Burden of HIV infection among aboriginal injection drug users in Vancouver, British Columbia.
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.
Wood
Evan
E
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
Montaner
Julio S G
JS
Li
Kathy
K
Zhang
Ruth
R
Barney
Lucy
L
Strathdee
Steffanie A
SA
Tyndall
Mark W
MW
Kerr
Thomas
T
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*
D013287:Illicit Drugs