There is an over-representation of HIV incidence, prevalence and mortality rates in the Indigenous population of Canada. Further, many do not adhere to HAART partly because of unresolved historic trauma (HT). Most research on HIV/AIDS therapy has focused on “maladaptive” characteristics of Aboriginal males and less on their adaptive, life-maintaining practices. This study explored the impact of HT on treatment among Indigenous males living with HIV/AIDS in BC, with a focus on adaptive/life maintaining practices, i.e., how the experience of HT positively affects male survivors’ ability to adhere to treatment, and the HT impact on treatment outcomes across age groups and residential school survivor status. Using interpretive description incorporating a cultural safety lens as the methodological framework, data was collected through one-to-one interviews, a focus group, and a few Life Story Board sessions. Thirty-six HT survivors told their lived experience stories, discussed how HT affected their adherence to HAART, and explained how they build resilience. Three main themes resulted from data analysis: 1) facilitators of choice or actions leading to HAART adherence; 2) factors leading to HAART non-adherence; and 3) comparative survivor responses on health, services, stigma and the historic trauma effect. Adherence choices and actions are promoted by psychological support, cultural services, religion and spirituality, structural services, resilience, strictness and discipline metered on indirect survivors through their parents. Negative choice or actions resulted from; personal reasons, cultural restrictiveness, lack of structural support and services, spiritual and religion-related factors, and intergenerational historic trauma effects. Finally, comparative responses of survivors’ views noted included the view of health with respect to resilience, availability of and access to services on-and off-reserve, stigma and confidentiality, and the effect of historic trauma through generations and across survivor status. The findings demonstrate how complex the experience and expression of HT is and that most Indigenous men can be resilient to stay on HAART and have better health and wellbeing. Cultural-safety informed recommendations are offered to better address HT, improve treatment-adherent behaviour and resilience, foster healing and reduce deaths due to HIV/AIDS. This study suggests promising resilience factors that have implications for both research and practice.
It is a pivotal time in cervical cancer prevention for young South African (SA) women. Cervical cancer and infection with human immunodeficiency virus are both major public health concerns in SA. This study describes knowledge of female adolescents and young adults (AYA) about HPV, cervical cancer and explores predictors of HPV vaccine and HPV self-sample testing acceptability. In this cross-sectional study, questionnaires were administered to 122 female AYA who involved in a longitudinal study (AYAZAZI) which examined risk factors involved with HIV acquisition. Results indicated that although awareness and knowledge about these topics was very low among participants, as were perceptions of risk of acquiring HPV and developing cervical cancer, acceptability was very high towards HPV vaccines for self (97%) and (future) children (95%), as well for self-sample testing (85%). No significant variables were found to be associated with risk perception or self-sample acceptance. A significant difference was found between participants’ perceived risk of acquiring HPV, HIV, and developing cervical cancer compared to the risk they felt other female AYA in their communities were at. The most influential sexual and reproductive health (SRH) information source and significant influences on HPV vaccine recommendations for participants were health care providers. Findings from this study are important in designing effective cervical cancer control programs that can attract more AYA for HPV vaccines and screening. As the HPV vaccine has only recently been introduced at a national level in SA, this study about awareness and vaccine acceptability is timely.
Hadiksm Gaax di waayu, I belong to the Ganhada (Raven Clan) and my Mother’s side of the family is from Gitxaala, we follow our Mothers. This research, writing, and data collection was done on the traditional unceded territories of the Tsimshian, Lheidli T’enneh, and Musqueam. This work was done in partnership with the people who shared their stories with me, the co-researchers, whose words provide a brief glimpse into the lived experience of First Nations identity and the thought processes involved in contemplating several sources of input informing how we think about identity. Stories of identity, perceptions of identity, and experiences of racism and discrimination have inspired this work and highlighted the need for engagement. This research is a validation of thought processes that surround how we, First Nations people, experience identity. A shift away from Western conceptualizations of identity, this research discusses experiential knowledge, racism and discrimination, impacts of racial microaggressions on self-perceptions and health, and a sampling of how some people have come to define their identity in their own way based on their experiences. The intent of this work is to both inform those who may not understand and to acknowledge and validate those who have thought about First Nations identity but do not have a safe space to share. I hope this work speaks to both First Nations and non-First Nations/Settler Canadians as we continue learning about one another and sharing with each other in the spirit of reconciliation.
This qualitative study was designed in collaboration with the Scia’new and Esquimalt Nations to learn how home and community design impacts the health and quality of life of those living with mobility challenges in their communities. The research questions were: 1) How does the presence or absence of the three structural visitability features (a zero step entry, 32 inch wide doorway and a wheelchair accessible bathroom on the main floor) impact First Nations people with disabilities, 2) What barriers and supports most impact the quality of life of those living with disabilities, 3) How does reserve community infrastructure influence individual home visitability? Methods included: a community scan to assess the layout and physical infrastructure, and photovoice, employed to provide a medium for documentation by participants and to stimulate individual interviews...
Background: The prevalence of Alzheimer’s disease (AD) and other dementias is perpetually increasing in Canada and worldwide with the aging baby boomer population. It is, therefore, important to identify risk factors for these major neurocognitive disorders, such as alcohol consumption, to mitigate the future burden on caregivers and the economy. The purpose of this study was to replicate previous research regarding the dose-response relationship between alcohol consumption and the odds of currently having AD or another dementia. The possibility of a sex effect moderating this relationship was also explored. Participants: Data were obtained for respondents to the combined 2015/16 cycles of the Canadian Community Health Survey who were aged 41 years or older at the time of the survey’s conduction (nweighted = 16,715,618). Methods: Logistic regression was used to crossectionally assess the relationship between various time- and frequency-related alcohol consumption exposures to outcome dementia status, while controlling for a number of demographic and risk factor variables. Results: A sex effect was identified for drinking at an average frequency of four to six times per week over the past year (p = 0.019, 95% CI: 0.03, 0.73) where women (ORw = 0.13) were more protected against currently having AD or dementia than men (ORm = 0.89) when compared to alcohol abstainers. Binge drinking two to three times per month (OR = 0.19, p = 0.015, 95% CI: 0.05, 0.73) and more than once per week over the past year (OR = 0.16, p = 0.007, 95% CI: 0.04, 0.61) significantly lessened the odds of currently having AD or dementia when compared against alcohol abstainers. A sex effect was present for those who were classified as very heavy drinkers (♂: 6+ drinks/day, ♀: 4+ drinks/day) over the past week (p = 0.018, 95% CI: 1.14, 39.41) where alcohol was protective against currently having AD or dementia in men (ORm = 0.29) and alcohol was a risk factor for currently having AD or dementia in women (ORw = 2.15) when both were referenced with alcohol abstainers. Conclusions: With the exception of very heavy drinker women, drinking alcohol was associated with a reduced likelihood of currently having AD or dementia and sex effects were identified for drinking at a moderate frequency over the past year and very heavy drinkers. However, these results should be interpreted with caution due to the possibility of selection, sparse data, and abstainer biases as well as misclassification error. The primary implication of this research is to inform future studies that a more thorough exploration of a sex effect influencing the relationship between alcohol consumption and having AD or dementia is warranted.
Complex trauma is a critical area to explore in terms of the emotional, physical, psychological, social, and spiritual well-being of survivors. This research explored the personal experiences of 12 adult survivors of childhood trauma by interpreting the meanings they attach to their stories of healing. A three phase analysis approach adapted from the work of Lieblich, Tuval-Mashiach, and Zilber (1998) was carried out. Individual interviews were analyzed following a narrative approach to capture each participant’s perspective and meaning. The themes that emerged from the narratives were organized into ten main categories. Five overarching metathemes occurring across all of the participants’ narratives included: Trauma Effects, Establishing Safety, Reclaiming Self, Healing through Relationships, The Healing Journey. The results of this study add important findings that increase understanding of how to address complex trauma in counselling and health care settings in order to restore individual’s sense of safety and well-being. By targeting the possible issues linked to the seven domains of complex trauma that underlie the presentation of traumatized individuals, survivors will feel more supported in their recovery and may be more likely to access appropriate support.
