Michelle Rugamba

This session highlighted the holistic aspects of care and how critical it is to address the impacts of treatment, social and structural determinants of health and vulnerabilities to HIV and co-infections within Indigenous populations. The colonization of medicines, barriers to treatment, and culturally appropriate funding were examined.

Presentations during this session included a presentation on the experience of Indigenous populations using antiretroviral therapy (ART) in New Zealand by Clive Aspin and one on decolonizing the cascade of care for Indigenous people living with HIV in Ontario by Sean Hillier. Presenters explored the systemic barriers faced by Indigenous peoples in Canada, Australia and New Zealand living with HIV and the inequities between Indigenous peoples and non-Indigenous peoples. The common themes in both presentations were the colonial and weak health systems that exist and the importance of culturally appropriate and localized care. Sean Hillier highlighted a study on the cascade of care for Indigenous peoples living in Ontario. The data from this study came from the Ontario HIV Treatment Network Cohort Study and was obtained through the Indigenous method of storytelling. One hundred Indigenous respondents completed the baseline study, and results showed that 70% of respondents reported forms of unfairness, including racial discrimination, being carded, and the denial of health services. Respondents also shared a desire to create a better life for young people and the next generations, and those living with HIV. This can only be achieved through new and increased funding efforts and systemic change.

Indigenous peoples around the world have not been approached as equal, especially with regard to treatment and access to HIV services. They continue to experience systematic oppression and marginalization and are silenced by settler colonialism. The key takeaway from this session is that funding for HIV treatments for Indigenous peoples needs to be stable and long-term. Access to ongoing, safe, culturally-competent care is critical. We must increase funding. Through appropriately funded and community-led initiatives, we will see a better uptake in testing and short & long-term follow-up care.