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The Cedar project : exploring the HIV vulnerabilities of young aboriginal women in two Canadian cities Mehrabadi, Azar

Abstract

Background: International attention has been drawn to the physical and emotional violence faced by Aboriginal women in Canada. Vulnerability to HIV and Hepatitis C virus (HCV) infection for Indigenous populations must be contextualized in experiences of current and past trauma from the displacement of families through colonization, the residential school system and child apprehensions. Purpose: The purpose of this study is to compare sociodemographics, drug use patterns, injection practices, sexual experiences, and HIV and HCV prevalence between young Aboriginal men and women using illegal drugs in two urban settings. A further comparison is made among young Aboriginal women using illegal drugs to compare women who were involved in recent sex work (in the last six months) versus women who were not. Methods: In a community-based sample of urban Canadian Aboriginal young people (status and non-status First Nations, Inuit and Metis) who reported using street drugs in the past month, 262 female participants were compared with 281 male participants with respect to sociodemographic characteristics, experiences of trauma, sexual risk variables, and drug use patterns. Participants were invited who were between the ages of 14 and 30 years and lived in either Vancouver or Prince George, Canada, and were recruited through word of mouth, posters, and by street outreach. Between October 2003 and July 11 2005, young people in the study completed a questionnaire administered by Aboriginal interviewers. Trained nurses drew blood samples for HIV and HCV antibodies and provided pre- and post-test counseling. Results: Prevalence of HIV and HCV were significantly higher among young Aboriginal women as compared to Aboriginal men. When the analysis was restricted to young people who reported injection drug use, HIV and HCV prevalence was still significantly higher among women. Multivariate analysis revealed daily injection of cocaine and smoking crack in the previous six months, and lifetime sexual abuse to be independently associated with recent sex work involvement among women. Conclusions: Young Aboriginal women using illegal drugs are experiencing increased prevalence of HIV and HCV infection, harmful injection patterns and increased sex work and sexual abuse. Women involved in sex work are experiencing increased frequent injection and non-injection drug use and sexual abuse. Harm reduction programs that are gender specific and that address historical and individual trauma are urgently required.

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