Tuesday, May 22, 2012

HIV/AIDS – Similarities and Differences between Uganda and First Nations Communities


Differences:
1.       In Uganda sharing needles is not too big of a concern when it comes to HIV transmission. It seems there isn’t a whole lot of IV drug use happening here. Everyone I’ve encountered has said this is almost a non issue here. In the First Nations communities, particularly urban First Nations populations it is estimated that IV drug use accounts for a high percentage of new HIV transmissions.
2.       Mother to child transmission of HIV during pregnancy, birth, and breast feeding is still a huge problem. There hasn’t been a baby born HIV positive in British Columbia since 1989, while it’s an everyday thing here in Uganda.
3.       People living with HIV or AIDS in Uganda are seen as vulnerable and in need of assistance to overcome their situation. In First Nations communities and Canada in general there is a view of “they did this to themselves and should deal with it themselves”. 

Similarities:
1.       There is still a lot of myths in First Nations and rural Ugandan communities about how exactly HIV is transmitted. Some people are still afraid that you can catch it doing daily activities such as sharing utensils or a cigarette or playing sports or swimming with someone who is HIV positive. This of course is untrue.

So HIV 101:

Bodily Fluid that has HIV+ Direct Opening into the Body + Activity = Possible Transmission of HIV

·         Only four bodily fluids can transmit HIV: blood, semen/precum, vaginal fluids, and breast milk
·         Only direct opening into the body with receptor sites: cervix, puncture, pee hole on penis, and anus
·         Activities: unprotected oral, anal, or vaginal sex, blood to blood (such as needle sharing or transfusion), and mother to child during pregnancy, birth, and breastfeeding.
·         HIV can only survive for 7 seconds in open air before the virus dies.
·         Waste fluids do NOT transmit HIV. You cannot get HIV from salvia, mucus, or pee. If someone with HIV coughs or sneezes on you, YOU ARE NOT AT RISK. Also mosquitoes cannot transmit HIV.

2.       Because of these myths there is still stigma in both First Nations and rural Ugandan communities. I have to say though that Uganda has come a long way in battling stigma. The government believes 80% of the population is educated about HIV and does not stigmatize those with HIV. I don’t know how true this is from my every day conversations with Ugandans, but that’s the official word on the streets.
3.       Lack of adherence to ARV (anti-retro viral) regimes. ARVs are medicine that can treat HIV but not cure it. In order for these to be the most effective there needs to be 90% adherence rate. In Uganda the challenge to adherence is access to ARVs, since there are frequent shortages and people cannot always afford them. In the First Nations community the biggest challenge is people not being in stable enough position to commit to taking ARVs every day. In both countries there is a lack of buy-in about ARVs effectiveness and benefits. ARVs have many side-effects and sometimes people just don’t see the point, in both Uganda and First Nation communities.
4.       There is great work going on in both countries about all aspects of HIV/AIDS. In Uganda there a lots of NGO’s and government organizations working to assist those affected by HIV/AIDS. There are lots of First Nations organizations working to improve the HIV/AIDS crisis. 
a.       Examples of Uganda Organization:
                                                               i.      TASO
                                                             ii.      CAP AIDS
                                                            iii.      AIDS Information Centers
                                                           iv.      Baiylor Uganda
                                                             v.      ACET (AIDS Care, Education & Training)
                                                           vi.      Action Aid Uganda
b.      Examples of First Nations Organizations:
                                                               i.      Red Road HIV/AIDS Network
                                                             ii.      Canadian Aboriginal AIDS Network
                                                            iii.      Youth Co
                                                           iv.      Healing Our Spirit
                                                             v.      Chee Mamuk