title: Burden of HIV infection among aboriginal injection drug users in Vancouver, British Columbia.
abstract: OBJECTIVE
  We sought to examine whether there were differential rates of HIV incidence among Aboriginal and non-Aboriginal injection drug users in a Canadian setting.
  
  
  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.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, 608-1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada. uhri@cfenet.ubc.ca
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: Kathy
authors.initials: K
authors.lastname: Li
authors.forename: Ruth
authors.initials: R
authors.lastname: Zhang
authors.forename: Lucy
authors.initials: L
authors.lastname: Barney
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.forename: Mark W
authors.initials: MW
authors.lastname: Tyndall
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D002170:Canada; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D013287:Illicit Drugs; D015994:Incidence; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D044382:Population Groups; D015995:Prevalence; D011446:Prospective Studies; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications*
chemical_list: D013287:Illicit Drugs