The Cedar Project: exploring the role of colonial harms and childhood maltreatment on HIV and hepatitis C infection in a cohort study involving young Indigenous people who use drugs in two Canadian cities. Issue 7 (8th July 2021)

• Record Type: Journal Article
• Authors: Pearce, Margo E; Jongbloed, Kate; Pooyak, Sherri; Christian, Wenecwtsin M; Teegee, Maaxswxw Gibuu (White Wolf) Mary; Caron, Nadine R; Thomas, Victoria; Henderson, Earl; Zamar, David; Yoshida, Eric M; Schechter, Martin T; Spittal, Patricia M
• Is Part Of: BMJ open. Volume 11:Issue 7(2021)
• Publication Date: 2021-07-08
• Subjects: HIV & AIDS -- epidemiology -- mental health; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-042545
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: This study examined associations between childhood maltreatment, colonial harms and sex/drug-related risks for HIV and hepatitis C virus (HCV) infection among young Indigenous people who use drugs. Design: The Cedar Project is a cohort involving young Indigenous people who use drugs in British Columbia (BC), Canada. Indigenous collaborators, collectively known as the Cedar Project Partnership, govern the entire research process. Setting: Vancouver is a large city on the traditional territory of the Coast Salish peoples. Prince George is a mid-sized city, on the traditional territory of Lheidli T'enneh First Nation. Participants: 420 participants completed the Childhood Trauma Questionnaire and returned for follow-up from 2003 to 2016. Primary/secondary outcome measures: Primary outcomes were HIV and HCV infection over the study period. Secondary outcomes included sex and substance use-related risks. Results: Prevalence of childhood maltreatment was 92.6% experienced any maltreatment; 73.4% experienced emotional abuse; 62.6% experienced physical abuse; 60.3% experienced sexual abuse; 69.5% experienced emotional neglect and 79.1% experienced physical neglect. We observed significant associations between childhood maltreatment and apprehensions into residential schools and foster care. All maltreatment types were associated with higher odds of sex/substance use-related risks; sexual abuse was associated with higher odds of HCV infection (adjusted OR: 1.67; 95% CI 1.05 to 2.66; p=0.031). Conclusions: Findings reflect high prevalence of childhood maltreatment and their associations with HIV/HCV risk and HCV infection. Public health prevention and treatment initiatives must be trauma informed and culturally safe to support healing, health, and well-being.