How indigenous communities are impacted by HIV

September 13th is the anniversary of the UN Declaration of the Rights of Indidenous Peoples. The United Nations finds that there are an estimated 370 million indigenous people in the world, living across 90 countries. While indigenous people make up less than 5 per cent of the world’s population, they account for 15 per cent of the poorest. HIV among indigenous populations is an emerging public health concern. Earlier this summer the Red Ribbon Award was given to the INA Foundation, which is a community-based organization in New Zealand that advocates for the inclusion and leadership of the indigenous communities in the effort to end the AIDS epidemic. UNAIDS spoke to Marama Pala, the Executive Director of  INA.

UNAIDS: Can you please tell us about your organization?

Marama: INA was started because we realized that there was a need for more aid and visibility for indigenous people living with HIV in New Zealand. We wanted to provide quality, up-to-date information and HIV services as well as spread awareness to Maori and other indigenous communities who did not have access to information about HIV.

The name INA honours the three children of one of the founders. Two of the children, Immanuel and Noelle lost their lives to AIDS while the third child, Apihaka survived.

UNAIDS: Why do you think INA won the Red Ribbon Award?

Marama: We believe we won because of the relationships that we have nationally and internationally and our ability to network with other indigenous populations and reach indigenous communities around the world. We were able to raise the voices of indigenous people, who until now have been a hidden population within the epidemic.

Winning the award is really an honour for us. We have been working for a long long time for indigenous people to be recognized by the AIDS response.

Community-based organizations are at the heart of the AIDS epidemic for us. We have a grassroots approach to engage people and our communities around prevention and support for people living with HIV. Along the way, we started to realize that there were a lot of areas nationally, regionally and internationally where advocacy for the indigenous population just wasn’t happening. We are hoping for a global impact which will trigger the success of other community based organizations. Already we’ve seen some evidence that organizations which previously had not been considered are now getting funds from governments and other funders. We have seen that by keeping them at the center of our response, communities will benefit.

We hope to continue focusing on and raising the voice of indigenous people nationally, regionally and internationally.  The Red Ribbon Award isn’t only for INA and New, Zealand, it’s for all the indigenous communities that have been working for the HIV cause for many many years since the beginning of the epidemic.

UNAIDS: What made you get involved in this field personally?

Marama: I’ve been living with HIV for 24 years. As a Maori indigenous woman it hasn’t been easy. In New Zealand, the epidemic predominantly impacts men who have sex with men and so I’m a minority within a minority within a minority. I got into this field to try and make a difference.

There is a one size fits all belief in terms of the approach to prevention. As Maori people, our values and principles are slightly different from those of our counterparts and our focus is a lot more orientated to our families, our wellbeing and the reciprocity that we have within our community. The challenge is fitting within the paradigm of HIV response which is quite individualistic, personal and operates from a one person-educated model in contrast to our family-oriented model.

One of the biggest challenges for us was also gaining recognition for our community in our own country and getting people to understand that one size doesn’t fit all. Internationally, we still have many challenges as we try to fit within a HIV response that has no understanding of what indigenous means for a start or even understands the issues that indigenous people face regardless of HIV. There is little social understanding of where we come from, where we are living, colonization, racism, poverty, imprisonment and living very much in a survival mode. INA has been through all those situations and continues to support those that have gone through or are going through them.

What is INA doing to overcome these challenges?

Marama : The more people that we have on board and the more that our network extends, the more we are able to have an impact on grassroots and our community. As far as reducing stigma and discrimination goes, getting people to understand indigenous issues is our key priority. We are also seeing that there is a paradigm that hasn’t been explored around human rights vs. indigenous rights yet. There has been no qualitative research that is made available. Pre-colonization – human rights were the same as indigenous rights. To tackle this, we work on our partnerships and we nurture them.

INA has a treaty claim with the crown in New Zealand. The British crown is a treaty partner with New Zealand so we work really hard to have an ongoing open dialogue with them. We started building partnerships outside of New Zealand when we realized that internally we weren’t getting listened to so. Our partnership with the Canadian Aboriginal Aids Network has been fundamental to our cause. It is through these partnerships that we are able to face all our challenges and get out in the open the advocacy that is needed for indigenous people who are still facing stigma and discrimination due to being indigenous and on top of that being HIV positive.

UNAIDS : How does the Red Ribbon Award help INA?

Marama: It takes us to another level of credibility. It gives us international recognition. The award has already brought us a lot of media attention. We’ve been on radio, on TV within our indigenous communities so we have been able to explain how we got the Red Ribbon, how we got the recognition. One of the things that the award will help us with is the visibility that is much needed towards indigenous issues.

We are looking at coming up with a project for the funds that we will be receiving. The project attempts to address another gap within the services of HIV. We are looking at working with the transgender community living with HIV and also looking at the intersectionality of the different key populations as far as sex work and drug users go within the indigenous community. We are probably going to end up doing that not only nationally, but extending to the Pacific and Australia. That’s one of our ideas. We really want to work with people living in isolation, people living rurally and with low access to support systems and prevention. We are looking at a lot areas like the fact that we still don’t have access to PrEP in New Zealand. We are looking at what the impact of PrEP could be for Maori in isolated areas.


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