The Experience of Active Injection Drug Use on Adherence to Antiretroviral Treatment in Aboriginal People Living in Prince George - A Qualitative Perspective.

In Canada the incidence rates of HIV in Aboriginal populations continue to grow, despite an overall reduction in HIV prevalence of the Canadian population as a whole. Reasons for the increased Aboriginal HIV incidence are varied including structural components such as socio-economic issues, and limited access to healthcare. In addition, personal coping strategies such as addiction and mental health issues increase incidence rates of HIV. With this context in mind, it is not surprising that the difficulties of managing HIV - a disease which involves complex treatment regimens and wide variations in health status - can create unbearable burdens on people infected (and affected) by HIV/AIDS. The complicated treatment regimens associated with HIV can pose great problems for Aboriginal people, but are exacerbated when active injection drug use is factored in. The purpose of this study is to gain insight into how active injection drug use impacts adherence to antiretroviral treatment in Aboriginal people living in Prince George, British Columbia. The study asked participants what they felt could be done by healthcare providers to better support them in their struggles to maintain the high levels of adherence needed for maximal HIV viral suppression. Eight interviews were conducted and analyzed using a Grounded Theory methodology. Analysis and interpretation revealed that healthcare providers need to me [sic] more caring and consistent in their approach. Adherence is facilitated by the knowledge of the health consequences of non-adherence trust in healthcare providers incorporating HAART into daily routines receiving support from AIDS services organizations, friends, and family and that combining HAART administration with methadone is an effective pathway to increase adherence. On the other hand, the most common barrier to adherence identified by the participants was being high'. Finally the study found that the majority of participants expressed a feeling of disconnection from Aboriginal culture. --P