The Experience of Active Injection Drug Use on Adherence to Antiretroviral Treatment in Aboriginal People Living in Prince George - A Qualitative Perspective.

Accessing HAART in northern BC: Understanding the barriers and supports to medication adherence and engagement in HIV-related care.

“…People who use injection drugs often face the effects of stigma and social exclusion which can create barriers to treatment; these effects have been reported to be greater for women and ethnic minorities (Krusi et al, 2010). Milligan (2011) also noted that forgetfulness was one o f the primary reasons reported for reduced adherence to HAART for active injection drug users. Illicit drug use has also been linked to a greater risk of unstable housing and food insecurity, which, as discussed previously, can affect treatment success as well (Krusi et al, 2010).…”

“…The establishment o f a routine as an important factor for adherence to HAART was articulated by Milligan (2011) in a qualitative study which focused on the experience of active injection drug use on adherence for Aboriginal people living in Prince George. The participants' ability to create a regular routine was challenged by "unstable housing, associated morbidities of addiction, other health issues, intergenerational effects of colonization, residential schools and the resulting marginalization, intergenerational trauma, violence, food insecurities, inability to find meaningful work, and societal exile that Aboriginal people o f Canada live with today -to name a few" (Milligan, 2011, p. 62).…”

“…A better understanding of peoples' experiences o f side effects with HAART in northern BC is important to understanding how well side effects are managed in this region, how to minimize these side effects, and reduce their impact as a barrier to adherence. Research focusing on the experiences of active injection drug use on adherence for Aboriginal people living in Prince George, BC found that while severe side effects from HAART were reported by participants they were not cited as a reason for missing doses (Milligan, 2011).…”

“…Research conducted by Milligan (2011) reported that "the resounding answer, when asked how HIV treatment could work better for participants, was that healthcare providers need to be more caring" (p. 72). This finding points to potential imbalances in power differentials between patients and healthcare providers.…”

“…Problems remain with ensuring everyone who needs HAART can receive it, and evidence indicates that this is particularly problematic in northern BC. Research addressing the potential barriers and supports to adherence to HAART has been done in Prince George (Milligan, 2011), but to my knowledge, little or no research has taken place in more rural areas in northern BC. Research on HAART has predominantly focused on adherence.…”