Exploring the social issues
AIDS may be a disease; but to understand its prevention and treatment we have to look beyond basic science and medicine to how it interacts with other aspects of people's lives. This point of view is shared by many AIDS researchers, including Dr. Catherine Worthington, an AHFMR Population Health Investigator from the University of Calgary.
"A disproportionate number of people living with HIV/AIDS are coming from populations such as injection-drug users, Aboriginal people, and street youth," she says. "We don't hear about HIV as much in the media as we used to, but the numbers prove it is still a huge problem."
Dr. Worthington recently concluded a study of HIV and the support services available to street kids in Calgary. Her work grew out of the increasing recognition that social services designed from a middle-class, nine-to-five perspective will probably not meet the needs of other groups. Working with youth organizations, health-service agencies, and young people themselves, the research team identified factors that promote or impede the use of these services. The results are already being used by various agencies in designing services for young people and in educating those who will provide these services. Round-table meetings and community workshops also helped get the results out to the community.
Dr. Worthington recently collaborated on another study about HIV and Aboriginal youth that was national in scope. A clear message coming from community consultations was that young Aboriginals don't know enough about HIV and their own HIV risk. "Part of that is just being young; but another part is being Aboriginal, from a culture where sexuality is not always easily discussed," says Dr. Worthington. "Young people's awareness of HIV in general has fallen off over the last decade. There is a lot of work to be done in making services more accessible, friendly, appropriate for youth, and for those from distinct cultures."
Another of her collaborative projects-this one involving AIDS Calgary and Dr. David Este from the University of Calgary's Faculty of Social Work-examines HIV/AIDS services to Calgary's communities of African immigrants. Through one-on-one interviews and focus groups, the team has identified service needs and gaps. "In African countries, messages about HIV/AIDS are plastered everywhere on billboards. It's not really visible here. The results [of our research] are telling us we need to integrate HIV services with services to immigrants. We need to get the message out that AIDS is an issue here too."
In the long term, Dr. Worthington plans to extend her community-based research by analyzing the extent to which people living with HIV in Alberta make use of health support services. "By doing this, we would have a better picture of who is going for what types of care, and what the outcomes are. This kind of insight would be of interest not only locally, but nationally as well."
The changing face of AIDS in Canada
The face of HIV/AIDS has changed dramatically in Canada over the past quarter of a century. On its website, the Public Health Agency of Canada says this about HIV/AIDS in Canada:
Canada's HIV/AIDS epidemic is now actually several epidemics, occurring in specific populations. Although men who have sex with men (gay men and homosexually active men) continue to be the population most affected by HIV/AIDS, the disease has also become a significant public health issue for injecting drug users, women, Aboriginal peoples, prison inmates, people from countries where HIV is endemic, as well as those already living with HIV/AIDS. Risk behaviour data on young Canadians also show significant potential for HIV transmission among youth.