Socio-demographic characteristics and response to antiretroviral therapy among indigenous participants in a population-based program
C L Miller, K V Heath, K Chan, P M Spittal, M V O’Shaughnessy, J S G Montaner, M T Schechter, R S Hogg
BC Centre for Excellence in HIV/AIDS, Vancouver, Canada
Background: There have been few studies characterizing access to antiretrovirals (ARV) and response to therapy among indigenous peoples. We undertook this study to provide a profile of indigenous people accessing ARV therapy and their response to treatment.
Methods: The HIV/AIDS Drug Treatment Program (DTP) distributes ARV medication province-wide to all eligible persons in British Columbia. Indigenous peoples in the DTP were identified through self-report by indicating they were Aboriginal/First Nations, Inuit or Metis. Socio-demographics and risk factors were compared with non-Indigenous participants using contingency table analysis. Viral load analysis was restricted to those on triple combination therapy and response to therapy was defined as having two plasma viral load measure below 500 copies/mL.
Results: Of 2096 participants, 226 (11%) self-identified as indigenous from 1997 through 2001. These participants were more likely to be female (p=0.001), younger (p=0.001), live in unstable housing (p=0.001), report an income of <10K CDN(p=0.001) and be co-infected with HCV (p=0.001). Indigenous peoples were less likely to report men who have sex with men (MSM) as a risk factor (p=0.001) and more likely to report IDU (p=0.001). Indigenous participants were more likely to be started on double combination therapy (p=0.001), and to have a physician less experienced with treating HIV (p=0.001). When these factors are controlled for, indigenous peoples treated with triple therapy are as likely to respond and suppress their viral load below 500 copies.
Conclusion: In digenous peoples living with HIV/AIDS may face additional challenges such as poverty, and historical acculturation and genocide. Furthermore, they may be at increased risk of receiving sub-optimal treatment and may have difficulty reaping the full benefits of available therapies. These findings identify a need for specific ARV treatment and support services directed at indigenous peoples.
The XIV International AIDS Conference
Abstract no. MoPeB3260
” C L Miller, et al. Socio-demographic characteristics and response to antiretroviral therapy among indigenous participants in a population-based program. Poster Exhibition: The XIV International AIDS Conference: Abstract no. MoPeB3260″