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HIV statistics for Inuit called deceptively low

Many refuse to be tested for deadly virus

JANE GEORGE

Karin and Kathy Kettler drum dance in front of Parliament in Ottawa as part of the Canadian Aboriginal AIDS Network's participation in the AIDS Day Positive Protest March. (PHOTO COURTESY OF ITK)

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Statistics for Inuit with HIV, the virus linked to the fatal auto-immune deficiency syndrome known as AIDS, are in all likelihood deceptively low because of the way information is collected and compiled.

Inuit who live in Nunavik and Nunavut don't like to be tested for HIV. Those who are tested are generally tested in the South, and, even when they agree to tests, there's often no "ethnic" information attached to the reports.

Since 1987, there have been 13 HIV infections reported in Nunavut, and none in Nunavik. Of the 459 full-blown AIDS cases officially reported to June 2002 in Canada, Health Canada says 18 were identified as Inuit.

But these low numbers among Inuit don't tell the whole story.

Dec. 1 marked the 15th annual World AIDS Day. There were media reports with images of people and countries devastated by AIDS and alarming statistics on global HIV infection rates as well as events such as the Canadian Aboriginal AIDS Network's "Positive Protest March" in Ottawa.

In 2003, there were more deaths and infections around the world from HIV and AIDS than ever before, with more than three million people killed and another five million infected. Between 34 million and 46 million are believed to have the HIV virus.

United Nations health officials say these numbers are also unreliable because of shortfalls in reporting and health care - just as in Nunavik or Nunavut.

"The reason why the HIV rate is very low here in Nunavut is that people aren't being tested for it. You can't be forced anywhere in the country to take a test, so everyone who goes to the hospital who is pregnant is offered an HIV test, but you can't force them to take a test. Anyone who comes with an STD [sexually transmitted disease] is also offered a test," said Ed Picco, Nunavut's health and social services minister.

Picco said there's still a huge stigma around HIV and AIDS in Nunavut. Those who are offered a test don't want one because they worry about leaks in confidentiality - particularly in a small community - and what could happen to them and their families if they test positive for HIV.

The same reluctance to be tested for HIV exists in Nunavik, where HIV testing is offered to anyone with an STD as well as to pregnant women.

In 2000, 25 per cent of pregnant women agreed to an HIV test, but this rate has since gone down, said Nunavik's director of public health, Dr. Serge Déry.

To change this trend, HIV testing will soon be offered to pregnant women in Nunavik as part of the total, regularly recommended package of pre-natal testing.

This means pregnant women won't have to agree to a separate HIV test. If they don't want any HIV testing, they'll have to refuse it.

Déry said the use of a more anonymous reporting system for HIV testing, one that uses numbers instead of names to identify people, is also being promoted.

Even with low compliance rates for testing, HIV rates can be gauged by STD rates. When STD rates are high, studies show HIV infection rates are often comparable. At the very least, high STD rates show that HIV could easily spread among the same sexually active population.

In Nunavik, from 2001 through 2003, chlamydia, a disease that causes infertility and ectopic pregnancies in women, and gonorrhea, another sexually transmitted infection, occurred among Nunavimmiut at a rate 12 times higher than in the rest of Canada, and about 20 times higher than in the rest of Quebec.

In 2002, chlamydia and gonorrhea occurred among Nunavummiut at a rate 11 times higher than in the rest of Canada. During 2003, syphillis, another STD, which had no reported cases in previous years, also made a comeback in Nunavut.

Pregnancy and cervical cancer rates are very high among women in Nunavut as well, pointing to high levels of unprotected sex.

Thirty-five per cent of cancers diagnosed in women in Nunavut are cancers of the cervix. Since cervical cancers are believed to be caused by a sexually transmitted papiloma virus, this is likely a sign of unprotected sexual activity.

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