The Indigenous Red Ribbon Storytelling Study: What does it mean for Indigenous peoples living with HIV and a substance use disorder to access antiretroviral therapy in Saskatchewan?

Earl Nowgesic, Ryan Meili, Sandra Stack, Ted Myers
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Abstract

Indigenous peoples living with HIV are less likely than non-Indigenous peoples living with HIV to access antiretroviral therapy; however, there is not enough contextual information surrounding this issue. The Indigenous Red Ribbon Storytelling Study was conducted in part to examine how Indigenous peoples living with HIV construct and understand their experiences accessing antiretroviral therapy. Our study design was critical Indigenous qualitative research, using the Behavioral Model of Health Services Use and community-based participatory research approaches. The study was conducted in partnership with Indigenous and non-Indigenous organizations. Study participants were adults from two Canadian cities. The study methods included 20 individual and two Indigenous sharing circle interviews, six participant observation sessions, a short survey and thematic analysis. Accessing antiretroviral therapy within the context of living with a substance use disorder was an overarching theme. Indigenous peoples living with HIV felt they had to choose between living with their active substance use disorder and accessing antiretroviral therapy. They felt misunderstood as a person living with a substance use disorder and often felt coerced into using antiretroviral therapy. Despite these challenges, they persevered as Indigenous peoples living with HIV and a substance use disorder. Further research on antiretroviral therapy access among Indigenous peoples living with HIV and a substance use disorder, particularly from the perspective of health service providers, is needed.

土著红丝带讲故事研究:萨斯喀彻温省的土著艾滋病毒和药物使用障碍患者获得抗逆转录病毒治疗意味着什么?
感染艾滋病毒的土著人民比感染艾滋病毒的非土著人民获得抗逆转录病毒治疗的可能性更小;然而,没有足够的上下文信息围绕这个问题。土著红丝带讲故事研究的部分目的是研究感染艾滋病毒的土著人民如何构建和了解他们获得抗逆转录病毒治疗的经历。我们的研究设计是关键的土著定性研究,使用卫生服务使用行为模型和基于社区的参与性研究方法。这项研究是与土著和非土著组织合作进行的。研究参与者是来自加拿大两个城市的成年人。研究方法包括20次个人访谈和2次原住民分享圈访谈、6次参与者观察、1次简短调查和专题分析。在有物质使用障碍的情况下获得抗逆转录病毒治疗是一个首要主题。感染艾滋病毒的土著人民感到,他们必须在患有活动性药物使用障碍和接受抗逆转录病毒治疗之间做出选择。他们感到被误解为患有物质使用障碍的人,经常感到被迫接受抗逆转录病毒治疗。尽管面临这些挑战,但作为感染艾滋病毒和药物使用障碍的土著人民,他们坚持了下来。需要进一步研究感染艾滋病毒和药物使用障碍的土著人民获得抗逆转录病毒治疗的情况,特别是从保健服务提供者的角度进行研究。
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