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Canadian Journal of Public Health

, Volume 102, Issue 3, pp 215–219 | Cite as

Inequalities in Determinants of Health Among Aboriginal and Caucasian Persons Living With HIV/AIDS in Ontario: Results From the Positive Spaces, Healthy Places Study

  • Laverne E. Monette
  • Sean B. Rourke
  • Katherine Gibson
  • Tsegaye M. Bekele
  • Ruthann Tucker
  • Saara Greene
  • Michael Sobota
  • Jay Koornstra
  • Steve Byers
  • Elisabeth Marks
  • Jean Bacon
  • James R. Watson
  • Stephen W. Hwang
  • Amrita Ahluwalia
  • James R. Dunn
  • Dale Guenter
  • Keith Hambly
  • Shafi Bhuiyan
  • Positive Spaces, Healthy Places Team
Quantitative Research

Abstract

Objectives

Aboriginal Canadians (i.e., First Nations, Inuit and Métis) are disproportionately affected by HIV/AIDS, and experience greater social and economic marginalization and poorer housing conditions. This study sought to understand the differences in the determinants of health and housing-related characteristics between samples of Aboriginal and Caucasian adults living with HIV/AIDS in Ontario.

Methods

We analyzed baseline demographic, socio-economic, health, and housing-related data from 521 individuals (79 Aboriginal and 442 Caucasian) living with HIV/AIDS and enrolled in the Positive Spaces, Healthy Places study. We compared the characteristics of Aboriginal and Caucasian participants to identify determinants of health and housing-related characteristics independently associated with Aboriginal ethnicity.

Results

Compared to Caucausian participants living with HIV, Aboriginal participants were more likely to be younger, female or transgender women, less educated, unemployed, and homeless or unstably housed. They were also more likely to have low incomes and to have experienced housing-related discrimination. In a multivariate model, gender, income, and experiences of homelessness were independently associated with Aboriginal ethnicity.

Conclusion

Aboriginal individuals living with HIV/AIDS in our sample are coping with significantly worse social and economic conditions and are more likely to experience challenging housing situations than a comparison group of Caucasian individuals living with HIV/AIDS. To develop effective care, treatment and support strategies for Aboriginal peoples with HIV, it is critical to address and improve their socio-economic and housing conditions.

Mots clés

VIH inégalité; déterminants de la santé logement population d’origine amérindienne 

Key words

HIV inequality determinants of health housing Aboriginal peoples 

Résumé

Objectifs

Les Canadiens autochtones (Premières Nations, Inuits et Métis) sont démesurément touchés par le VIH et le sida; ils sont aussi plus marginalisés sur le plan socioéconomique et ont des conditions de logement inférieures. Nous avons cherché à comprendre les différences dans les déterminants de la santé et les caractéristiques de l’habitat d’échantillons d’adultes autochtones et blancs vivant avec le VIH ou le sida en Ontario.

Méthode

Nous avons analysé les données de base (démographiques, socioéconomiques, sanitaires et liées au logement) de 521 sujets (79 Autochtones, 442 Blancs) vivant avec le VIH ou le sida et participant à l’étude Positive Spaces, Healthy Places. Les caractéristiques des participants autochtones et blancs ont été comparées afin de cerner les déterminants de la santé et les caractéristiques de l’habitat présentant une association indépendante avec l’ethnicité autochtone.

Résultats

Comparativement aux participants blancs vivant avec le VIH, les participants autochtones étaient plus susceptibles d’être des jeunes, des femmes ou des femmes transgenre, d’être moins scolarisés, sans emploi, sans abri ou de vivre dans un logement précaire. Ils étaient aussi plus susceptibles d’avoir un faible revenu et d’avoir été victimes de discrimination liée au logement. Dans notre modèle multivarié, le sexe, le revenu et les expériences d’itinérance présentaient des associations indépendantes avec l’ethnicité autochtone.

Conclusion

Les sujets autochtones vivant avec le VIH ou le sida dans notre échantillon composent avec des conditions socioéconomiques beaucoup plus difficiles et sont plus susceptibles d’éprouver des problèmes à se loger que le groupe témoin de sujets blancs vivant avec le VIH et le sida. Pour élaborer des stratégies de soins, de traitement et de soutien efficaces pour les Autochtones atteints du VIH, il est essentiel d’aborder et d’améliorer leurs conditions socioéconomiques et de logement.

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Copyright information

© The Canadian Public Health Association 2011

Authors and Affiliations

  • Laverne E. Monette
    • 1
  • Sean B. Rourke
    • 2
    • 3
    • 4
    • 5
  • Katherine Gibson
    • 2
  • Tsegaye M. Bekele
    • 2
  • Ruthann Tucker
    • 2
  • Saara Greene
    • 5
    • 6
    • 7
  • Michael Sobota
    • 5
    • 8
  • Jay Koornstra
    • 5
    • 9
  • Steve Byers
    • 10
  • Elisabeth Marks
    • 5
  • Jean Bacon
    • 2
    • 5
  • James R. Watson
    • 2
  • Stephen W. Hwang
    • 3
    • 11
  • Amrita Ahluwalia
    • 7
  • James R. Dunn
    • 3
    • 12
  • Dale Guenter
    • 13
  • Keith Hambly
    • 7
  • Shafi Bhuiyan
    • 2
  • Positive Spaces, Healthy Places Team
  1. 1.Ontario Aboriginal HIV/AIDS StrategyTorontoCanada
  2. 2.Ontario HIV Treatment Network, The Ontario HIV Treatment NetworkTorontoCanada
  3. 3.Centre for Research on Inner City Health, The Keenan Research CentreLi Ka Shing Knowledge Institute, St. Michael’s HospitalTorontoCanada
  4. 4.Department of PsychiatryUniversity of TorontoTorontoCanada
  5. 5.The CIHR Centre for REACH in HIV/AIDS (Research Evidence into Action for Community Health)TorontoCanada
  6. 6.Faculty of Social SciencesMcMaster UniversityTorontoCanada
  7. 7.Fife HouseTorontoCanada
  8. 8.AIDS Thunder BayThunder BayCanada
  9. 9.Bruce HouseOttawaCanada
  10. 10.AIDS NiagaraSt. CatharinesCanada
  11. 11.Faculty of MedicineUniversity of TorontoTorontoCanada
  12. 12.Department of Health, Aging & SocietyMcMaster UniversityHamiltonCanada
  13. 13.Department of Family MedicineMcMaster UniversityHamiltonCanada

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