Saskatchewan may have the highest rates of HIV infection in Canada, but First Nations communities in the province's north are making strides toward battling the disease with a tailor-made program, says a researcher at the University of Saskatchewan.
An approach designed by and for First Nations people to address HIV infections is seeing success in improving outcomes, says Dr. Stuart Skinner. Now, a $2-million grant from a federal agency, the Canadian Institutes of Health Research, will help expand the program — called Know Your Status — to more First Nations communities.
"The timelines will be far faster than we thought, because the communities are very passionate," Skinner said. "If they are ready to move forward, we will figure out how to support them anyway we can."
Combining western medicine and Indigenous knowledge
Since 2011, Skinner has been working with Big River First Nation, which developed Know Your Status as a way to address the fact that community members were facing barriers to getting treatment from specialists in larger care centres. The First Nation is 80 kilometres northwest of Prince Albert.
The program works to expand local doctors' knowledge and ability to treat infectious diseases, including HIV, hepatitis C, and other blood-borne diseases, with a focus on developing primary care in these communities.
Skinner, the co-ordinator for the program, said the approach integrates western medicine with traditional Indigenous knowledge: elders offer mentoring, and people in the program receive physical, emotional and spiritual care to maintain their health and wellness.
'The communities themselves ... are the ones who design the program, design the treatment, and we're just following what they want us to do.' - Dr. Stuart Skinner, University of Saskatchewan
The five-year project involves 50 researchers, clinicians, policymakers and others knowledgeable about the issue. Almost half of the participants are Indigenous community members, chiefs and people who have themselves experienced infections.
"This is their program. The communities themselves, the leaders and the people who are affected are the ones who design the program, design the treatment, and we're just following what they want us to do," said Skinner.
Communities meeting WHO targets
First Nations communities in Saskatchewan have Canada's highest rate of HIV infections, more than seven times the national average. Women are over-represented in HIV infections among Saskatchewan First Nations at 40 per cent, compared to 22 per cent of all cases nationally.
But Skinner said that while many are aware of the high rates of HIV infections in Saskatchewan, there has been "tremendous work" within First Nations communities to improve outcomes.
The World Health Organization's department of HIV has proposed a 90-90-90 target for HIV testing, with the goal to have 90 per cent of people with HIV aware of their infection. Of those 90 per cent diagnosed, 90 per cent should be on antiretroviral treatment, and 90 per cent receiving the treatment should have undetectable levels of HIV in their blood.
Skinner said "these communities have achieved those outcomes in Saskatchewan."