%) self-reported their hiv status as positive compared to white youth (3.0%; Linton et al 2009).…”

“…Prevalence rates were also high for hepatitis B and herpes simplex virus 2 (hsv-2), the primary cause of genital herpes. Studies in Toronto, Montreal and Vancouver have reported high hiv prevalence among homeless youth, ranging from 1.9 percent to 2.8 percent (DeMatteo et al 1999;Marshall et al 2008;Roy et al 2000). Comparable data on hiv prevalence rates among youth in the general population are not available, likely because this age group makes up an extremely small proportion (approximately 3.5%) of the total number of hiv cases in Canada (phac 2007).…”

“…Canadian studies that have examined ethnic differences in sexual heath have primarily compared non-Aboriginal youth to Aboriginal youth (e.g., Marshall et al 2008;Shields et al 2004). Studies have consistently reported that Aboriginal youth demonstrate more sexual risk behaviours and higher prevalence rates of stis and hiv.…”