Barriers to Holistic Treatment Access • Duties and responsibilities between federal and provincial/territorial governments in terms of health care delivery is unclear. Lack of accountability, responsibility and priority has impeded access to HIV treatment. • Cultural sensitivity, especially traditional healing practices and customs, have been dismissed as ineffective options. Most non-Western medical approaches are not publicly funded. • Stigma, discrimination and racism are all factors that deter Aboriginal people from disclosing their status to loved ones, as well as accessing programs and services imperative to HIV management.
• Negative coping strategies, including drug and alcohol use, has impeded efforts to seek and adhere to treatment.
Barriers to Holistic Treatment Access • Geography plays a critical role in inhibiting access. Aboriginal people residing in rural and remote settings, particularly small and reserve communities, face a considerable lack of privacy protection in health service delivery. • Many Aboriginal people living with HIV are forced to leave their communities and relocate to urban centres where specialized services are available and privacy can be better maintained. • A lack of specialized services or knowledge regarding key issues among service providers in remote and rural communities exists. • Many providers, such as addictions counsellors, often have minimal HIV knowledge, and HIV specialists may lack the expertise required to treat Viral Hepatitis co-infection.
• Providers may also be unaware of how the social determinants of health, such as access to housing and employment, impacts HIV treatment management and care.
Take Action: Tools, Solutions and Alternatives • Healthcare provider education is critical. Providers must possess knowledge regarding HIV management, care and treatment that is current and up-to-date. • Culturally competent care, which incorporates traditional medicines and healing practices, is required to adopt more holistic approaches to care. • While it is important to include these practices in care, it is also important to have knowledgeable staff on how and if traditional medicines and practices impact other forms of treatment management. • Staff must be knowledgeable and responsible for abiding to non-discriminatory policies, as well as comprehensive confidentiality and privacy training. Such efforts must be effectively maintained through surveillance and evaluation methods. • Those who compromise privacy and confidentiality should be held accountable and be reprimanded.
Take Action: Tools, Solutions and Alternatives • Community outreach programs that facilitate education and direct HIV positive people to support services and programs is necessary. • HIV/AIDS education in communities and within the schooling system is necessary to sensitize young Aboriginal people to HIV/AIDs, as well as to reduce discriminatory practices. • Federal and provincial/territorial/municipal governments must delegate clear duties and responsibilities. This involves outlining accountability and responsibility for health care delivery. In addition, improved communication and service coordination among all levels of government and inter-departmentally is required. • Community engagement is fundamental to improving access barriers. Aboriginal people need to actively participate in and provide input into decision-making processes.
Take Action: Tools, Solutions and Alternatives • The power of mobilization and community solidarity is essential in making positive changes. This requires developing sustainable partnerships in order to know who to approach and how to approach them. • Initiatives that foster a social of determinants of health approach, such as employment, education, and housing strategies, must be given priority. Not only do higher levels of socioeconomic status improve treatment management and adherence, enhance overall quality of life, but also contribute to economic prosperity.