Trauma and cultural safety: providing quality care to HIV-infected women of aboriginal descent

J Assoc Nurses AIDS Care. Jan-Feb 2014;25(1 Suppl):S70-8. doi: 10.1016/j.jana.2013.05.005. Epub 2013 Sep 4.

Abstract

In Canada, the Aboriginal community is most at risk for HIV infection. Aboriginal peoples have disproportionately high rates of violence, drug use, and challenging socioeconomic circumstances. All of this is related to a history of colonization that has left Aboriginal people vulnerable to HIV infection through unsafe sex, needle sharing, and lack of access to health promotion and education. Aboriginal women are at particular risk for HIV infection. They experience a disproportionate degree of trauma, which is associated with colonization, high rates of childhood sexual abuse, and illicit drug use. A history of trauma impacts on access to health care, uptake of antiretroviral therapy, and mortality and morbidity in people with HIV. We describe the case of a 52-year-old, HIV-infected Aboriginal woman. We review the current evidence related to her case, including colonization, intersectionality, post-traumatic stress disorder, depression, revictimization, and substance use.

Keywords: Aboriginal; American Indian; HIV; PTSD; colonization; cultural safety; trauma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult Survivors of Child Abuse / psychology*
  • Anti-HIV Agents / therapeutic use
  • Canada
  • Culture
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / ethnology*
  • HIV Infections / psychology
  • Humans
  • Indians, North American* / ethnology
  • Mental Disorders
  • Middle Aged
  • Patient Compliance
  • Quality of Health Care / statistics & numerical data*
  • Socioeconomic Factors
  • Stress Disorders, Post-Traumatic / ethnology
  • Stress Disorders, Post-Traumatic / psychology*
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / psychology
  • Violence / ethnology*
  • Violence / psychology

Substances

  • Anti-HIV Agents