HIV in Canada: A primer for service providers

Aboriginal people

Key Points

  • There were an estimated 1,400,685 aboriginal people in Canada in 2011.
  • Aboriginal people were 2.7 times more likely to get HIV than people of other ethnicities in Canada in 2014.
  • Aboriginal people accounted for an estimated 11% of new HIV infections in 2014.
  • HIV incidence may have decreased slightly in Aboriginal people since 2011.
  • Injection drug use is an important risk factor for HIV transmission among Aboriginal people.
  • Aboriginal people accounted for an estimated 9% of all Canadians living with HIV in 2014.
  • Five percent of aboriginal people are HIV positive (based on a pilot A-Track site in Regina).

There were an estimated 1,400,685 aboriginal people in Canada in 2011. This accounts for 4.3% of the Canadian population.

Aboriginal people in Canada are 2.7 times more likely to get HIV than people of other ethnicities in Canada. According to national 2014 estimates, there were 18.2 new HIV infections for every 100,000 Aboriginal people in Canada. This compares to only 6.7 new HIV infections for every 100,000 people of other ethnicities in Canada.  

An estimated 278 new infections occurred in Aboriginal people in 2014 (11% of new HIV infections). HIV incidence may have decreased slightly in Aboriginal populations since 2011, when an estimated 349 new HIV infections occurred.

Injection drug use is an important risk factor for HIV transmission within the Aboriginal community. In 2014, an estimated 45% of new HIV infections among Aboriginal people were attributed to injection drug use; an estimated 40% were attributed to heterosexual contact; an estimated 10% were attributed to sex between men; and an estimated 4% were attributed to sex between men or injection drug use (in men who reported engaging in both behaviours). We can tell from these numbers that the epidemic among Aboriginal people in Canada is very different than among non-Aboriginal people.

An estimated 6,850 Aboriginal people were living with HIV at the end of 2014, accounting for 9% of HIV infections in Canada (prevalence). Females make up a comparatively large proportion of the Aboriginal HIV epidemic. Between 1998 and 2012, 47% of all HIV diagnoses among Aboriginal people were in females whereas among other ethnicities 20% of HIV diagnoses were in females. Aboriginal people testing positive for HIV tend to be younger than non-Aboriginal people. Between 1998 and 2012 almost one-third (32%) of Aboriginal HIV diagnoses were in people between 15 and 29 years of age whereas 22% of diagnoses among other ethnicities were in this age group.

Caution should be used, however, when drawing conclusions from the numbers reported for Aboriginal peoples. An adequate description of the HIV epidemic among Aboriginal people in Canada requires accurate and complete access to ethnicity data. Ethnicity data are not available for all provinces and territories. As a result, only data from certain provinces and territories (all but Ontario and Quebec) are used when examining HIV diagnoses data on Aboriginal people.

A-Track collects dried blood spot samples to test for HIV (2012). Five percent of Aboriginal people enrolled in the study tested positive for HIV. Interestingly, only 56% of participants, who tested positive for HIV, were aware of their status. It should be noted that this A-Track data is from only one pilot site in Regina and may not represent all Aboriginal people in Canada.  

According to A-Track, among those who self-reported they were HIV positive, 87% reported being under the care of a doctor for their HIV and 67% reported ever taking prescribed drugs for their HIV.

In Canada, Aboriginal populations are very diverse, with communities that reflect variations in historical backgrounds, language and cultural traditions. These communities are disproportionately affected by many social, economic and cultural factors (determinants of health) that increase their vulnerability to HIV infection.

Resources

The epidemiology of HIV in Canada – CATIE fact sheet

Summary: Estimates of HIV Incidence, Prevalence and Proportion Undiagnosed in Canada, 2014 – Public Health Agency of Canada (PHAC)

HIV/AIDS Epi Updates Chapter 8: HIV/AIDS among Aboriginal people in Canada – PHAC

HIV/AIDS in Canada – CATIE infographic

People living with HIV in Canada – CATIE infographic

New HIV infections in Canada – CATIE infographic

Where is HIV hitting hardest? – CATIE infographic

HIV in Canada – PHAC infographic

Sources

  1. Statistics Canada. Aboriginal Peoples in Canada: First Nations People, Métis and Inuit. 2013. Available at: https://www12.statcan.gc.ca/nhs-enm/2011/as-sa/99-011-x/99-011-x2011001-eng.cfm
  2. Public Health Agency of Canada. Summary: Estimates of HIV Incidence, Prevalence and Proportion Undiagnosed in Canada, 2014. Ottawa: Surveillance and Epidemiology Division, Professional Guidelines and Public Health Practice Division, Centre for Communicable Diseases and Infection Control, PHAC; 2015. Available at: http://www.catie.ca/en/resources/summary-estimates-hiv-incidence-prevalence-and-proportion-undiagnosed-canada-2014
  3. Public Health Agency of Canada. HIV/AIDS Epi Updates Chapter 1: National HIV Prevalence and Incidence Estimates for 2011. Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, 2014. Available at: http://www.catie.ca/en/resources/hivaids-epi-update-chapter-1-national-hiv-prevalence-and-incidence-estimates-2011-0
  4. Public Health Agency of Canada. HIV/AIDS Epi Updates Chapter 8: HIV/AIDS among Aboriginal people in Canada. Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, 2014. Available at: http://www.catie.ca/en/resources/hivaids-epi-updates-chapter-8-hivaids-among-aboriginal-people-canada
  5. Public Health Agency of Canada. Summary of key findings from the A-Track pilot survey (2011-2012). Available at: http://www.catie.ca/en/resources/summary-key-findings-track-pilot-survey-conducted-regina-saskatchewan