Abstract
Background
In Canada, Aboriginal people are overrepresented in the HIV epidemic and infected at a younger age than non-Aboriginal people. This paper discusses some of the ways Aboriginal youth in Toronto understand HIV/AIDS risk and the relevance of their comments for HIV prevention education. This research is part of a larger study conducted with Ontario youth through the Gendering Adolescent AIDS Prevention (GAAP) project.
Methods
We conducted 11 GAAP focus groups with Ontario youth. This paper focuses primarily on the four groups of Aboriginal youth. A modified grounded theory approach guided analyses. Data were coded using Nud*ist qualitative data management software.
Findings
Aboriginal youth were more aware of HIV/AIDS and the structural inequities that contribute to risk than their non-Aboriginal counterparts. In addition, they were the only group to talk about colonialism in the context of HIV in their community. Aboriginal youth were, however, more likely to hold a fatalistic view of their future and to blame their own community for high infection rates.
Interpretation
We argue for incorporating structural factors of risk, including the legacy of colonialism, in HIV prevention programs for all youth. This may help to eradicate the stigma and self-blame that negatively impact on Aboriginal youth while allowing other youth populations to distance themselves from the disease.
MeSH terms: Aboriginal, adolescent, HIV, risk, prevention, colonialism
Résumé
Contexte
Au Canada, les Autochtones sont surreprésentés dans l’épidémie de VIH, et ils sont infectés à un âge moins avancé que les non-Autochtones. Dans cet article, il est question de la perception du risque de contracter le VIH chez les jeunes Autochtones de Toronto et de la pertinence des commentaires de ces jeunes pour les programmes d’éducation visant à prévenir le VIH. Cette étude s’inscrit dans une étude de plus grande envergure menée auprès des jeunes Ontariens dans le cadre du projet GAAP (Gendering Adolescent AIDS Prevention).
Méthode
Nous avons organisé 11 groupes de discussion GAAP avec des jeunes Ontariens. Dans cet article, nous nous intéressons principalement aux quatre groupes composés de jeunes Autochtones. Nos analyses se sont inspirées d’une approche théorique à base empirique modifiée. Les données ont été codées à l’aide du logiciel de gestion de données qualitatives Nud*ist.
Résultats
Les jeunes Autochtones étaient plus conscientisés que leurs concitoyens non- Autochtones au VIH et au sida, ainsi qu’aux inégalités structurelles qui font augmenter le risque de contracter le virus. De plus, ils ont été les seuls à parler du colonialisme dans le contexte du VIH dans leur communauté. Les jeunes Autochtones étaient cependant plus susceptibles d’envisager l’avenir avec fatalisme et de blâmer leur propre communauté pour les taux d’infection élevés qui y prévalent.
Interprétation
Nous préconisons l’intégration de facteurs de risque structurels, y compris l’héritage du colonialisme, dans les programmes de prévention du VIH, et ce, pour tous les jeunes. Cette mesure pourrait contribuer à éradiquer la stigmatisation et l’auto-accusation dont souffrent les jeunes Autochtones tout en permettant aux autres groupes de jeunes de prendre leurs distances par rapport à la maladie.
References
- 1.HC. HIV AIDS Epi Update. 2004. HIV/AIDS among Aboriginal people in Canada: A continuing concern. [Google Scholar]
- 2.CDCP. HIV/AIDS Epi Update: HIV and AIDS Among Youth in Canada. Ottawa, ON: Centre for Disease Prevention and Control, Health Canada; 2003. [Google Scholar]
- 3.UNAIDS. Canada. Epidemiological Facts Sheets on HIV/AIDS and Sexually Transmitted Infections. Switzerland: UNAIDS/WHO Working Group on Global HIV/AIDS; 2004. [Google Scholar]
- 4.Albertyn C. Contesting democracy: HIV/AIDS and the achievement of gender equality in South Africa. Feminist Studies. 2003;29(3):595–615. [Google Scholar]
- 5.Farmer P. Infections and Inequalities: The Modern Plagues. Berkeley, CA: University of California Press; 1999. [Google Scholar]
- 6.Flicker S, Skinner H, Read S, Veinot T, McClelland A, Saulnier P, Goldberg E. Falling through the cracks of the big cities: Who is meeting the needs of HIV-positive youth? Can J Public Health. 2005;96(4):308–12. doi: 10.1007/BF03405172. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Flicker S, Goldberg E, Read S, Veinot T, McClelland A, Saulnier P, et al. HIV-positive youth’s perspectives on the internet and e-health. J Med Internet Res. 2004;6(3):e32. doi: 10.2196/jmir.6.3.e32. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Veinot T, Flicker S, Skinner H, McClelland A, Saulnier P, Read S, Goldberg E. “Supposed to make you better but it doesn’t really”: HIVpositive youths’ perceptions of HIV treatment. J Adolesc Health. 2006;38(3):261–67. doi: 10.1016/j.jadohealth.2005.03.008. [DOI] [PubMed] [Google Scholar]
- 9.Young TK. Review of research on aboriginal populations in Canada: Relevance to their health needs. Br Med J. 2003;327:419–22. doi: 10.1136/bmj.327.7412.419. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Strauss A, Corbin J. Grounded theory methodology: An overview. In: Lincoln YS, Denzin NK, editors. Handbook of Qualitative Research. Thousand Oaks, CA: Sage Publications; 1994. [Google Scholar]
- 11.Strauss A, Corbin J. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage Publications; 1990. [Google Scholar]
- 12.Taylor SJ, Bogdan R. Introduction to Qualitative Research Methods: A Guidebook and Resource. 3rd, ed. New York, NY: John Wiley & Sons, Inc.; 1998. [Google Scholar]
- 13.Charmaz K. Grounded theory: Objectivist and constructivist methods. In: Denzin NK, Lincoln YS, editors. Handbook of Qualitative Research. 2nd, ed. Thousand Oaks: Sage Publications, Ltd; 2000. pp. 509–36. [Google Scholar]
- 14.Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, IL: Aldine; 1967. [Google Scholar]
- 15.Flicker S. “Ask me no secrets, I’ll tell you no lies”: What happens when a respondent’s story makes no sense. The Qualitative Report. 2004;9(3):528–37. [Google Scholar]
- 16.Israel BA, Eng E, Schulz AJ, Parker EA. Methods in Community-Based Participatory Research for Health. San Francisco, CA: Jossey Bass; 2005. [Google Scholar]
- 17.Lincoln YS, Guba E. Naturalistic Inquiry. Beverly Hills, CA: Sage; 1985. [Google Scholar]
- 18.Cresswell J. Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Thousand Oaks: Sage Publications; 1998. [Google Scholar]
- 19.Miles MB, Huberman AM. Qualitative Data Analysis: A Sourcebook of New Methods. Beverly Hills: Sage; 1984. [Google Scholar]
- 20.Devers KJ. How will we know “good” qualitative research when we see it? Beginning the dialogue in health services research. Health Serv Res. 1999;34(5):1153–88. [PMC free article] [PubMed] [Google Scholar]
- 21.Larkin J, Mitchell C, Flicker S, Dagnino M, Koleszar-Green R, Mintz S. HIV risk, prevention education, and youth. Toronto, ON: Report to the Canadian Foundation for AIDS Research (CANFAR); 2004. [Google Scholar]
- 22.Patton C. Globalizing AIDS. Minneapolis, MN: University of Minnesota Press; 2002. [Google Scholar]
- 23.Patton C. Inventing ‘African AIDS’. In: Parker R, Aggleton P, editors. Culture, Society and Sexuality. London, UK: UCL; 1999. pp. 387–404. [Google Scholar]
- 24.AHS. Access and Utilization of Health Care Services and HIV Testing among British Columbia’s First Nation. Vancouver, BC: Aboriginal HIV/AIDS Society, Healing Our Spirit; 2004. [Google Scholar]
- 25.CAAN. HIV Prevention Messages for Canadian Aboriginal Youth. Ottawa: Canadian Aboriginal AIDS Association (CAAN); 2004. [Google Scholar]
- 26.An Ethnographic/community based research investigation into why First Nation youth take risks: Recommendations for health care providers, youth and elders on HCV prevention. (poster). Canadian Association for HIV Research Conference (CAHR), Vancouver, BC, 2005.
- 27.HC. Research on HIV/AIDS in Aboriginal people: A Background Paper. Winnipeg, MB: Health Canada & University of Manitoba; 1998. [Google Scholar]
- 28.Canadian HIV/AIDS Policy & Law Newsletter. 1999.
- 29.CAAN. An Aboriginal Strategy on HIV/AIDS in Canada for First Nations, Inuit and Métis People. Ottawa: Canadian Aboriginal AIDS Network (CAAN); 2003. Strengthening Ties — Strengthening Communities. [Google Scholar]
- 30.Hackett P. From past to present: Understanding First Nations health patterns in a historical context. Can J Public Health. 2005;96(Suppl.1):S17–S21. doi: 10.1007/BF03405311. [DOI] [PMC free article] [PubMed] [Google Scholar]