Not only is the first day of December World AIDS Day, it is also the kick-off of Aboriginal AIDS Awareness Week. The week will be comprised of a series of events connecting Indigenous communities, organizations, government partners, and health care providers across the country.
Edmonton, Vancouver, Prince Albert, Sturgeon Lake, Winnipeg, Montreal, Happy Valley-Goose Bay and other cities will host gatherings to share lessons learned to create community readiness and culturally-safe approaches to holistic HIV testing, care and treatment.
Many of the Aboriginal AIDS Awareness Week events will focus on education about test options or even offering free HIV testing using a new fast and simple and finger prick test.
I think there is still a lot of misinformation about HIV," said Trevor Stratton, Canadian Aboriginal AIDS Network. "Some still think that people who are on effective treatment and maintain an undetectable viral load can still spread HIV sexually. That is just not true; undetectable equals untransmittable."
“It’s vital that everyone has an understanding and awareness of HIV, AIDS and Sexually Transmitted and Bloodborne Infections (STBBIs), because that awareness reduces stigma and discrimination, and that is the most critical step for people facing those challenges to find support,” said Stratton.
In Canada, infection rates are almost three times higher in First Nations, Métis and Inuit peoples than in the rest of the population. This is significant given Indigenous peoples only represent 4.9% of the total Canadian population.
2017 data from the Government of Canada indicates over 65,000 Canadians have HIV. A total of 2,402 new HIV cases were reported in Canada, an increase of 3%. Indigenous peoples comprise 20.1% of those new HIV cases.
For Canada to meet its part of the global HIV targets to eradicate HIV means 90% must be diagnosed by 2020, however one in seven does not know their HIV status. Only 86% of Canadians living with HIV are diagnosed; 81% of those diagnosed with HIV are on treatment and; 91% of HIV-positive Canadians on treatment were virally suppressed.
A critical part to meeting global targets is knowing they’re tested. However, there’s a stigma attached to HIV and AIDS along with other stereotypes and access that prohibit testing. While ambitious, these targets are now a realistic possibility due to a new test that is showing promising potential to remove many of those barriers.
The new HIV test takes a few minutes and just five drops of blood on a specialized card that can be used to do multiple blood tests.
The technique is called Dried Blood Spot Testing, and the test is as simple as testing blood sugar levels for a diabetes test and can help reduce stigma surrounding diseases such as HIV and hepatitis, encouraging more people to get tested.
Dried blood spot testing also breaks down other barriers to getting tested because people feel more comfortable getting this test than the conventional methods.
Normalizing the test is a factor encouraging more participants to get tested. For example, at some point of care locations entire families have come in to get tested together, largely due to Dried Blood Testing similarity to glucose prick testing.
It can be administered by any healthcare worker, instead of needing to be carried out by a nurse or doctor. This expands the reach to remote and rural communities and makes it easier for people who want to be tested but worry about being seen at a clinic.
Another unexpected outcome is that Indigenous communities in particular have been showing a preference to not getting the results right away which respected community needs. It is often more culturally appropriate to not have to wait onsite for their test results, rather the two-week lag time between the test and the results allows health workers to help prepare patients for the possibility of a positive result. Receiving test results on site on the same day, has also been seen as a barrier to testing because of confidentiality concerns.
The Dried Blood Spot method is being piloted in First Nations communities as a way to increase the number of number of people getting tested.
Leading a Saskatoon project is Ceal Tournier, the general manager of Saskatoon Tribal Council Health and Family Services. Tournier observed, “the number of people tested for HIV in Saskatoon Tribal Council partner communities [recently] — 114 — is four times higher than the number for the previous six months.” The Saskatoon Tribal Council is in the process of analyzing the results of this project.
Several challenges exist, however, including how to provide follow-up for test results in remote communities or hard-to-reach populations. For example, a positive Dried Blood Spot result would require confirmation with a conventional blood test.
The Canadian Aboriginal AIDS Network says it’s important to raise awareness about this preventable disease and for all Indigenous peoples to have the knowledge to make a difference in their own communities and take control of the health.
Dried Blood Spot Testing involves an element of reconciliation, offering Indigenous peoples control over their health care because it allows them to get tested on their terms.
Stratton said, “Our events are about sharing our stories and providing education. We’re providing a comfortable environment that is surrounded in our culture, whether that’s a drum circle, throat singers, or serving up light refreshments along with important conversations.”
To find an event near you, visit: www.aboriginalaidsawareness.com