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International Journal of Indigenous Health最新文献

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Introduction 介绍
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-02-12 DOI: 10.32799/ijih.v16i2.36040
R. Jock, Colleen Erickson
On behalf of the First Nations Health Authority (FNHA) in British Columbia (BC), and FNHA’s Board of Directors, we welcome you to this two-part guest edition of the International Journal of Indigenous Health (IJIH): “Health Systems Innovation: Privileging Indigenous Knowledge, Ensuring Respectful Care, and Ending Racism toward Indigenous Peoples in Service Delivery.” This guest edition encompasses two issues, “Honouring the Sacred Fire: Ending SystemicRacism toward Indigenous Peoples” and “Wisdom of the Elders: Honouring Spiritual Laws in Indigenous Knowledge,” which address significant determinants of Indigenous Peoples’ health, and issues in health systems here in Canada and globally.
我们代表不列颠哥伦比亚省第一民族卫生局(FNHA)和FNHA董事会欢迎您参加《国际土著卫生杂志》(IJIH)的两部分客座版:“卫生系统创新:特权土著知识,确保尊重护理,并在服务提供中结束对土著人民的种族主义。“本期客座版包括两期,《尊重圣火:终结对土著人民的系统性种族主义》和《长者的智慧:尊重土著知识中的精神法则》,它们涉及土著人民健康的重要决定因素,以及加拿大和全球卫生系统中的问题。
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引用次数: 0
Editorial 社论
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-02-12 DOI: 10.32799/ijih.v16i1.36037
Sonia Isaac-Mann, Evan M. Adams, Ted Mala
Welcome to this two-part guest edition of the International Journal of Indigenous Health (IJIH), produced by the First Nations Health Authority (FNHA) in the province of British Columbia (BC), Canada. As guest co-editors, we are pleased to present to you this collection of research, promising and wise practices, innovations, and Indigenous Knowledge on health and wellness. These papers constitute a substantive contribution to, as our call for submissions framed it, “Health Systems Innovation: Privileging Indigenous Knowledge, Ensuring Respectful Care, and Ending Racism toward Indigenous Peoples in Service Delivery.”
欢迎收看由加拿大不列颠哥伦比亚省第一民族卫生局制作的由两部分组成的《国际土著卫生杂志》客座版。作为客座联合编辑,我们很高兴向您展示这本关于健康和身心健康的研究、有前途和明智的实践、创新和土著知识集。正如我们对提交材料的呼吁所阐述的那样,这些文件对“卫生系统创新:尊重土著知识,确保尊重护理,并在服务提供中结束对土著人民的种族主义”做出了实质性贡献
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引用次数: 0
Editorial 编辑
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-02-12 DOI: 10.32799/ijih.v16i2.36039
Sonia Isaac-Mann, Evan M. Adams, Ted Mala
Welcome to this two-part guest edition of the International Journal of Indigenous Health (IJIH), produced by the First Nations Health Authority (FNHA) in the province of British Columbia (BC), Canada. As guest co-editors, we are pleased to present to you this collection of research, promising and wise practices, innovations, and Indigenous Knowledge on health and wellness. These papers constitute a substantive contribution to, as our call for submissions framed it, “Health Systems Innovation: Privileging Indigenous Knowledge, Ensuring Respectful Care, and Ending Racism toward Indigenous Peoples in Service Delivery.”
欢迎阅读由加拿大不列颠哥伦比亚省第一民族卫生局编印的《国际土著卫生杂志》特约两部分。作为客座共同编辑,我们很高兴向您介绍这一系列关于健康和保健的研究、有前途和明智的做法、创新和土著知识。这些论文对“卫生系统创新:在服务提供中给予土著知识特权、确保尊重和结束对土著人民的种族主义”这一主题做出了实质性贡献。
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引用次数: 0
Gum yan asing Kaangas giidaay han hll guudang gas ga. I Will Never Again Feel That I Am Less Than: Indigenous Health Care Providers’ Perspectives on Ending Racism in Health Care 甘甘斯基德汉山古当气气气。我再也不会觉得我比:土著卫生保健提供者关于结束卫生保健中的种族主义的观点
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-02-04 DOI: 10.32799/IJIH.V16I1.36021
Madeleine Stout, Cornelia Wieman, Lisa Bourque Bearskin, B. Palmer, L. Brown, Monica Brown, N. Marsden
Racism toward Indigenous Peoples continues to permeate throughout the health care system, a reality the authors know all too well in their shared and yet unique personal and professional experiences. Although acknowledging and speaking up against racial injustice is daunting, and is often met with disregard or inaction, the authors contend that this is a necessary undertaking to redress the ongoing harms of colonialism. Correspondingly, those who do not speak up must not have their voices silenced. Instead, the perspectives that Indigenous Peoples have regarding their own experiences of racism must be heeded seriously and produce real and tangible solutions. In narrating their own encounters of confronting and challenging racism, the authors juxtapose activism and resistance with the preservation of Indigenous Knowledge as a catalyst for propelling the necessary changes forward within health care to end racism. To be truly impactful, all efforts taken to address racism must occur alongside advancing equity of care and human rights for and by Indigenous Peoples at individual, community, and systemic levels. Changes are not needed after more evidence. The time to act is now.
针对土著人民的种族主义继续渗透在整个医疗保健系统中,这是作者在他们共同而又独特的个人和专业经历中非常了解的现实。虽然承认和公开反对种族不公正是令人生畏的,而且经常遭到忽视或不作为,但作者认为,这是纠正殖民主义持续危害的必要努力。相应地,那些不大声疾呼的人也不能被压制他们的声音。相反,必须认真注意土著人民对其自身种族主义经历的看法,并提出切实可行的解决办法。在叙述他们自己面对和挑战种族主义的遭遇时,作者将激进主义和抵抗与保护土著知识并列,作为推动医疗保健领域必要变革的催化剂,以结束种族主义。要真正发挥作用,解决种族主义问题的所有努力必须同时在个人、社区和系统层面推进土著人民的平等关怀和人权。在更多的证据之后,就不需要改变了。现在是行动的时候了。
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引用次数: 7
Paddling Together for Culturally Safe Emergency Care for Elders 一起划桨为老年人提供文化安全的紧急护理
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-02-03 DOI: 10.32799/IJIH.V16I1.33051
L. Hasan, J. Johnson
This paper describes a wise practice for collaborative change through the Trauma- Informed and Culturally Safe Emergency Care for Nuu-chah-nulth Elders project. For decades, Nuu-chah-nulth Elders have been avoiding emergency care due to colonial trauma and a lack of culturally safe care. To begin addressing this community priority, the First Nations Health Authority, in partnership with Island Health and university partners, organized a two-day workshop in September 2017 with Nuu-chah-nulth Elders, community members, and health partners. Key to ensuring the process was culturally sensitive was following the guidance of the West Coast General Hospital Cultural Safety Committee, a partnership between Nuu-chah-nulth people and health providers. Respect and trust were developed by centring the voices of Elders and giving them a safe space for discussion before developing recommendations with health partners. Feedback from participants was gathered from notes and audio recordings and thematically analyzed into eight major recommendations (i.e., increase engagement and relationship building; develop action plans; increase education and awareness; increase advocacy and support; incorporate First Nations medicine, healing, and foods; provide culturally safe spaces; develop policy and protocol; and link to comprehensive community support), with attention to preserving Elder voices. The recommendations were validated by returning and new participants at a gathering in June 2019. Elders noted that while experiences of unsafe care continue, noticeable improvements in cultural safety are being made and they feel heard.
本文描述了通过Nuu chah nulth老年人创伤知情和文化安全紧急护理项目进行合作变革的明智做法。几十年来,由于殖民地的创伤和缺乏文化上安全的护理,努查努思长老一直在避免紧急护理。为了开始解决这一社区优先事项,原住民卫生局与岛屿卫生和大学合作伙伴合作,于2017年9月与努查努思长老、社区成员和卫生合作伙伴组织了一次为期两天的研讨会。确保这一过程具有文化敏感性的关键是遵循西海岸综合医院文化安全委员会的指导,该委员会是努查努思人和卫生服务提供者之间的伙伴关系。尊重和信任是通过集中老年人的声音来发展的,在与卫生合作伙伴制定建议之前,给他们一个安全的讨论空间。参与者的反馈来自笔记和录音,并按主题分析为八项主要建议(即,加强参与和建立关系;制定行动计划;提高教育和认识;加强宣传和支持;纳入原住民医药、治疗和食品;提供文化安全空间;制定政策和协议;并与全面的社区支持联系起来),注意保护老年人的声音。这些建议在2019年6月的一次聚会上得到了回归者和新参与者的验证。老年人指出,尽管不安全护理的经历仍在继续,但文化安全方面正在取得显著改善,他们感到自己被倾听了。
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引用次数: 0
Improving Dementia Care for Gitxsan First Nations People 改善吉克桑原住民的痴呆症护理
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-28 DOI: 10.32799/IJIH.V16I1.33225
G. Gaspard, David McAtackney, D. Sullivan, Mavis Sebastian
This project originated from nursing staff’s learning need for knowledge, approach, attitude, and skills in dementia care that was identified by the Gitxsan Health Society. In collaboration with the First Nations Health Authority, the Gitxsan Health Society sought to educate nurses on how to provide culturally appropriate care to older Gitxsan persons living with dementia, and also to increase the understanding of nurses, family caregivers, and the wider community about dementia as a chronic condition. This project involved a mixed-methods approach (multiple qualitative approaches, as well as a quantitative component). The team was guided at each stage by a Cultural Advisory Council of four Elders recognized as Knowledge Holder from the community. The project involved a strong element of reciprocal co-learning and knowledge exchange. From discussions and exchange with community members, three large interlinking themes emerged to guide the researchers: (a) loss and grief; (b) relationality; and (c) access and connection. These themes gave voice to the gaps and needs in care, but also highlighted the potential areas of strength that can be built on to improve care for the older Gitxsan person living with dementia. Family and other community members identified the need for more information regarding dementia, the need to access in-community and external supports, and the need to inform nurses about what considerations are required when caring for Gitxsan people living with dementia. A better understanding of the Gitxsan ways of knowing about dementia can help nurses incorporate more culturally safe practices into the care of persons living with dementia.
该项目源于Gitxsan健康协会确定的护理人员对痴呆症护理知识、方法、态度和技能的学习需求。Gitxsan健康协会与第一民族卫生局合作,试图教育护士如何为患有痴呆症的Gitxsan老年人提供文化上合适的护理,并提高护士、家庭护理人员和更广泛的社区对痴呆症这一慢性疾病的理解。该项目涉及一种混合方法(多种定性方法和一个定量组成部分)。该团队在每个阶段都由文化咨询委员会指导,该委员会由四位社区公认的知识持有者组成。该项目包含了相互合作学习和知识交流的强大元素。从与社区成员的讨论和交流中,出现了三个相互关联的主题来指导研究人员:(a)损失和悲伤;(b) 相对性;以及(c)接入和连接。这些主题反映了护理方面的差距和需求,但也突出了可以用来改善老年痴呆症患者护理的潜在优势领域。家庭和其他社区成员确定了需要更多关于痴呆症的信息,需要获得社区和外部支持,以及需要告知护士在照顾Gitxsan痴呆症患者时需要考虑哪些因素。更好地了解Gitxsan了解痴呆症的方式可以帮助护士将更安全的文化实践纳入痴呆症患者的护理中。
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引用次数: 1
Collaborative and Systems Approach to Transforming Primary Health Care in Manitoba First Nations Communities 协作和系统方法,以改变初级卫生保健在马尼托巴省第一民族社区
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-28 DOI: 10.32799/IJIH.V16I1.33207
Grace Kyoon-Achan
The models of primary health care currently operating in First Nations communities are rooted in policies that were crafted without prior appropriate consultations. Many have continued to be applied even though they no longer adequately serve the needs of First Nations communities and people, if they ever did. Transforming primary health care will necessarily involve community- inclusive and self-determined reviewing of existing policies with a goal of implementing opportunities to update policies and models of care. This study was a partnership with university-based researchers, a First Nations health and social development entity separately established by a regional organization of First Nations Chiefs, and eight First Nations communities. A multi-pronged methodology was used in which five concurrent studies employing qualitative, quantitative, and case-study methods provided information on the primary health care experiences of First Nations and rural and remote communities. The program of research took a community-based participatory approach to engage participants in designing and carrying out data gathering while strengthening local capacity and encouraging long-term ownership of the process of research for change. Participating communities pointed out key setbacks to community- based primary health care, including differing models of care, jurisdictional complexities, funding that creates isolated programs within the same community, lack of promotion of cooperation among health care services, and a general acute approach to health care service delivery in the community. These barriers are both problems and opportunities for change. A borderless health care system that is jurisdictionally seamless and that promotes collaboration through cooperative funding models that reflect community priorities is recommended and advocated for all Manitoba First Nations communities.
目前在原住民社区运作的初级卫生保健模式植根于未经事先适当协商制定的政策。尽管它们不再充分满足原住民社区和人民的需求,但许多仍然被应用,如果有的话。初级卫生保健的转变必然涉及对现有政策的社区包容性和自我决定的审查,目的是实施更新政策和护理模式的机会。这项研究是与大学研究人员、一个由原住民酋长组成的区域组织单独成立的原住民健康和社会发展实体以及八个原住民社区的合作。采用了多管齐下的方法,其中五项同时进行的研究采用了定性、定量和案例研究方法,提供了有关原住民以及农村和偏远社区初级卫生保健经验的信息。研究方案采取了以社区为基础的参与方式,让参与者参与设计和开展数据收集,同时加强地方能力,鼓励对变革研究过程的长期所有权。参与社区指出了以社区为基础的初级卫生保健的主要挫折,包括不同的护理模式、管辖权的复杂性、在同一社区内创建孤立项目的资金、缺乏促进卫生保健服务之间的合作,以及在社区提供卫生保健服务时采取了普遍而尖锐的方法。这些障碍既是变革的问题,也是变革的机遇。建议并倡导马尼托巴省所有原住民社区建立一个无国界的医疗保健系统,该系统在司法管辖范围内无缝衔接,并通过反映社区优先事项的合作筹资模式促进合作。
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引用次数: 2
Strengthening Indigenous Australian Perspectives in Allied Health Education: A Critical Reflection 在联合健康教育中加强土著澳大利亚人的观点:一个批判性的反思
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-28 DOI: 10.32799/IJIH.V16I1.33218
D. Manton, Megan Williams
While professional education in medicine and nursing in Australia has been implementing strategies to increase accessibility for Indigenous Australians, allied health professions remain underdeveloped in this area. Failure to improve the engagement of allied health professions with Indigenous Australians, and failure to increase the numbers of Indigenous staff and students risks perpetuating health inequities, intergenerational disadvantage, and threatens the integrity of professions who have publically committed to achieving cultural safety and health equity between Indigenous and non-Indigenous people. Knowing this, leaders in the allied health professions are asking “What needs to change?” This paper presents a critical reflection on experiences of a university-based Indigenous Health Unit leading the embedding of Indigenous perspectives in allied health curriculum, informed by Indigenous community connections, literature reviews, and research in the context of an emerging community of practice on Indigenous health education. Key themes from reflections are presented in this paper, identifying barriers as well as enablers for change, which include Indigenous community relationship building, education of staff and students, and collaborative research and teaching on Indigenous Peoples’ allied health needs and models of care. These enablers are inherently anti-racism strategies that redress negative stereotypes perpetuated about Indigenous Australians and encourage the promotion of valuable Indigenous knowledges, principles, and practices as strategies that may also help meet the health needs of the general community.
虽然澳大利亚的医学和护理专业教育一直在实施增加土著澳大利亚人获得机会的战略,但联合保健专业在这一领域仍然不发达。如果不能改善联合保健专业人员与土著澳大利亚人的接触,以及不能增加土著工作人员和学生的人数,就有可能使保健不平等、代际劣势长期存在,并威胁到公开承诺实现土著和非土著人民之间的文化安全和健康平等的专业人员的诚信。知道了这一点,联合医疗行业的领导者们都在问:“需要改变什么?”本文对一所大学土著卫生单位的经验进行了批判性反思,该单位通过土著社区联系、文献综述和新兴土著卫生教育实践社区背景下的研究,将土著观点纳入联合卫生课程。本文提出了反思的关键主题,确定了变革的障碍和推动因素,其中包括建立土著社区关系,对工作人员和学生进行教育,以及就土著人民的综合保健需求和护理模式进行合作研究和教学。这些促进因素本质上是反种族主义战略,纠正对土著澳大利亚人的消极陈规定型观念,并鼓励推广宝贵的土著知识、原则和做法,作为有助于满足一般社区保健需要的战略。
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引用次数: 8
Forced or Coerced Sterilization in Canada: An Overview of Recommendations for Moving Forward 强迫或胁迫绝育在加拿大:建议的概述向前推进
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-28 DOI: 10.32799/IJIH.V16I1.33369
Christine Shawana, Chaneesa Ryan, Abrar Ali
Between 2015 and 2019, over 100 Indigenous women from six provinces and two territories have come forward to say that they were forced or coerced to undergo a sterilization procedure in Canada. Despite this, government action is lacking. Through this paper, the research team aims to collect and synthesize the recommendations that have been made in response to the recent cases of forced or coerced sterilization of Indigenous women in Canada. Through a secondary analysis of data, we outline the findings of a thematic analysis of 162 recommendations from four selected sources: (a) Tubal Ligation in the Saskatoon Health Region: The Lived Experience of Aboriginal Women, an external review by Senator Yvonne Boyer and Dr. Judith Bartlett, July 22, 2017; (b) a meeting of the Senate Committee on Human Rights, April 3, 2019; (c) meetings of the House of Commons Standing Committee on Health, June 13 and 18, 2019; and (d) a letter from Bill Casey, Member of Parliament and Chair of the House of Commons Standing Committee on Health, to three federal ministers, August 2, 2019. Seven themes emerged following the thematic analysis of the 162 recommendations: (a) Services and Supports (b)Accountability, (c) Training and Education, (d) Legislation and Policy, (e) Criminalization, (f) Data Collection, and g) Investigation. These themes represent seven areas where immediate government action is required to meaningfully and appropriately respond to the recent cases of forced or coerced sterilization of First Nations, Inuit, and Metis women in Canada.
2015年至2019年期间,来自6个省和2个地区的100多名土著妇女站出来表示,她们在加拿大被迫或被胁迫接受绝育手术。尽管如此,政府仍缺乏行动。通过这篇论文,研究小组的目的是收集和综合针对最近加拿大土著妇女被强迫或胁迫绝育的案件所提出的建议。通过对数据的二次分析,我们概述了对来自四个选定来源的162项建议进行专题分析的结果:(a)萨斯卡通卫生地区的输卵管结扎:土著妇女的生活经验,参议员Yvonne Boyer和Judith Bartlett博士于2017年7月22日进行的外部审查;(b)参议院人权委员会会议,2019年4月3日;(c) 2019年6月13日和18日举行的下议院卫生常务委员会会议;(d) 2019年8月2日,国会议员兼下议院卫生常务委员会主席比尔·凯西给三位联邦部长的信。在对162项建议进行专题分析之后,出现了七个主题:(a)服务和支助(b)问责制,(c)培训和教育,(d)立法和政策,(e)定罪,(f)数据收集和g)调查。这些主题代表了七个需要政府立即采取行动的领域,以便对加拿大最近发生的强迫或强迫第一民族、因纽特人和梅蒂斯妇女绝育的案件作出有意义和适当的反应。
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引用次数: 3
Indigenous Women Voicing Experiences of HIV Stigma and Criminalization Through Art 土著妇女通过艺术讲述艾滋病毒的耻辱和犯罪经历
IF 1.5 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2021-01-26 DOI: 10.32799/IJIH.V16I2.33903
Amy Sanderson, Flo Ranville, Lulu Gurney, B. Borden, S. Pooyak, K. Shannon, Andrea Krüsi
Indigenous women living with HIV are disproportionately affected by the criminalization of HIV nondisclosure. The purpose of this paper is to better understand how the criminalization of HIV nondisclosure shapes the lived experiences of HIV-related stigma, disclosure, and health service among cis and transgender Indigenous women living with HIV (IWLWH). This study was developed based on a community roundtable on HIV criminalization with engagement of legal experts, HIV service organizations, and IWLWH on the unceded traditional territory of the Coast Salish Peoples, including the ter̓ritories of the xwməθkwəy̓ əm (Musqueam), Sḵwx̱ wú7mesh (Squamish), and Səlílwətaɬ (Tsleil-Waututh) Nations (Vancouver, British Columbia, Canada) in 2016 to 2018. Drawing on community-based participatory photovoice methodology, Indigenous Peer Researchers played a central role throughout this project, including planning, facilitation of photo-voice workshops, and analysis. This analysis includes 17 IWLWH. Through a peer-engaged analysis process, the photovoice images and narratives illustrated how the criminalization of HIV nondisclosure is intertwined with colonial violence to shape experiences of social isolation and exclusion, disclosure, access to safe health care, responsibility, fear, and resilience. The legal requirements of HIV nondisclosure are unattainable for many IWLWH who are not able to safely disclose their HIV status, negotiate condom use, and maintain a low viral load. In line with the Truth and Reconciliation Commission of Canada and National Inquiry into Missing and Murdered Indigenous Women and Girls, the justice system must be reoriented from punishment and oppression to healing and wellbeing for all Indigenous women living with HIV. Simultaneously, we call for culturally safe services that protect privacy and recognize strengths of IWLWH.
携带艾滋病毒的土著妇女受到不披露艾滋病毒的刑事定罪的不成比例的影响。本文的目的是更好地理解艾滋病毒不披露的刑事化如何影响土著顺性和跨性别艾滋病毒感染者(IWLWH)的艾滋病毒相关耻辱,披露和卫生服务的生活经历。这项研究是在2016年至2018年期间,由法律专家、艾滋病毒服务组织和IWLWH参与的关于艾滋病毒刑事定罪的社区圆桌会议的基础上开展的,会议涉及沿海萨利希民族的未被割让的传统领土,包括xwm æ θkw æ y k æ m (Musqueam)、Sḵwx´wú7mesh (Squamish)和S´lílw´ta æ (Tsleil-Waututh)民族(加拿大不列颠哥伦比亚省温哥华)的ter æ领土。利用基于社区的参与式光声方法,土著同伴研究人员在整个项目中发挥了核心作用,包括规划、促进光声讲习班和分析。该分析包括17个IWLWH。通过同行参与的分析过程,照片语音图像和叙述说明了对艾滋病毒保密的刑事定罪如何与殖民暴力交织在一起,形成了社会孤立和排斥、披露、获得安全保健、责任、恐惧和复原力的经历。对于许多无法安全地披露自己的艾滋病毒状况、协商使用安全套和保持低病毒载量的IWLWH来说,保密的法律要求是无法实现的。根据加拿大真相与和解委员会和失踪与被谋杀土著妇女和女孩全国调查,司法系统必须从惩罚和压迫转向为所有感染艾滋病毒的土著妇女提供治疗和福祉。同时,我们呼吁提供文化上安全的服务,保护隐私,并认识到IWLWH的优势。
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引用次数: 4
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International Journal of Indigenous Health
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