title: Elevated rates of HIV infection among young Aboriginal injection drug users in a Canadian setting.
abstract: OBJECTIVE
  Recent reports have suggested that Aboriginal and American Indian people are at elevated risk of HIV infection. We undertook the present study to compare socio-demographic and risk variables between Aboriginal and non-Aboriginal young (aged 13 - 24 years) injection drug users (IDUs) and characterize the burden of HIV infection among young Aboriginal IDUs.
  
  
  METHODS
  We compared socio-demographic and risk variables between Aboriginal and non-Aboriginal young IDUs. Data were collected through the Vancouver Injection Drug Users Study (VIDUS). Semi-annually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for HIV and Hepatitis C (HCV).
  
  
  RESULTS
  To date over 1500 Vancouver IDU have been enrolled and followed, among whom 291 were aged 24 years and younger. Of the 291 young injectors, 80 (27%) were Aboriginal. In comparison to non-Aboriginal youth, Aboriginal youth were more likely to test seropositive for either HIV (20% vs 7%, p=< 0.001) or Hepatitis C virus (HCV) (66% vs 38%, p =< 0.001), be involved in sex work and live in the city's IDU epi-centre at baseline. After 48 months of follow-up, Aboriginal youth experienced significantly higher HIV seroconversion rates than non-Aboriginal youth, 27.8 per ppy (95% CI: 13.4-42.2) vs. 7.0 per ppy (95% CI: 2.3-11.8) respectively (log-rank p = 0.005) and the incidence density over the entire follow-up period was 12.6 per 100 pyrs (CI: 6.49-21.96) and 3.9 per 100 pyrs (CI: 1.8-7.3) respectively.
  
  
  CONCLUSIONS
  These findings demonstrate that culturally relevant, evidence based prevention programs are urgently required to prevent HIV infection among Aboriginal youth.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada. cmiller@cfenet.ubc.ca
authors.forename: Cari L
authors.initials: CL
authors.lastname: Miller
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Spittal
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
authors.forename: Kathy
authors.initials: K
authors.lastname: Li
authors.forename: Martin T
authors.initials: MT
authors.lastname: Schechter
authors.forename: Evan
authors.initials: E
authors.lastname: Wood