Addressing HIV/AIDS among Aboriginal People using a Health Status, Health Determinants and Health Care Framework: A Literature Review and Conceptual Analysis.

Earl Nowgesic
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引用次数: 0

Abstract

Objectives: (1) To describe the Human Immunodeficiency Virus (HIV) infection among Aboriginal populations using a mixed methods approach (i.e. quantitative and qualitative methods); (2) to examine the individual-level and community-level relationships between HIV/AIDS, health determinants, and health care (e.g. diagnosis, access to treatment and health services planning); and (3) to explore innovative solutions to address HIV/AIDS among Aboriginal populations based upon research and infrastructure (e.g. partnerships, data sources and management, health indicators and culture) and policy (i.e. self-determination of Aboriginal Peoples).

Methods: Literature review and conceptual analysis using a health status, health determinants and health care framework.

Results: In comparison to non-Aboriginal persons, HIV infection is higher among Aboriginal persons, is more directly attributable to unique risk factors and socio-demographic characteristics, and yields more adverse health outcomes. Culture, poverty and self-determination are determinants of health for Aboriginal populations. Aboriginal people have inadequate primary care and, in particular, specialist care. It is necessary to include traditional Aboriginal approaches and culture when addressing Aboriginal health while understanding competing paradigms between modern medicine and Aboriginal traditions.

Conclusion: There is a need for self-determination of Aboriginal Peoples in order to improve the health of Aboriginal communities and those living with HIV/AIDS. Research and policy affecting Aboriginal people should be of the highest quality and based upon Aboriginal community relevance and involvement.

利用健康状况、健康决定因素和保健框架解决土著人的艾滋病毒/艾滋病问题:文献回顾和概念分析。
目的:(1)采用混合方法(即定量和定性方法)描述土著人口中的人类免疫缺陷病毒(艾滋病毒)感染情况;(2)检查艾滋病毒/艾滋病、健康决定因素和卫生保健(如诊断、获得治疗和卫生服务规划)之间的个人和社区一级的关系;(3)在研究、基础设施(如伙伴关系、数据来源和管理、健康指标和文化)和政策(即土著人民自决)的基础上,探索解决土著人口中艾滋病毒/艾滋病问题的创新解决办法。方法:采用健康状况、健康决定因素和卫生保健框架进行文献综述和概念分析。结果:与非土著人相比,土著人的艾滋病毒感染率更高,更直接归因于独特的风险因素和社会人口特征,并产生更多不利的健康后果。文化、贫穷和自决是土著居民健康的决定因素。土著人得不到充分的初级保健,特别是专科保健。在处理土著健康问题时,有必要将传统土著方法和文化纳入其中,同时了解现代医学与土著传统之间相互竞争的范式。结论:土著人民需要自决,以改善土著社区和艾滋病毒/艾滋病感染者的健康。影响土著人民的研究和政策应具有最高质量,并以土著社区的相关性和参与为基础。
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