Summary findings from Tracks surveys implemented by First Nations in Saskatchewan and Alberta, Canada, 2018-2020

Kathleen Lydon-Hassen; Leigh Jonah; Lisa Mayotte; Ashley Hrabowy; Bonny Graham; Beverley Missens; Amanda Nelson; Mustafa Andkhoie; Deana Nahachewsky; Dharma Teja Yalamanchili; Sabyasachi Gupta; Nnamdi Ndubuka; Ibrahim Khan; Wadieh Yacoub; Maggie Bryson; Dana Paquette

doi:10.14745/ccdr.v48i04a05

Summary findings from Tracks surveys implemented by First Nations in Saskatchewan and Alberta, Canada, 2018-2020

Can Commun Dis Rep. 2022 Apr 6;48(4):146-156. doi: 10.14745/ccdr.v48i04a05.

Authors

Kathleen Lydon-Hassen¹, Leigh Jonah¹, Lisa Mayotte², Ashley Hrabowy², Bonny Graham², Beverley Missens², Amanda Nelson², Mustafa Andkhoie³, Deana Nahachewsky⁴, Dharma Teja Yalamanchili⁵, Sabyasachi Gupta⁵, Nnamdi Ndubuka⁵, Ibrahim Khan³, Wadieh Yacoub⁴, Maggie Bryson¹, Dana Paquette¹

Affiliations

¹ Centre for Communicable Diseases Infection and Control, Public Health Agency of Canada, Ottawa, ON.
² Participating First Nations Health Services Organization.
³ First Nations and Inuit Health Branch, Saskatchewan Region, Indigenous Services Canada, Regina, SK.
⁴ First Nations and Inuit Health Branch, Alberta Region, Indigenous Services Canada, Edmonton, AB.
⁵ Northern Inter-Tribal Health Authority, Prince Albert, SK.

Abstract

Background: The Public Health Agency of Canada's integrated bio-behavioural surveillance system-Tracks surveys-assesses the burden of HIV, hepatitis C and associated risks in key populations in Canada. From 2018-2020, Tracks surveys were successfully implemented by First Nations Health Services Organizations in Alberta and Saskatchewan.

Methods: First Nations-led survey teams invited community members who identified as First Nations, Inuit or Métis to participate in Tracks surveys and testing for HIV, hepatitis C and syphilis. Information was collected on social determinants of health, use of prevention services, substance use, sexual behaviours and care for HIV and hepatitis C. Descriptive statistics are presented.

Results: Of the 1,828 survey participants, 97.4% self-identified as First Nations and 91.4% lived in an on-reserve community. Over half (52.2%) were cisgender female, average age was 36.3 years, 82.5% lived in stable housing, 82% had access to primary healthcare and 73.8% reported having good to excellent mental health. Most participants (97%) had a family member who had experienced residential school. High proportions experienced stigma and discrimination (65.6%), financial strain (64.3%) and abuse in childhood (65.1%). Testing for HIV (62.8%) and hepatitis C (55.3%) was relatively high. Prevalence of HIV was 1.6% (of whom 64% knew their infection status). Hepatitis C ribonucleic acid prevalence was 5% (44.9% of whom knew their current infection status).

Conclusion: Historical and ongoing experiences of trauma, and higher prevalence of hepatitis C were identified, reaffirming evidence of the ongoing legacies of colonialism, Indian Residential Schools and systemic racism. High participation in sexually transmitted blood-borne infection testing and prevention reflect the importance of First Nations-led culturally sensitive, safe and responsive healthcare services and programs to effect improved outcomes for First Nations peoples.

Keywords: Canada; First Nations; HIV; Indigenous Peoples; STBBI; STI; Tracks survey; care and treatment; community-led; hepatitis C; on-reserve communities; resilience; testing.