Behind the Pandemic in Aboriginal Communities - Interagency ...

approach must be undertaken with integrity and purpose.• Research should strive to develop the capacity of individuals and communities andmust allow the widest possible participation of the targeted communities.Marginalized groups:Some Aboriginal people belong to groups such as sex workers, drug users, prisoners,transgendered people and men who have sex with men. These groups face additionalforms of social and economic exclusion, including from within Aboriginal communities.a) Prisoners• Most prisons have rules that prohibit or discourage prisoners from engaging insexual activity, tattooing and injection drug use.• Prisoners continue to have sex, get tattoos and inject drugs, but risk being punishedif caught by prison staff; participating in banned activities usually results inrestrictions of movement and restricted access to programming.• Such policies make it impossible for prison staff or community organizations toprovide clean injecting equipment, safe tattooing equipment, dental dams, condomsand even basic education on developing safer sex and tattooing practices insideprisons.b) Sex workers• Male, female and transgender sex workers have sexual contact with a large numberof people. This puts them at high risk of getting infected with many forms of sexuallytransmitted infections and even to HIV.• Canada’s laws on sex work increase vulnerability. It is legal to be a sex worker butalmost every activity associated with sex work is illegal. This creates conditions thatincrease risk: laws that prohibit people from talking about exchanging sex for moneymake it hard for sex workers to screen potential clients or negotiate condom use,and laws that make it illegal to run a bawdy house or live off of the profits of sexwork force some women to work on the street.• Aboriginal sex workers also face high rates of violence.c) People who use drugs• Many countries have prohibitionist drug laws and policies, which try to limit thesupply and demand for drugs through public education, policing, and imprisoningdrug traffickers and users.• These efforts have not been effective at stopping drug use among citizens of manycountries, but do contribute to HIV vulnerability by creating unsafe conditions forpeople who use drugs and by making it hard for them to access health services thatcan prevent the spread of HIV and Hepatitis C, such as clean needles.• Criminalizing drug use also contributes to an increased population of HIV+ prisoners,increasing vulnerability within prisons.84d) Men who have Sex with Men• Homophobia can make it hard for men to accept their attraction to other men andcan contribute to low self-esteem and internalized homophobia. This can make ithard for men who have sex with men to access information and services to helptake care of their health; contribute to high risk sexual practices with male partnerssuch as anonymous sex, multiple partners, and unprotected sex; and increase the