Grant: Catalyst Grant: HIV/AIDS Community Based Research Program - Indigenous Stream

In Canada, First Nations (FN) people, and especially those living on reserves, experience disproportionate health and social inequities, including elevated rates of chronic illnesses and illicit drug use. Due to increased substance abuse and injection drug use (IDU), FN populations are at a greater risk for the transmission of blood-borne viruses (BBV), such as HIV and Hepatitis C, and drug overdose. In recent years, prescription opioid (PO), and specifically Oxycontin, misuse and related harms have become a very serious and extensive problem in FN communities. In several Nishnawbe Aski Nation (NAN) communities in northern Ontario, over half of both adult and adolescent populations were estimated to be misusing Oxycontin in 2011, which led the Assembly of Chiefs to declare a public health emergency. In an attempt to reduce PO abuse across the province, the Ontario government delisted Oxycontin in March 2012. This is very concerning given the limited treatment options for Oxycontin misusers in NAN communities and the risks for BBV transmission and drug overdose that may be further amplified by (largely undesired) effects of this policy intervention. The goal of this study is to explore changes in drug use and risk behaviours related to HIV transmission among drug users in NAN communities following the Oxycontin delisting in March 2012. Using community-based research (CBR) methods, this study will take place in 3 NAN communities with large PO misuse populations. Interviews will be conducted with regular Oxycontin users and key informants in each community. Interviews will focus on shifts in BBV risk behaviors since the delisting of Oxycontin. Results will be finalized in collaboration with all members of the project team and with community partners. Findings from the study will be provided to NAN communities and shared with key policy, program and practice stakeholders in order to improve much needed substance abuse and HIV interventions in this high-risk population.