HIV Among Indigenous peoples: A Review of the Literature on HIV-Related Behaviour Since the Beginning of the Epidemic

Abstract

From the early days of the HIV epidemic, Indigenous peoples were identified as a population group that experiences social and economic determinants-including colonialism and racism-that increase exposure to HIV. There are now substantial disparities in HIV rates between Indigenous and non-Indigenous peoples in some countries. We conducted a comprehensive literature review to assess the evidence on HIV-related behaviors and determinants in four countries-Australia, Canada, New Zealand and the United States-in which Indigenous peoples share important features of colonization and marginalization. We identified 107 articles over more than 20 years. The review highlights the determinants of HIV-related behaviors including domestic violence, stigma and discrimination, and injecting drug use. Many of the factors associated with HIV risk also contribute to mistrust of health services, which in turn contributes to poor HIV and health outcomes among Indigenous peoples.

Fig. 1

Selection of articles for comprehensive literature review of HIV and Indigenous populations

Fig. 2

Number of articles published by year and focus country

Fig. 3

Determinants of HIV Risk Behavior among Indigenous Peoples (adapted from Meade and Sikkema [26]) Solid lines represent determinants that impact HIV behavior. Note: Dashed lines represent hypothesized relationships between determinants