HIV/AIDS Prevention in Indigenous and Ethnic Minority Communities

AIDS the last nail in our coffin

Grace Smallwood (Australia) made it patently clear that the standard picture of the epidemic is not the same for the aboriginal community as it is generally for the white Australian community. The applications of solutions devised for white middle class society do not apply. Television commercials such as the "Grim Reaper" campaign do not show aboriginal people and are irrelevant where there is no television. It was very easy for the perception to develop that this message applied to the mainstream society depicted in the promotion. There has been a major failure of government and the bureaucracy to recognise the problems of the Aboriginal community. To understand the cultural perspectives surrounding sexuality, men's business, women's business and how this makes it absolutely essential that any educative approach is from the Ôbottom up'. Grace quotes Jonathon Manne,"Poverty is a breeding ground for HIV" she then quoted statistics from Townsville where 50 percent of the prison population is Aboriginal and this is also a major vector for HIV infection. Life expectancy is 25 years less than the white population and infant mortality is three times higher. Unemployment runs at 90 percent. In some circumstances infrastructure development is dependant on the income from the local liquor store and thus the cycle of alcohol abuse is institutionalised. Grace cites the example of Condoman as an excellent example of the bottom up approach. She regrets the perception that there was no culture of healing among the aboriginal people and is working to restore some of this knowledge.

Karen Adams also made it clear that ordinary epidemiological studies are not necessarily relevant to indigenous communities. That the communities are undercounted and there is an intergenerational suspicion fear of being counted. She makes it clear that if there is to be an accurate epidemiological study of this community it needs to be undertaken with greater cultural awareness and the outcomes have to be oriented toward the community. It should be done by aboriginal researchers that are accountable to the community they are studying. Karen states the statistics for HIV infection in the Aboriginal community as quite different to the mainstream. 26 percent of infections are among women as opposed to eight percent in the wider community. She points out that births are undercounted by 50 percent.