Inter Press Service - September 19, 2002
Paul Weinberg

On the one hand, the data will be valuable in pinpointing the extent of HIV/AIDS in what is considered a high-risk group in Canada, says Art Zoccole, executive director of Ottawa-based Canadian Aboriginal AIDS Network (CAAN).

At the same time, if any of the samples are found to contain the HIV virus there is no way to relate that information back to the women who indirectly provided the blood following prenatal examinations by their local doctors.

"If there is a hidden epidemic, how do we address that? It is a double-edged sword," says Zoccole. He notes that HIV/AIDS carriers who are public about their affliction face serious discrimination within the generally small aboriginal communities.

In what is called an anonymous unlinked surveillance study, the women's blood is being examined by Canadian Blood Services in Vancouver for the federal government's Health Canada and the BC First Nations Chiefs' Health Committee.

The blood samples arrive without identifying the donor or the community she is from, explains Vancouver-based David Martin, one of the co-coordinators of the study.

It will be another year before the statistical findings are released.

Martin estimates that HIV positive cases among Canadian aboriginals - usually known as "first nations" or "native" people - vary year to year, from 11 to 19 percent of all HIV cases in Canada.

This is "inordinately high", he says, given that aboriginals represent about three to five percent of Canada's 30 million people.

Martin estimates that at least 50 to 60 percent of pregnant aboriginal women whose leftover blood is being studied have voluntarily had their blood tested for HIV during prenatal examinations that are completely unconnected to the BC study.

But that still leaves 40 or 50 percent of this same group of pregnant aboriginal women who for one reason or another are not being tested for HIV during the prenatal tests. Still, that is no justification for the 'blind' test, according to one activist.

"I think that is completely unethical," says LaVerne Monette, coordinator of the Ontario Aboriginal HIV/AIDS Strategy in Toronto. "You are not helping anyone. All you are doing is helping some researcher in the government or attached to the government."

Monette says that when a similar anonymous study of pregnant aboriginal women was conducted in her own province of Ontario, the women's participation in prenatal examinations dropped from 85 to 25 percent. It is a scenario that horrifies this activist, who wants more aboriginal women, not fewer, getting tested for HIV/AIDS voluntarily.

"I was really hoping that they would never do another one like this in Canada," says Monette.

One of Martin's associates said that pregnant women undergoing prenatal examinations in rural aboriginal communities are being informed that their leftover blood samples are the subject of an anonymous three-year study.

"Patients can refuse to participate and basically of the 1,200 (samples) that have been collected, so far two (of the pregnant women) have refused," says Dennis Wardman, who, like Martin, works for the Pacific office of the 1st Nations Inuit health branch of Health Canada.

"They can refuse to participate and there is a lot of effort that has gone on to create awareness of this surveillance," he adds.

But Monette says plenty of information already exists on the extent of HIV/AIDS in BC. Drawing parallels with other groups, like Canada's Haitian community, which has been found to have a high preponderance of people with HIV/AIDS, she suggests that the results of the BC study will further stigmatise an already marginalized group of people.

A more fruitful strategy from her point of view would be to focus on providing information in aboriginal communities about how HIV/AIDS is spread, the importance of safe sex and the value of women getting tested for HIV before they become pregnant.

Martin counters that the study is similar to other medical surveys of the spread of infectious or communicable disease in a particular area or population. The research, he says, follows all of the standard ethical guidelines.

He insists it is "not a new concept. It is something that has developed over the years with the HIV epidemic. And it has been found to be a good way of objectively assessing just what your infection rates are in any population group."

AIDS researchers sense that the high HIV rates among aboriginals occur in cities like Vancouver where hard drug use is more rampant.

"We are trying to find out to what degree is that virus infiltrating into the rural communities. People go back and forth (between city and country)," says Martin.

Aboriginals "are no more ignorant" about HIVS/AIDS than other people in Canada, says Monette. But poverty, overcrowding amidst poor housing, a high birth rate, and the isolation of many communities means, "we have less information about HIV/AIDS then most people", she adds.

Zoccole at CAAN is the first to admit that homophobia within first nations communities and among their top chiefs has made it difficult to develop an HIV/AIDS prevention strategy for aboriginals. Some of the leaders, for instance, are opposed to needle exchange as a means to curtail HIV among drug users.

The activist hopes that the BC research will at least provide useful ammunition to pressure the Canadian government to raise the level of spending on HIV/AIDS prevention in impoverished aboriginal communities in Canada.

Zoccole estimates that of the 42 million Canadian dollars that Ottawa has set aside to fight HIV-AIDS, two to three million dollars goes to meeting the needs of aboriginals on and off first nations territory in Canada.

"One of the recommendations of the Royal Commission on Aboriginal Peoples, to have 10,000 aboriginal health workers, doctors and nurses, was never realised. It was not followed up by the government," says Zoccole. (END/IPS/NA/HD/HE/PW/AN/ML/02) .

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