Mobility patterns of Aborginal injection drug users between on- and off-reserve settings in northern British Columbia, Canada
Callaghan RC, Tavares J, Taylor L

ABSTRACT [full text] [back to issue 66(3)]

Objectives. In Canada, public health policymakers and Aboriginal health service leaders have warned that the reciprocal movement of Aboriginal injection drug users (IDUs) between urban and rural settings may serve as a critical vector for the continuing spread of HIV among Aboriginal peoples. The current study aimed to describe the mobility patterns of Aboriginal injection drug users between on- and off-reserve locations in northern British Columbia.

Study Design. Retrospective medical-chart review of inpatient detoxification records.
Methods. We employed a medical-chart review of all self-reported Aboriginal IDUs (n = 302) admitted at least twice to an adult inpatient hospital-based substance-abuse detoxification treatment centre between 4 January 1999 and 31 December 2005, and analysed place-of-residence transitions between on- and off-reserve settings.

Results. Over the course of the 7-year study period, 26% (n = 73) of Aboriginal IDUs changed their primary residence from an off-reserve to an on-reserve location. Almost all (96%, n = 23) of those living on-reserve at their first IDU-related admission had moved to an off-reserve setting at a subsequent visit.

Conclusions. The high rates of reciprocal movement between on- and off-reserve locations are a critical public health concern. The results show that the problems associated with both IDU and infectious disease are not limited to urban centres. Our results stand as a clear call for support of Aboriginal-directed, culturally appropriate and accessible services to reduce IDU-related harms. The specifics of such programs are a topic for Aboriginal health care leaders and the communities themselves to discuss, develop and implement (Int J Circumpolar Health 2007; 66(3): 241-247).

Keywords: HIV infections, Aboriginals, North American, substance abuse, intravenous, rural populations, residential mobility