Comparison of coping strategies and supports between aboriginal and non-aboriginal people living with HIV in Ontario

Abstract

Complex historical and cultural factors have contributed to the HIV epidemic among Aboriginal populations in Canada. This study assesses social supports, adaptive and maladaptive coping mechanisms, stress, and mastery of Canadian-born Aboriginal and Canadian-born Caucasian people living with HIV in Ontario and posits that coping and social support are important micro- and meso-level factors associated with the epidemic. This cross-sectional analysis included questionnaire data collected from 2007 to 2011 at HIV clinics in Toronto. Categorical and continuous variables were compared using chi-square and Wilcoxon rank sum tests, respectively. Correlates of social support and coping were determined using univariate and multivariable linear regression. The analysis included 70 Aboriginal and 665 Caucasian participants. Aboriginal participants had lower levels of employment, education, and annual household income. Aboriginal participants reported more overall (7 vs. 4, p = 0.0003), ongoing (4 vs. 2, p = 0.0004), and early childhood (2 vs. 1, p = 0.02) stressors. Maladaptive coping, adaptive coping, and mastery scores were similar between Aboriginal and Caucasian participants. In multivariable analysis, injection drug use and lower education levels were significant correlates of higher maladaptive coping and lower overall support scores. Despite numerous socioeconomic challenges and personal stressors, Aboriginal people living with HIV who are accessing care exhibited comparable coping and mastery scores to Canadian-born Caucasian people living with HIV, suggesting remarkable strengths within Aboriginal people living with HIV and their communities.

Keywords:

• Indigenous population
• HIV
• Canada
• coping
• stress
• social support

Acknowledgements

We gratefully acknowledge all of the people living with HIV who volunteered to participate in the OHTN Cohort Study and the work and support of the past and present members of the OCS Governance Committee: Anita C. Benoit, Adrian Betts, Les Bowman, Tracey Conway, Patrick Cupido (Chair), Tony Di Pede, Brian Finch, Michael J. Hamilton, Brian Huskins, Rick Kennedy, Ken King, Nathan Lachowsky, Joanne Lindsay, Shari Margolese, John McTavish, Colleen Price, Lori Stoltz, Darien Taylor, Rosie Thein, and Drs. Ahmed Bayoumi, Evan Collins, Curtis Cooper, Clemon George, Troy Grennan, Claire Kendall, and Greg Robinson. We thank all the interviewers, data collectors, research associates and coordinators, nurses and physicians who provide support for data collection and extraction. The authors wish to thank the OHTN staff and their teams for data management and IT support (Robert Hudder, Nahid Qureshi), and study Coordinators (Kevin Challacombe, OCS Data, & Brooke Ellis, OCS Research).

Disclosure statement

No potential conflict of interest was reported by the authors.

Conflict of interest

The authors do not have any conflicts of interest to declare.

Supplementary material

Supplementary (content) is available via the ‘Supplementary’ tab on the article's online page (http://dx.doi.org/10.1080/09540121.2015.1061634).

Additional information

Funding

This work was supported by the AIDS Bureau, Ontario Ministry of Health and Long-Term Care. The opinions, results and conclusions are those of the authors and no endorsement by the Ontario HIV Treatment Network is intended or should be inferred. This work was supported by an OHTN Chair in Biostatistics award to JR and a CIHR New Investigator award to ANB.