Evan Wood ^1*, Julio S.G. Montaner ¹, Kathy Li ², Ruth Zhang ², Lucy Barney ³, Steffanie A. Strathdee ⁴, Mark W. Tyndall ², Thomas Kerr ²

¹ University of British Columbia
² BC Centre for Excellence in HIV/AIDS
³ BC Centre for Disease Control
⁴ University of California, San Diego

^* To whom correspondence should be addressed. E-mail: uhri.cfe{at}gmail.com.

	Abstract

Objectives. We sought to examine whether there were differential rates of HIV incidence among Aboriginal and non-Aboriginal injection drug users in Canada.

Methods. Data were derived from 2 prospective cohort studies of injection drug users in Vancouver, British Columbia. Using the Kaplan–Meier method and Cox proportional hazards regression, we compared HIV incidence among Aboriginal and non-Aboriginal participants.

Results. Overall, 2496 individuals were recruited between May 1996 and December 2005. Compared with that of non-Aboriginal persons, the baseline HIV prevalence was higher among Aboriginal persons (16.0% vs 25.1%; P<.001). Among participants who were HIV negative at baseline, the cumulative HIV incidence at 48 months was higher among Aboriginal persons (18.5% vs 9.5%; P <.001). In multivariate analyses, Aboriginal ethnicity was independently associated with elevated HIV incidence (relative hazard=1.59; 95% confidence interval=1.12, 2.26; P =.009).

Conclusions. Aboriginal persons in Vancouver had a significantly elevated burden of HIV infection, which calls for a culturally sensitive and evidence-based response. Policymakers in other settings with at-risk Aboriginal populations should seek to avert similar public health emergencies by being proactive with evidence-based HIV-prevention programs.

Key Words: HIV/AIDS, Native Americans, Drugs, Urban Health