Breaking Down Barriers to HIV Prevention in Alaskan Natives

PROGRAM DESCRIPTION Although Indigenous Peoples account for just 3.8% of Canada’s total population, they represented 16% of positive HIV tests in the country, according to a 2013 report from the ...

PROGRAM DESCRIPTION
Although Indigenous Peoples account for just 3.8% of Canada’s total population, they represented 16% of positive HIV tests in the country, according to a 2013 report from the Public Health Agency of Canada. Over the 10-year period 2005 to 2014, the annual number of HIV diagnoses increased 19% among Native Americans/Alaska Natives overall and 63% among gay and bisexual men in these same populations.Co-occurring factors responsible for this increased incidence include: biological factors, such as increased rates of sexually transmitted infections and pregnancy; social factors, such as homophobia and distrust in health systems; economic factors, such as poverty, which can inhibit access to good healthcare and health education; socioeconomic factors related to gender inequality and violence; and substance abuse, which often are not direct routes of HIV transmission but do influence risky behaviors such as unprotected sex. This case vignette features a 32-year-old Alaska Native man who has faced these manifest economic and sociocultural barriers within his Inupiat community in Northern Alaska and has a prior history of intravenous drug abuse. The case also outlines many HIV-prevention strategies and public health interventions that can help to reduce the HIV burden, morbidity, and mortality in Alaska Native populations.

EDUCATIONAL OBJECTIVES
After participating in this activity, clinicians should be better able to:Describe the role of HIV-prevention strategies in individuals at increased risk for infection Counsel/educate at-risk individuals about HIV-prevention strategies Employ HIV-prevention strategies for individuals at risk for HIV infectionImplement practical, evidence-based strategies to ensure that HIV-prevention services are delivered to patients in a culturally competent manner

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