Canada's First Nations people are disproportionately becoming infected with HIV and AIDS.

"Aboriginal people now total 16.4 per cent of all AIDS cases," said Chief Angus Toulouse, Ontario Regional Chief-Chair of the Assembly of First Nations, during a news conference at the 16th International AIDS Conference in Toronto.

"This is a 500-per-cent increase over the past 20 years, compared to a 24 per cent decrease in the general Canadian-born population."

Aboriginal people make up just three per cent of the country's population, but the infection rate for First Nations people is nine per cent, according to the Public Health Agency of Canada.

And the numbers have been rising rapidly.

Kevin Barlow, executive director of the Canadian Aboriginal AIDS Network, tells the AIDS conference about the unique challenges facing Canada's aboriginals in the fight against the disease.
(Robin Rowland/CBC)

"I've had a lot of friends die (from AIDS)," says Kevin Barlow, executive director of the Canadian Aboriginal AIDS Network and a speaker at the Toronto AIDS conference.

"I've seen so many die that in some ways, there are times when I have to numb myself to that kind of loss. But I also draw upon their strength because every person that has touched my life who has been HIV-positive, their spirit teaches me that I must do more."

It's hard to analyze the figures for aboriginal people exclusively, because ethnicity isn't always reported when cases or test results are recorded. But, looking at the cases where the cultural background of the infected person is known reveals some unsettling patterns.

In 2005, aboriginal people represented an estimated 200 to 400 new HIV infections that year, according to Canada's public health agency. At the end of 2005, there was an estimated 3,600 to 5,100 aboriginal people living with the disease.

Before 1993, aboriginal people represented about two per cent of AIDS cases Canada reported to the Centre for Infectious Disease Prevention and Control (CIDPC) where ethnicity was known. By 2003, the number had climbed to 14.4 per cent.

Barlow told CBC News he believes that the problem is much larger than the numbers suggest.

"We also know that aboriginal people are not getting tested," he said. "They're not getting the information as much as we would like them to. Given those kind of dynamics, and the marginalization of some of our people, that creates the formula for the virus to be spreading a little more rapidly than we would like."

That's why he is pushing to create an international HIV-AIDS secretariat to bring a higher profile to the issues of aboriginals and other indigenous people.

"So that in these future conferences, there will be a bigger indigenous presence. It's sad that at this conference there was only one workshop that was indigenous-led."

Epidemic hits women, children and intravenous drug users hardest

Injection drug use is the most common way aboriginal people in Canada come in contact with the HIV virus.

It's a trend that has been getting worse over time. Before 1993, 11 per cent of all aboriginal people AIDS cases stemmed from injection drug use. By 2003, this rose to 51.7 per cent. The pattern is even more apparent when looking at HIV infections for the period between 1998 and 2004: 59.4 per cent of aboriginal people HIV infections stemmed from injection drug use, compared with 27.5 per cent of cases for the non-aboriginal people population.

And the proportion of women with HIV and AIDS is greater when comparing the aboriginal people and general Canadian populations. Women represent nearly half (45 per cent) of all positive HIV reports in the aboriginal people population, while for the non-aboriginal population the figure is about 20 per cent.

Root causes

The HIV virus and AIDS is a relatively new phenomenon for aboriginal people in Canada, speeding the pace at which it has been spreading in the community, Barlow says. While most AIDS organizations have been around for more about 25 years, he says most aboriginal people AIDS agencies have been in existence for just 10 or 12 years years - and as little as four in some cases.

"When we finally mobilized around HIV/AIDS we hit a lot of roadblocks," he said. "One, we didn't have the data that we needed. Second, the dollars were pretty much committed. There were no new dollars for aboriginal people to get into the sectors and start doing some work."

As the frontline response tried to catch up to the AIDS epidemic, he says, the disease kept shifting its spreading pattern within the aboriginal people community. From homosexual men, to women, to sex trade workers and the prison population - its changing shape made it hard for AIDS workers to focus their response, he says.

"We have had to do more work in the last 10 years than many of these other groups because our population shifted so quickly … and that has created pressures in itself because the resources haven't grown the way we would have liked," says Barlow.

Plus, poverty, lower education levels, poor housing, and the leftover scars from the residential school years have resulted in more high-risk activities, such as higher intravenous drug use in the aboriginal people community, he says.

"These types of lifelong traumas don't just go away. And sadly, some people turn to negative coping patterns, which include addiction," he says.

Mounting a response

The Canadian government hasn't responded adequately, Toulouse says.

"A $5.1 billion commitment was made at the First Ministers Meeting in Kelowna last November to eliminate poverty among the First Nations over the next 10 years," he says. "This included $1.3 billion in new health investments. So far none of this has been approved by the Conservative government."

The Assembly of First Nations estimates that the health-funding shortfall will reach close to $2 billion over the next five years, he says, most likely resulting in cutbacks to HIV-AIDS prevention and promotion programs.

"I would say there would still be a stigma [about HIV and AIDS] in the aboriginal [people] community, because of the lack of resources that aren't there to provide the education and awareness to the youth, and also to the general First Nations population as a whole," Toulouse says.

To stop the rising numbers of HIV-infected aboriginal people, more resources need to be directed towards the front lines, says Barlow.

"Since the Conservative government took [office], four aboriginal [people] AIDS organizations have closed their doors. Two of them have reopened, because the funding finaly started flowing. But two of them remain closed in Manitoba. So here we are listed in the federal initiative as a target population, but yet our service agencies are closing down."

He says even the existing organizations are overwhelmed - some have just two or three workers to serve an entire province.

It's only been recently that the federal government has allotted money to deal with AIDS, of which portions are earmarked for aboriginal people, he says. Despite losing loved ones to the disease himself, Barlow says he's optimistic about the future.

"I must continue to make sure there are more people in our communities that don't get infected.

"And when there are people living [with] HIV, that we support them and we stand by them. That's the aboriginal way. We don't have the luxury of throwing away any of our people because we've had so much loss."

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