She added: "The other big structural barrier is that funding has been incrementally reduced in the last 10 years. All around the world HIV exceptionalism has always been where people are giving priority to HIV and then the funding started to shift and HIV was no longer a priority - despite the fact that we still have many people in our indigenous community testing positive and just when we felt like we were having some successes then the funding got pulled back."
Globally every country should have ensured that at least 90% of persons living with HIV know their status, 90% of them are receiving lifesaving antiretroviral therapy, and 90% of them remain virally suppressed. Ensuring undetectable viral load translates into untransmittbale (undetectable equals untransmittable) is vital if we are to end AIDS by 2030.
Canada made remarkable progress towards 90-90-90 goals by 2020 but those who were not diagnosed, or diagnosed with HIV but not receiving treatment, or those receiving treatment but not virally suppressed, are likely to come from most marginalized sections of its population - including indigenous peoples. Those most at risk like indigenous peoples must be reached first.
Racial inequity
"Another big structural barrier in our response to HIV in indigenous communities in Canada lies within the healthcare system itself. We are quite often dealing with structural racism within healthcare settings. So a lot of people are reluctant to access services within healthcare systems. This is yet another deterrent for achieving the global goals," said Doris.
It is not just HIV services that become inaccessible for indigenous peoples due to these barriers but TB services as well.
"Access to treatment for HIV and TB is another issue that has not been addressed at the national level despite the fact that TB is quite high especially in the northern region. TB has now trickled into little pockets within the urban settings and so we are only now responding to it," said Doris.
Holistic response to HIV
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