Introduction

Because of public attitudes about sexually transmitted infections and the discrimination that can result, take special care to preserve confidentiality and privacy in addressing these issues.


The growing number of Aboriginal people with sexually transmitted infections (STIs) shows the need to educate our people about the dangers of unprotected sex, and to raise awareness about prevention so that Aboriginal people can enjoy the benefits of sexual intimacy without risk and shame. Overall, Aboriginal people have higher rates of HIV infection than Canadians in general. Rates of infection among people under 30, women, two-spirit people and injection drug users are a concern.

Most people are now aware of HIV/AIDS, but it is important to remember that there are many other sexual infections that pose a threat to health, such as chlamydia, hepatitis C and herpes. In the last five years, Inuit, First Nations and Métis communities have been leaders in the field of HIV/AIDS prevention and support. Many of their innovative, culture-based programs and resource materials can be applied to other STIs.

People, especially youth, need information about the realities of STIs, how we catch them, how we can protect ourselves and our partners from infection, and what to do if we think we might be infected. In addition to information, we need to understand that peer pressure and using alcohol and drugs can make us forget about sexual responsibility and can result in unsafe sexual activity. We need support to make sound decisions about sexual activity and to develop our skills to talk about safer sex and to protect ourselves and others. We also need access to confidential testing and treatment. As with other sexual matters, lack of self-esteem, drug and alcohol problems, and violence can get in the way of prevention.

Human Immuno-Deficiency Virus (HIV) is a virus that attacks the white blood cells of the immune system so that the body is unprotected. If any other virus invades the body, it could be fatal. HIV is transmitted from an infected person in blood, semen, vaginal fluids and breast milk. Unprotected vaginal or anal sex, sharing injection drug needles, infected blood products, tattooing, scarification or body piercing are the main ways of getting HIV. HIV can also be transmitted to infants during pregnancy, at birth or through breastfeeding. There presently is no cure for HIV/AIDS. While modern drug treatments can control symptoms and prolong life for many people with HIV, the high cost, the complicated mix of drugs and the strict daily schedule, make their use unrealistic for many people with HIV or AIDS.

Other more common STIs can have serious health consequences. A growing number of Aboriginal people are suffering from infections such as: chlamydia, herpes, genital warts, syphilis, gonorrhea, hepatitis B and hepatitis C. Chlamydia and gonorrhea, which often have no symptoms, can lead to sterility (inability to have children) or pelvic inflammatory disease, a chronic and painful condition. Human papilloma virus is linked to increased risk of cervical cancer, and hepatitis B and C can result in liver disease and cancer of the liver.

If diagnosed right away, many STIs are easily treated, but they all cause emotional distress as well as physical harm. An important part of building strong and healthy communities is providing public education, confidential testing, effective treatment and support.

The majority of the 45,000 Inuit live in the 53 remote communities of Arctic Canada. Many Inuit in Arctic communities still think that their isolation from southern Canada will protect them and their families, while others believe that ... if they do not share needles to do drugs, then they are not at risk. The fact is that unprotected heterosexual sex remains the number one way Inuit become infected with HIV [and other sexually transmitted infections].
Many Inuit are afraid to be tested in their home community out of fear that other community members will find out. Some Inuit choose not to be tested because they realize they may have to go south for treatment.¹ (click here for footnote)



I can remember always being unhappy in my childhood and my teens. I don’t remember any happy times. It seemed like whenever something would go well in my life, it always got ruined because I would get home and my dad would be there either drunk or ready to yell at me. I honestly think that it is because of this that I spent my teens and almost all of my 20s drinking and smoking pot constantly. I abused my body without a care for my health. I’ve had every kind of STD at one time or another. Luckily, I didn’t contract HIV.
Métis woman living in northern Ontario

Below are some key issues and a few ways that health care providers and others can support efforts to improve sexual health with education, prevention and treatment services.

Aboriginal activists in the field think the increasing risk of sexually transmitted infections in Aboriginal communities is related to:

• more travel, especially of Aboriginal youth and young adults, between reserves and urban communities
• residential school experiences, sexual abuse and sexual violence in our communities
• breakdown of the family and stress on relationships
• poor access to health services
• loss of parental guidance and support
• poverty

These situations result in greater risk through:

• people having many sexual partners living in different places
• low self-esteem and alcohol abuse and their negative effects on sexual decision making
• negative experiences of sexuality leading to problems making healthy sexual decisions
• a lack of knowledge about safer sex practices and the risk of sexually transmitted infections
• intravenous drug use
• contracting sexually transmitted infections in prison and spreading them in the community
• being poor, which makes it hard to stay healthy and resist infection, and to buy condoms and travel to sexual health clinics

Train and Organize

• Identify resources, workers and leaders in the community.
• Develop a community task force or committee.
• Receive education and awareness.

• Develop a mission statement for the task force or committee.
• Develop HIV/AIDS protocols and policies.

• Set up education programs.
• Set up prevention programs.
• Provide for the care and needs of Aboriginal people with HIV/AIDS and their families.
• Ensure support for caregivers.

Education is the first and most important step in preventing the transmission of STIs in our communities. Harm reduction activities such as condom distribution and needle exchanges are other important activities for prevention and health promotion.