Young Eagles - First Nations youth and HIV

Adapted from the young eagles manual

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Book: Young Eagles - First Nations youth and HIV
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Date: Wednesday, 29 January 2025, 12:05 AM

Table of Contents

Introductory Video

A Video from 2spirits.com



The Eagle

adapted from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

Soaring Eagle


In many First Nations, the Eagle is a symbol of sacred status, gifted to
fulfill a certain role of being a leader among our feathered relatives. There
are many aspects of how the Eagle lives and fulfills these responsibilities.

Eagles are known to be superb hunters. They also fly so high, it is
believed that they can carry our prayers up to the Creator. They can see
dangers because they fly so high and their vision is so good, they can
spot food deep below the waters. Eagles mate for life, and both the
male and female Eagle work together to protect and care for the Eaglets
in their nest.

Even in how Eagles make their nest, there is good planning. First, they
start building the nest with large branches. The nest itself can be about 20
feet wide. Next, they put in other rough items, such as glass and smaller
twigs to help the nest stay strong. But obviously, branches and glass
would be too rough to raise babies. So they add straw to help soften it,
and finally, they will add feathers to make a nice soft, warm bed to help
raise their family. Both the male and female Eagle will take turns
watching the babies.

When it comes time for the Eaglets to be on their way, the mother Eagle
begins to prepare them, by first taking the softer items out of the nest.
She will remove the feathers and straw, so that after awhile, the Eaglets
are standing on roughness. She makes it uncomfortable for them to stay
because she knows they must go out and experience the world on their
own. Eventually, the young Eagles get tired of standing and are pushed
out of the nest. The parents have done their job.

This manual is what happens after Young Eagles are pushed from their
nest. It is hoped that parents have done their job to protect and care for
their young ones. But there comes a time when they too must go out
into the world and fend for themselves. Whether the echoes of the
teachings those parents have provided is enough, only time will tell. This
manual is a meant to offer important information, so that Young Eagles
can learn about a serious threat, and find ways to protect themselves. In
the spirit of our heritages, it is also about sharing this information
because it is important for everyone to know.

Fly strong and proud Young Eagles - and share the teachings.

What is HIV/AIDS?

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

HIV is a virus and has been in North America for over twenty years. It attacks the human immune system, which is what people need to fight off simple things like the cold or flu. HIV stands for Human Immunodeficiency Virus.

When a person becomes infected with HIV, their immune system slowly begins to weaken. You start off with HIV and it eventually turns to AIDS. AIDS is when the body gets much sicker with different diseases and other infections can become major problems for the body. AIDS stands for Acquired Immune Deficiency Syndrome.

A human being has what is called T-Helper cells (T-4 and T-8), also known as CD4 and CD8 cells. These are like the Warriors inside our bodies, which attack any threat to our health. Once they sense something is inside us - like a virus that does not belong there it immediately begins to try and get rid of it.

With HIV it is different and instead, the T-Helper cells begin to die off. This leaves the body with no defense or no Warriors to protect itself. Most human beings have about 1700 T-Helper cells at any time. This number can go up and down depending on different things, like stress or poor nutrition. When someone catches HIV, the T-Helper cell counts begin to go down. This takes many years before it becomes serious. Today, people living with HIV are living much longer than before, mostly because Doctors know more and have new medications to help a person stay healthier. The issue though, is that AIDS is still a killer. As reported on Pride Vision TV, according to a BioChem and Glaxxo Wellcome Survey, a person living with HIV/AIDS can take between six (6) to ninety-six (96) pills per day to fight the disease. Many of these pills make you feel sick, with upset stomach or diarrhea, because of the side effects. It isn't fun or easy living with this disease. Some Aboriginal People living with HIV/AIDS (APHA's) live in poverty and misery.

The pills do not work for everyone with some people developing resistance to them and many (especially Aboriginal people) are still dying from AIDS related infections. It can often take many tries and combinations, with huge side effects before the Doctor finds the right one to help a person live longer. Remember, there is still NO CURE for HIV/AIDS. Once you have it - you have it for life! There is no pill you can take afterwards to get rid of it. There is no needle or vaccine to protect yourself against getting it. There is only PREVENTION which comes from knowing what it is, how it is spread and how to protect yourself. Nobody has to catch HIV and ONLY YOU can prevent yourself from getting it. The basics about HIV/AIDS do not take long to learn that HIV is a virus that is preventable and the virus is found in all body fluids. Some body fluids have more HIV than others. Contact with these fluids can lead to HIV infection and the risk depends on what type of contact and which fluid.

The real challenge though is to look at what behaviors you may be taking and change those behaviors so that you get rid of or lessen the risks that may be involved. For example, some people get involved in what is called bare-backing or sex without a condom. This is considered very high risk when you do not know your sexual partner(s). HIV can be spread through:

One person must have HIV or be HIV-positive to infect another person. Because HIV is a virus, medical tests can show how much of the virus is in the body. This is called VIRAL LOAD, and over time, without medications, most people with HIV will have their viral load go higher. This is a major reason why people who are taking risks should try and find out if they have been infected. It lets Doctors treat you and keep the viral load down and keep the T-Helper cells up. The sooner someone finds out whether they have HIV or not is better, because you can do things to live longer. The other important reason is to not infect other people you care about or have sexual contact with - like your boyfriend or girlfriend.

Where do you find HIV?

WHERE DO YOU FIND HIV?

When a person has HIV, the virus can be found in ALL body fluids, but each body fluid has different levels or concentration of HIV. When someone does not have HIV and has contact with HIV, there are RISKS involved.

HIV is found the most in:

· a man's semen (cum and precum);

· blood

· vaginal fluids

There is some HIV in:

· breast milk

There is almost no HIV in:

· tears

· sweat

· spit

HIV is really weak outside the body and dies fast in open air!

HOW IS HIV SPREAD?

HIV can be SPREAD by:

· anal (ass) or vaginal (pussy) sex without using condoms;

· oral sex (done to a guy or girl) can have more risks, especially if there are problems inside the mouth like bleeding gums, throat infections or recent dental work where there is a break in the skin;

· sharing injection drug needles (using a syringe with more than one person) which have not been cleaned with bleach and water

· in between use - this includes any substance injected into the blood stream to get high or steroids;

· unsterilized tattooing or piercing equipment can also increase risk for HIV if someone else has HIV and the same equipment was used on you;

· sharing equipment that is used to snort (inhale up the nose)

· cocaine and other drugs up the nose - these drugs cause blood

· vessels to burst and cause a nose bleed. When there is blood and more than one person uses the straw or other object, blood with HIV could be exchanged;

· sharing any type of medical equipment (e.g. glucose monitor equipment for diabetes, etc.) where blood or other body fluids become present, with more than one person may have some risk if one of those people has HIV;

· mother to child (at birth) unless the mother knows she is HIVpositive and takes medications as well as use a caesarian section during birth which reduces much of the risk.

Tattooing and piercing can carry risks if the equipment is not new or sterilized. There is evidence that even cleaning with bleach and water may not be enough, because other disease like Hepatitis C cannot be killed by bleach and water. However, cleaning equipment is better than not cleaning them and it is better if new equipment is used.

One person must have HIV and the other needs to have certain direct contact with that person's body fluids (semen, blood, vaginal fluids) to catch HIV. Today, the blood supply system is much safer than it was before, and all blood donated is screened to remove blood that comes from people who may have taken risks for HIV. There can be a theoretical risk from the blood supply and some people believe there is still a very minor risk because not all blood can be checked. Many feel the blood supply is much safer than before.

Highest Risks for the Spread of HIV

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

Direct blood to blood contact is one of the highest risks for catching HIV. Blood that has been out in the open air, is NOT as high a risk, because air kills HIV very fast. If there is a deep puddle of blood from a fight or if someone was in an accident or cut themselves, plus the room is very warm, HIV could stay alive for awhile. Whenever there is blood around, latex gloves should ALWAYS be worn for clean up.

Some games can be a concern, like bloody knuckles, which is where the knuckles are hit by the other persons knuckles and eventually, the skin gets broken. If one of the people playing the game has HIV, there could be risks. When you get blood from a person who has either HIV or AIDS inside you, there is HIGH RISK to catch HIV. There could be some risks with fighting too, but because blood is open to air and both people may only have minor contact that lasts a few seconds at a time, then there can be risks but not as much as some other activities.

Some ways you may come in contact with blood are:

WOMEN'S ISSUES:
For First Nations women, HIV is becoming a growing concern and many Aboriginal women are becoming HIV-positive. There are many negative side affects for women when they have to live with this disease. The risk factors are slightly different for Aboriginal women than non-Aboriginal women which will be talked about more in a later section. However, evidence shows that injection drug use is a key factor for many. Unprotected sex is another, which raises the issues of whether First Nations women feel safe or strong enough to make their sexual partners wear condoms. Sexual assaults are one clear example of where this control would not be available for a woman. Substance use can also be a factor for some. Partners who cheat on them is another.

Women can be at HIGHER RISK for HIV when they are near or on their period. This is because the vagina has small blood vessels which are opened where the virus can enter the body more easily. Broken skin or open vessels mean when cum with HIV goes inside the women, there is high risk. Women who are pregnant and HIV positive can give it to their babies during childbirth. Pregnant women once they know they have HIV, can take HIV medications to reduce risk to the baby when born. Also, the type of birth (caesarian) can reduce risks. Also important is the issue of sexual assault, including date rape. There are people who prey on women at night clubs or parties by dropping pills into their drinks which cause them to pass out and be unaware of what is happening to them. The person then takes them to some place and forces sex on them, and the woman is unable to defend herself. This type of vicious attack can also happen at parties where a woman has too much to drink and passes out. There are situations where a group of guys have sex or gang bang the woman. These acts of aggression are against the law and simply wrong behavior that needs to be addressed and corrected. Obviously, all of these sexual attacks can put the woman at risk if any of the guys has HIV or any other sexually transmitted disease.

OTHER DISEASES:

There are other diseases, which can be very serious that can be spread whenever blood is involved. Some are known as Hepatitis A, B or C. They affect the liver and some can cause major health problems. STI's or sexually transmitted infections, which used to be called sexually transmitted diseases, can also be spread when there is unprotected sex. Some common ones are: chlamydia; syphilis; gonorrhea; genital warts; herpes; and crabs. Having a Sexually Transmitted Infection (STI) puts people at higher risk for contracting HIV because it weakens the immune system and open sores are ways for the HIV to enter the body.

UNPROTECTED SEX:

Sex involves the physical acts. Unprotected sex means sex without a
condom or other things, like a dental damn or plastic food wrap, that are
used to block contact with the body fluids.

Sex can include:


All of these sexual acts have different levels of risk. Remember, one
person must have HIV to give it to another person. Also remember, that
you cannot tell by simply looking at someone whether they have HIV, and
it may not be enough if someone says they do not have it. Trust in an
intimate relationship takes time to build. Semen (cum) can have a lot of
HIV in it, including pre-ejaculate or pre-cum. The following three
examples are all sexual acts without using a condom or other barrier like
a dental dam.


For a guy, the penis (dick) can have small tears or scratches which can have some risk if it comes in contact with HIV. The opening (urethra) where the urine (piss) comes out has tiny blood vessels which can be one area where HIV can make its way inside the blood stream. For guys that are not circumcised and have a foreskin, it is extremely important to clean underneath the foreskin because this is one area of the penis where HIV can enter the body because it is a warm, moist fold of skin that allows the virus to live longer when the penis has had unprotected contact with body fluids that have HIV.

HIV symptoms and AIDS-related diseases

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

Symptom means "subjective evidence of disease or physical disturbance." When someone becomes infected with HIV, eventually, there will be evidence or signs that will show up. With HIV and like many infections, a person might feel really tired for no reason or feel like they have a flu that lasts longer than usual. This happens shortly after they have been infected. This does not necessarily mean it is HIV, because the signs can seem like many other diseases. Because the body tries to fight off the infection with those warrior THelper cells, the person usually starts to feel better again in a little while.

However, little by little, the immune system begins to weaken and the THelper cells start to die off and the viral load begins to go up. Most experts believe that a person starts off with an HIV infection and over time, ends up with AIDS. This takes many years, especially if the person goes for a test and finds out they are HIV-positive. There is NO CURE for HIV/AIDS, and there is no vaccine like a needle or pill that can make it go away.

Once you have HIV, you have it for life!


MEN'S SYMPTOMS:

(Remember, many people will not see any serious signs for quite awhile after becoming infected.)

When someone gets sicker from HIV, they might have:



WOMEN'S SYMPTOMS:

These signs or symptoms mean that things are getting more serious and that other illnesses may be happening. Again, men and women get different kinds of illnesses but symptoms may be similar because the human body is reacting to a new threat. It is the following serious illnesses, cancers and what are called opportunistic infections that eventually take the life of the person living with HIV/AIDS.

AIDS-RELATED ILLNESSES FOR WOMEN

YEAST INFECTIONS: The vagina will burn and itch. The vaginal walls will be swollen, have a white or creamy discharge, like cottage cheese. Sex could be painful. The yeast infection might come back a lot, and is hard to get rid of.

SWOLLEN GLANDS: The glands become swollen and sensitive to touch. Glands are in the neck, under arms, behind ears, and inner thighs. THRUSH: Thrush is like what babies get. It happens in the throat andwill be creamy white patches on the tongue and in the mouth.

MENSTRUAL PERIOD CHANGES: Instead of the usual time of month, they may not happen each month. They may get really painful or just seem different from the usual ones.

PELVIC INFLAMMATORY DISEASE (PID): This disease causes pain in the stomach, legs and back. There is an unusual discharge from vagina, which has a strong smell and is a thick substance. There may be pain when you go to the bathroom to urinate. There could be bleeding in between periods, fever, nausea, vomiting, and sex becomes painful.

HORMONE CHANGES: Hormone changes can happen with menopause for older women, or from birth control pills, as well as during pregnancy. There can be normal changes within your period cycle, or if the ovaries are removed. HIV can cause hormone changes, like hot flashes, mood changes and certain kinds of vaginal infections.

BACTERIAL PNEUMONIA: This infection attacks the lungs. It is like a cold, usually with fever, chills, and coughing up mucus. The chest area may be sore and have a hard time breathing. This type of pneumonia is common for women with HIV/AIDS.

CERVICAL CHANGES: HIV positive women should go for pap smears every 6 months, since there are greater risk for changes to happen.

AIDS-RELATED ILLNESSES FOR MEN

PNEUMOCYSTIS CARINII PNEUMONIA (PCP): For men, PCP is the most common infection that comes with AIDS. It fills the lungs, causing coughing and shortness of breath. The cough usually doesn't make any phlegm.

KAPOSI'S SARCOMA (KS): This is a rare skin cancer, and men with AIDS can have it spread throughout the body and organs. It makes different colored blotches on the skin that are dark purple, reddish brown or pink. They also can be different sizes, almost the size of a loonie.

TOXOPLASMOSIS (TOXO): This is a parasite that attacks the brain and could even attack the heart and lungs. It brings fever, seizures, weakness, confusion and headaches.

CRYPTOSPORIDIUM: This can cause severe diarrhea lasting for months. The person with AIDS cannot keep food in the body long enough to allow the body to get any nutrients from it. The person becomes very weak and usually will die from so much loss of fluids.

MYCOBACTERIUM AVIUM INTRACELLULARE (MAI): This bacteria is related to Tuberculosis (TB) which can also be a disease that Doctors use to define an AIDS diagnoses. It also affects the lungs and the lymph nodes, and can spread throughout the body. It causes wasting, which means major weight loss in a very short time. This is not an exhaustive or totally complete list of AIDS Defining Illnesses. It is offered here to show some of the more serious ones and how they can be different for men and women.

HIV can turn into AIDS based on:


Only a Doctor can tell when you have AIDS.

Doctors can tell by:


People living with HIV/AIDS can take three types of treatment. These are known as:

1. Western medicine;
2. Traditional medicine; and
3. Alternative therapies.

Western medicine is what is used by mainstream Doctors who use different tests and medications to treat the illness. Traditional medicine is what some First Nations people use, such as Sweat Lodge ceremonies and many herbs and plants to treat their illness and use what is called aholistic approach that addresses the physical, spiritual, mental and emotional health of a person. Alternative therapies are things like naturopathic or homeopathic medicines, massage, therapeutic touch, and reiki, etc. to help keep the body, mind and spirit strong. Some people use one or more of these approaches.

HIV antibody testing

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

HIV Antibody testing involves having a blood test done. Even making the decision to go get tested can be hard for some people, especially if they feel they have taken risks where they could have caught HIV. Getting tested has many benefits, a key one is that it clears up any doubt for whether you have HIV or not. This is sometimes called a baseline test when it is your first test. This means that at that point in time, the results of the test can give you a clean bill of health or confirm whether you have HIV. The next most important benefit of HIV antibody testing is really the counseling you should get from the professional (Doctor/Nurse) doing the test. Sadly, these professionals may only ask a few questions of you rather than take the time needed to "educate" you on the disease, what test results mean, and what risks you may be taking and whether you need to think of making changes to your risk behaviors. Having a test done for HIV antibodies provides you with sound results, unless you are in the window period, which can be up to three months after being exposed to HIV. During the window period, you can still infect others if you have HIV and the antibodies will not show up in blood tests until later.

Not everybody needs to be tested for HIV, for example, if two people have been married for many years and have never cheated on each other, then it is unlikely they would need an HIV antibody test. But this scenario is not always true, because some partners may cheat on the other or be involved in risky drug use, increasing risk for all involved, including unborn children that come about during a pregnancy. HIV antibody testing is an excellent way, for when a person meets a new sexual partner, to openly talk about taking risks. You can talk about going for the test together and sharing the test results BEFORE you both decide to not use protection. Building and earning trust is important before you decide to put your life and health at risk.

Some reasons for being tested can be:

1. I need to know what my risks are;

2. I need to know if I have HIV;

3. I need to stay healthy;

4. I need to protect myself and others;

5. I need to not get infected;

6. I need to not infect others if I do have HIV.

Some people feel it is important to know your risks BEFORE you go for a test, however, if someone is sexually active or possibly taking others risks, it is always useful to go for a test just to confirm that you do not have HIV and to better understand if you are taking risks. Nobody will know whether you are tested or what the results will be, unless you tell someone. If you do tell someone you want to get tested or are worried that you took risky behaviors, it is important to think carefully about who you might tell. Some people also refuse to go for testing but continue to be sexually active and take other risks.

You might want the following when you go for a test:

· someone you feel you can trust;

· someone who will not judge you;

· someone who will not repeat what you say; and

· someone who knows something about HIV/AIDS so they can support you.

This could be a teacher, someone on the Steering Committee, a brother or sister, or a friend. It could even be the Peer Educator.

There are three different types of HIV tests: Nominal, Non-nominal and Anonymous. Nominal is another word for name. So the three types are really only how records are taken by the medical people. Nominal means they place your name on the forms and can trace your identity. Nonnominal means they do not use your name and place a coded number instead, to protect your identity. Anonymous means they do not ask your name at all, and use a file number, which means they cannot identify your true identity. Many clinics offer little or no pre or post test counselling (especially in the isolated communities) which is a very important part of the process when someone goes for a HIV test.

Here is basically what should happen when you go for a HIV test:

· A Doctor or Nurse can take the blood sample either at your Doctor's office, the hospital or a specific place set up for HIV testing, like an Anonymous testing site which could be set up at an Aboriginal AIDS Service Organization or health clinic.

· Depending on where you go, you may get more counselling than other testing sites. There are two types of counselling called pre and post-test counselling. This means before and after the test.

· Before the test is taken and after you make your appointment, the person who will take your blood sample by a needle, should ask some questions on how much you know about HIV, what you feel your risks were, and what you will do when the results come back negative or positive. This helps you to understand why you need or do not need a test. For example, if you have not taken any high risks, then they may feel you do not need a test. It is your right to insist on a test to confirm that you do not have HIV.

· It could take 2-4 weeks for results to come back. They send the blood to a Lab and this will show if HIV antibodies are in your blood stream. If they do show the antibodies, they will do a second test to double check using a different type.

· Post-test counselling (after your blood test) is to help you understand the results and to also listen to your questions and worries. Whatever the test result, good counselling helps you know basic things and especially what to do with the information.

· ‹ If need be, they can set up referrals to Support Agencies or HIV

· Specialists who can help you when you get your test results back.

What are the HIGHEST RISK behaviors for HIV/AIDS?

· Sharing injection drug needles, that have not been cleaned with a bleach and water mixture;

· Unprotected anal and/or vaginal sex;

· Some tattooing, if the tools have not been cleaned with bleach and water mix;

· Some piercing, if the tools have not been cleaned with bleach and water mix;

· sharing snorting equipment, with someone who has HIV to snort drugs up the nose;

· sharing any medical equipment that is exposed to blood or body fluids;

· any activity with direct blood contact that may have got inside you.

Being tested for HIV gives you knowledge, and that knowledge means power to control and make your own decisions in the future!!! Most types of HIV antibody tests are very accurate. Sometimes, though, results could get mixed up or other things might affect results. For example, in some cases, people who get a flu shot around the same time

they go for an HIV antibody test might have their test results come out HIV-positive, but the results could be wrong. This would be an example of a false positive.

HIV TEST RESULTS CAN BE:

· POSITIVE: This means that you have HIV in your blood and body fluids and can infect others or you are HIV-positive.

· NEGATIVE: This means that there is no HIV in your blood or body fluids, so you do not have HIV or are HIV-negative.

· FALSE POSITIVE: This means that the blood test results might show up as positive but that it was a wrong result. It rarely happens, but some tests can be wrong. If you ever have a positive test result, it is useful to have another test done to be sure.

· FALSE NEGATIVE: This also means the blood test results are wrong. It can show up as negative, meaning you are ok, but in reality you do have HIV. This is why it is important to use protection if you are going to take risky behaviors. A window period could be why no antibodies show up, as described below.

On the other hand, when someone has come in contact with HIV, it takes awhile before the antibodies show up in your blood. This is called the "window period", meaning you had contact with HIV and were infected, but the antibodies have not shown up yet. The window period is usually about 6 to 12 weeks after being infected with HIV. During this time your blood test results could show up HIV-negative. This would be an example of a false negative. During the window period, you can infect others if you have HIV.

Safer Sex

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

This section is to describe some basic ways of protecting yourself, if and when a youth decides to become sexually active. The information can also be used if someone is already sexually active and wants to protect themselves more. Sex after marriage is an issue too (and includes those who are waiting to have sex until after marriage).

CONDOM USE:

There is strong evidence that shows that many people - young or older – are not using condoms when they have sex. As mentioned before, if two people are in a relationship and have not cheated on each other, then condoms or any other protection is not necessary. There can still be a risk, for example when partners are unfaithful or have shared needles in the past and do not know their HIV status. It is a good idea for both people to get a HIV test and again in 6 months, after they start their relationship to be sure. This does not address whether one person is unfaithful and that requires trust and open dialogue. Couples trying to have children fit here too. If this couple does not want a pregnancy, then there are other options like diaphragm, birth control pills, etc. that can be used instead of a condom. Many people say condoms are simply not fun - they take time to put on, or they lower the pleasure or feeling.

These are opinions, some based on experience, and others based on preference, which needs to be dealt with. Some guys even joke about the condom being too small, when in fact a condom is made to stretch quite a bit and can even fit over your hand. Some condom packages have instructions inside that you can read, some even have diagrams. Latex condoms are the best because they do not allow HIV to get through the material unless the condom breaks. Some condoms can break if they are not stored properly, are old or have been carried in pockets or wallets which have caused wear. All condom packages have expiry dates. If someone is not used to using condoms, it is useful to open one up in the privacy of your bedroom and look it over. This helps to become familiar with how they open, feel, unroll, etc.

To use a condom, remove from package. Take a corner of the wrapper and tear open gently. You don't want to rip the condom itself. Some condoms are lubricated with nonoxonyl-9 (N-9) which helps the condom move more freely. N-9 can increase the chances of contracting HIV. It causes irritation which makes the body more likely to get HIV if it is exposed to the virus. It can hurt, burn or cause irritation if used for anal sex. Some females are also allergic to N-9 or even to latex condoms. Other personal lubricants may be useful, and these should always be water-based. NEVER use baby oil, Vaseline, or anything that has an oil-base. These cause the condoms to break down and tear, making them useless. If the guy has a foreskin (is uncut), it is helpful to pull the foreskin back a little before placing the condom over the head of the penis. To increase feeling, guys can also place a small amount of the personal lubricant on the head of the penis before putting on the condom. As mentioned earlier, if you want to avoid being awkward with putting a condom on in front of another person, it may be helpful to try it out on your own. One other way, is to use this time to talk with your sexual partner and have both of you put it on together. Remember the personal lubricant can be slippery, so if you have it on your hands before trying to open the condom package, it could be hard to get open. You may want to open the condom package first, then reach for the tube or bottle of personal lubricant. These lubricants also come in small single use containers.

LATEX BARRIERS: (dental dams, plastic food wrap, latex gloves)

A barrier is something that comes between you and something else. In this case, the barrier will be for blocking direct contact between the mouth and body fluids. This can protect the person who is giving pleasure with their mouth from coming in contact with other sexually transmitted infections, like genital warts, herpes or any of the other infections listed earlier or hepatitis A or B.

Again, latex is the best type, because when used properly with water-based lubricants, it can be an effective way of blocking direct contact. A dental dam is what the dentist uses when you go for dental work, like a tooth filling. It is the rubbery piece of material that is stretched over your mouth and held in place to stop things from going down into the throat while the dentist does their work.

To use a dental dam properly, you will want to use personal lubricant on the side that touches the other person. This will increase the sensitivity for them and allow the dental dam to move around with some ease. The other person would hold the dental dam over the vagina or anus (mouth to pussy/ass) and place their face down onto the area. They would then press their tongue against the dental dam which is between the other person and the mouth. It can be awkward and take some time to get used to, but if a person is going to perform oral sex on a vagina or anus, a dental dam is recommended. Some people use plastic food wrap because they can tear off a larger piece. However, the microwaveable type is not recommended because they have more pores or small openings. The same method would be used as with a dental dam.

Latex gloves can be used if you want to insert one or more fingers inside someone. Once again, latex along with water-based lubricant is best. Gloves protect hands and fingers which may have small tears or hang nails from being exposed to body fluids. Lubricant generally provides the easy movement which allows the entry to be less harsh. Some people use latex gloves to perform oral sex on a vagina or anus, like they would with a dental dam. What they do is place the latex glove on one hand. They cut the top part of the glove which covers the back of the hand down the middle stopping at the knuckles. This way, they can insert fingers to help pleasure their partner, while also having a large piece of plastic to keep a barrier between their mouth and the vagina or anus.

SEX TOYS:

The last piece of information under safer sex will be sex toys. Some people choose to use sex toys so that the sexual experience lasts longer. Most people who have full sexual intercourse alone may last only five to fifteen minutes on average. By learning what your partner enjoys, and trying to fulfill their pleasures, one possible way is the use of sex toys. These are not for everyone and it really is an individual choice on whether they want toys used or not.

Sex toys can include: vibrators; dildos; benwah balls; butt plugs; among others. The important thing to remember about any sex toy is that they should be cleaned properly after each use; caution and care should be used; water-based lubricants are recommended, and never share the toy between more than one person. They are used by inserting them into the vagina or anus, and as such are exposed to body fluids. It is important for each person to have their own sex toys for use on themselves rather than sharing them between individuals. If you do share, you can also use condoms over these to avoid contact between each person's body fluids.

Sexual Health and Holistic Health

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

Sexual health is not easy to define because each human being is so different from the next. Sexual health is much more than how healthy our sexual and reproductive organs are. Everything in our lives affects our health because we are interconnected with all of Creation.

Maintaining a balance between the physical, emotional, spiritual and mental aspects or our experiences creates a healthy First Nations person. If we allow one of these four things to get out of balance, we can experience ill health.

The Medicine Wheel has been used by many First Nations people for thousands of years and may be a good model to apply to any aspect of our health, including sexual health. It is also useful to recognize that some First Nations may not use the Medicine Wheel today. The following Medicine Wheel can be used as a teaching tool to talk about balance, life, responsibilities, about gifts and of life cycles. For communities or individuals who choose not to use the Medicine Wheel, this information can still be presented without having to use this visual exercise.

The Medicine Wheel starts in the east where the sun rises and the day begins - which is why this direction also refers to the infant stage. Just as the sun travels, we next look south, as with life and move from infancy to being a youth. Then we continue in a clockwise direction looking west, which we refer to as the adult stage of life. Lastly, we look north, and to the wisdom of Elders. This same Medicine Wheel can be used to teach about the stages of the HIV virus, or about sexual development because it covers all four main stages of life. Some examples follow and more examples about how to teach this is found later in this section.

For example, when applying it to HIV, the infant stage is when a person becomes infected. The youth stage is when the body begins to feel the affects of the virus and may experience some health warnings. The adult stage is when the person has had HIV for awhile and may be struggling with many health setbacks. The elder stage is when a person develops full-blown AIDS and begins to face the possibility that their time in this world may not be plentiful.

When talking about sexual development, the same cycle or wheel can be used to explain what happens during the Infancy stage to the body. The youth stage can be talking about puberty and the physical changes that a youth goes through. Girls begin their moon-time (menstrual periods) and guys have their voices change, among other things. The adult stage can be about parenting, marriage, and responsibilities of being in an intimate relationship and about commitments. The elder stage can be about
menopause including male menopause and how relationships may change to being non-sexual. And so the cycle of life continues. We all have one common mother and that is Earth. We are forever connected to her and so it makes sense that the state of Earth's health affects the health of individuals, our families, our communities and all things around us. The air we breathe, the water we drink and the food we eat from the land all affect our health. This is a holistic view of health.

Changes that happen to us in the transition from youth to adult can be a real challenge. Boys' voices get lower, girls' breasts begin to develop and we start growing pubic hair. We are slowly transforming from youth to adult. These changes affect us physically but also emotionally, mentally and spiritually. Strong feelings of sexual attraction to others which are new to teenagers and young adults can be difficult to deal with. How we think of ourselves can change too. Most of us begin to wonder whether we are attractive to the guys and/or girls we have been thinking about. In the midst of these feelings, a young person may be more vulnerable or prone to try various substance use, such as drugs and alcohol, to help make us feel more comfortable or less shy. There are concerns when this happens, which are discussed later in this section under Sex, Drugs and Alcohol.

Our minds and how we think of ourselves and the world around changes as we reach this growing stage. Spirituality is a big part of sexuality as well. Traditionally, in First Nations cultures, our sexuality was considered a gift from the Creator as a way of sharing pleasure with our partner and also a way to be gifted with children. Many religions teach that sexuality is something to be shared by two people who are married for the purpose of creating families. Sexuality affects what we do, how we feel about ourselves and others, what we think and how we experience our connection to the Creator. Sexual health is a good thing. Before first contact with Europeans, First Nations people commonly used traditional ways of educating infants, youth, adults and elders about sexual health through stories, songs, ceremonies, rituals and teachings of roles and responsibilities. Over the last 500 years many of our old ways changed and our overall health has been negatively affected. The role of the residential school system, the decline of First Nations languages, limited access to our traditional use of the land, the food we eat, and even racism continues to affect our holistic health in negative ways.

But humor and love remain with us and keep us strong. It is only with deep love and respect for ourselves and others that we can adapt and remain strong and healthy. We have never lost the ability to laugh about ourselves and our situations. With love and humor we can heal and reclaim what has always been ours - the health of each individual, our families, our communities and Earth herself.

Holistic health goes further than our personal experiences because we know that we are intimately connected to everything that exists on Mother Earth and the entire universe. Sexual health is woven into holistic health in the same way. We each experience our sexual feelings in unique ways.

Intimacy

True intimacy is not just about physical sex and touching each other. It is about talking openly about who you are, what you like, your fears and your needs. It is not just about having sex. In fact, you can have true intimacy without having sex because it involves being open and honest with someone and sharing a very private part of you. It involves trust and earning trust.

STAGES OF THE MEDICINE WHEEL:
INFANT, YOUTH, ADULT, ELDER

Human sexual development normally happens in stages as we age. Many of us are not used to thinking about infants, teens or Elders being sexual, but it is a fact of life that we must look at. Traditionally we are taught that human sexuality is a sacred gift from the Creator. Sexuality begins as soon as we are born and we continue to be sexual beings until the day we draw our last breath.

Medicine Wheel



Infant (infant, toddler, child)

Infants and babies need to feel that they are cared for. A parent's or care-giver's love and caring is very important. Snuggles and hugs, calm surroundings, bathing, talking softly, providing comfortable clothing, feeding and diaper changing are all ways that we show our love for our babies and toddlers. Even as babies, the connection between our genitals and our brains is already established. Any kind of infant care that involves touching the genitals can stimulate sexual feelings in babies. Infants will not have sexual thoughts or images when they become sexually stimulated, however, they can and do experience pleasure. To them, it simply feels good. At some point, an infant will discover that by touching themselves they can experience pleasure. This is a common stage in our sexual development. This is also how we first learn to trust and enjoy human connections.

Youth (youth, adolescent, teen)

In the youth to teen stage of life we continue to develop sexually. At an early age children become curious about how their bodies work. For example, often children begin to wonder about where babies come from or they may ask about the family dog who they saw humping another dog. It is very important for children to be able to ask questions and get simple, honest answers from the adults in their lives about what is going on. This can be a good time to pass on a traditional teaching or story that helps explain the cycle of life from birth to death or to use religious teachings that deal with these topics. It's important that the child feels that he/she can talk about these sexual thoughts and feelings with the caring adults in their lives.

Talking about the cycle of life, reproduction and sexual health is also a good opportunity to teach the child the difference between right and wrong. For example, a child can be taught what kind of touching by an adult is right or wrong. A child who has already talked with an adult about healthy touching is much more likely to tell that adult about sexual abuse. They will have established trust, language and background to use for talking about sex. If a child feels shame talking about sex, they will not likely reach out for help when they run into trouble. Children who can't talk about having been sexually abused often feel that the abuse was their fault and keep it a secret for many years leading to sexual ill health. Sexual abuse is never the victim's fault. Sex education is one of the best ways to protect a child from sexual abuse.

Between the ages of 9 and 14 most people begin to experience puberty. During this time, our bodies are flooded with powerful sex hormones which cause physical changes. How we think and feel change too. Some of us wonder if we're the only ones going through changes and without someone to talk to, sometimes we feel alone, isolated and vulnerable.

Sometimes we become physically and emotionally attracted to others of the opposite and/or same gender and we have a lot of feelings and thoughts that we don't understand. Getting sex information from friends or peers can be a good thing but a lot of times the information we get from friends is not based on fact.

With any gift, including the gift of human sexuality, there comes roles and responsibilities. During puberty we become intensely aware of our sexuality but what do we do with these thoughts and feelings? We spend a lot of time thinking about it. There are worries, questions, hopes and dreams that can seem overwhelming such as: "Does she like me?", "When will my breasts grow?", or "Am I a pervert for feeling this way?" Once the physical changes of puberty are well under way and a teenager begins to enjoy some of the roles and responsibilities of young adulthood, a different set of concerns begin to come into play. For example: sexual intercourse for the first time (when, what, where, who and how?); Should I wait until I'm married?; What about STI's, HIV/AIDS and pregnancy?; What do other people think about me?; Will anybody ever fall in love with me? These issues will be addressed further on in this section. These questions can be good topics to discuss in Talking Circles or with a Counsellor.

Adult (adult, older, parent, senior)

Adulthood or the adult stage means that people have lived long enough to gain what is called life experience. It also includes responsibilities and growing from past mistakes. It is about being mature and taking ownership of your choices. Adult choices include issues like: reproduction (having and raising children); fulfilling our sexual lives; teaching or sharing about how to live life to the fullest. The adult stage also includes being a rotector, a role model, showing love and care for others.

Adulthood is about being a provider, doing proper family planning (when to raise children), and, living an active role in the community. The adult stage is about being a worker, a warrior in that they defend things that are right and good for the community. Adults can be nurturer's and caregivers. That is if they are healthy and are not engaged in negative behaviors such as substance use that interferes with these roles.

Elder, (Elder, grandfather/grandmother)

Lastly, the elder stage is like the adult stage. Elders are Traditional Teachers, Keepers of Knowledge. They can be care-givers and story tellers. They continue providing or sharing their Teachings (depending on their health). Elders are our policy makers, historians, stabilizers and mediators because they know enough from living a long life that they can be called upon to correct situations. They were our Treaty Makers when Treaties were being negotiated with Canada. Despite misconceptions, Elders can continue to enjoy sexual pleasures, depending on health and the situation. Elders do not have to worry so much about pregnancy, as older bodies no longer can conceive a child because of menopause and other factors, like diabetes. There is a difference between Elders and senior citizens. Elders generally have gained a standing in the community and are respected and seen as having wisdom. A senior citizen may be old by age, but may not always have the same standing in the community, for different reasons, such as a dependency on substances or they simply do not meet that role.

Native Medicine

from: coping with HIV-AIDS, The path for Aboriginals living with HIV/AIDS

Traditional native medicine is not merely classified as an alternative therapy to Western medicine, since for most Aboriginal peoples it is their primary form of medicine. Traditional native medicine focuses on the four main dimensions of the human person. Plant extracts and natural beverages are used to bring physical relief to the body. Rituals and ceremonies are organized to bring relief to the soul. Talking with a traditional healer or an Elder helps restore peace of mind and get emotions back on track. Each Aboriginal Nation developed its own stream of traditional medicine over the centuries. Some nations use their own traditional medicines, such as sage, cedar and sweet grass for healing purposes.

Native Spirituality

from: coping with HIV-AIDS, The path for Aboriginals living with HIV/AIDS

Spirituality defines everything relating to the human soul, the relationship we hold with our living environment and the creative force which lies within. It allows one to give meaning to his or her life experience or living environment. People who are faced with hardship often find great comfort in spirituality.

Each person holds his own conception of spirituality and is the sole person responsible for that spirituality. This is also true for people who learn they are HIV/AIDS infected. A person who practices his spirituality may develop a stronger sense of belief after finding out he is infected with HIV/AIDS. The opposite situation may also happen: a person living with the disease may turn away from spirituality. Respect is of utmost importance in this type of situation. Spirituality reflects the different
colours of a culture. In other words, a community may give a certain direction to its values, beliefs and rituals, but each and everyone is free to choose and to adapt his spiritual practices according to his own beliefs and values.

Native Spirituality

Spirituality is very important for Native people. Every Nation has developed its own spiritual ceremonies. None the less, some aspects are common to all Nations, as for example, reference to the Creator of Life and the recurring theme of Nature and animals as benefactors. There are differences between all First Nation peoples. However, similarities can shed light on spirituality and make it easier to approach and understand.

Spiritual Values

The fundamental values which are at the heart of native spirituality are goodness, honesty, sharing, care, respect, wisdom and strength. Elders are important because they can pass on and reflect these values. That is why they can be very inspiring resource persons and can help others to practice their spirituality.

Religion

Catholic and Protestant religions are integral to the spiritual beliefs of many Aboriginals. Although residential schools were a traumatizing experience for many people7 who then rejected religion, for others it is an important source of spiritual inspiration. Once again, it is important to respect every person’s beliefs.

Traditional Values:

Traditional healers are seen as wise people. They incarnate spiritual values and can be of precious help for people faced with hardship. In order to support a person, traditional healers use a holistic approach, reaching out to every dimension of a person’s life. The methods used by traditional healers include listening, observing, touching, sensation, reflection, speech, song, dance, tales, prayer and fasting. Sweat lodges are also part of some traditional healers’ methods. However, not every First Nation community agrees on this method.

Spiritual Dimension of Health:

Ancestral traditional healers believed in three causes of disease: loss of one’s spirit, an object entering the body or a bad spell thrown by a medicine man. To heal a person, spiritual techniques served mainly to restore balance, to extract the unwholesome object or to regain ones spirit. To this day, our communities have a holistic conception of sickness and healing. The spiritual dimension is one of the four fundamental dimensions of life and well-being. It cannot therefore be removed from the path chosen by a person living with HIV/AIDS. This dimension is also important for the physical, mental and emotional dimensions of life and can influence ones improvement, deterioration and health. Loved and trusted family members and friends can help us establish a healthy relationship with spirituality. For example, a person can join a self-help group to discover spirituality with the support and friendship of others. Elders are often a good support to discuss spirituality and to find a balance between daily life and spirituality.

A healthy relationship with spirituality can help to restore inner peace with others and through the events disrupting daily life. This peace and balance can have a beneficial influence on the life of a person living with HIV/AIDS. Spirituality is an important part of a person’s health. Ancestral traditional healers believed in three causes of disease: loss of one’s spirit, an object entering the body or a bad spell thrown by a medicine man. To heal a Person, spiritual techniques were therefore mainly used to find balance, to extract the unwholesome object or the regain one’s spirit. To this day,
our communities have a holistic conception of disease and healing. The medicine wheel described in the introduction is an essential element to understand the spiritual concept that Aboriginals hold of health.

Prayer

Emotional Dimension

from: coping with HIV-AIDS, The path for Aboriginals living with HIV/AIDS

The emotional dimension of life is linked to the heart, feelings and emotions, which have an impact on a person’s health, body and soul. The body and soul can also cause us to experience different emotions. People living with HIV/AIDS go through several emotions which can greatly affect their well-being. Understanding the emotions which may arise and knowing that they may be normal and legitimate in destabilizing situations can prepare a person to cope with them and reduce their impact.

Pain:

Pain is what a person feels when the body and soul indicate that something is wrong. It can be felt in the four dimensions of life: physical, spiritual, emotional and mental. Every person has his own personal and unique way of experiencing pain. Everyone has a different threshold of tolerance when faced with pain. Although people who tolerate pain are often seen as strong and brave, it is important to remember that no one should have to uselessly endure pain. It is a signal of distress given by the body and soul. We must describe and discuss our pain with the people we trust.

Everybody conceives pain in his own personal way. Some people refuse to face pain because it means that death is close by. For others pain is precious because it is a sign of life. Others believe that they deserve to suffer because of the harm they’ve done or because they are HIV/AIDS infected. Although pain is physical, it gives rise to several emotions and difficult issues.

Different Types of Pain

There are different types of pain which have their own particular aspect. Knowing them can help us
respond to them. Acute pain is felt in a specific part of the body and can easily be identified. The pain is sharp, intense and shortlived. A person with acute pain can show facial contortion, cry, moan, sweat, be agitated, nervous or tense, avoid movement and protect the painful area. Chronic pain is vague, diffuse and hard to support. It is linked to chronic illness. Its intensity can fluctuate or
it can be constant. It considerably weakens the person. The body adapts itself to chronic pain and therefore few physical signs can be seen. On the other hand, the person’s mood can
be altered. Frustration, anxiety, irritability, loss of appetite, depression and suicidal tendencies can
be observed.

Emotional pain comes from intense spiritual, psychological or emotional suffering. However, it can affect the body and give rise to physical symptoms. Even though it is hard to perceive by other people, emotional pain is just has real and difficult to cope with.

Pain Relief Techniques

There are several pain relief techniques. The use of medication is fairly widespread but there are
alternative pain relief therapies. Medication is sometimes the last resort when the pain can no longer be tolerated. It is usually effective and relieves the pain quickly. However, people don’t always react the same way to a product. In some cases, the medication does not relieve the pain and some products can even lead to side effects which are also hard to tolerate. The choice of medication
must be made wisely. Alternative pain relief therapies include distraction, day-dreaming, massage, relaxation, therapeutic touch, skin stimulation and acupuncture. Here is a brief description of these therapies. Warm and respectful human contact is always comforting and soothing for people who suffer.

• Distraction is a way to take the person’s mind off the pain, either by listening to music, taking up a hobby or just having a conversation with a loved one.

• Day-dreaming is a technique used to stimulate a person’s imagination and to take a journey into a more pleasant world.
• Massage is used to bring soothing and comfort through muscle and skin manipulation.
• Relaxation can relieve tense muscles, fatigue and anxiety. It can also increase the efficiency of other pain relief techniques.
• Therapeutic touch is a technique through which hands are pressed on a person’s body to release energy zones.
• Skin stimulation is similar to massage but it is a technique through which heat, ice or pressure is also applied on the body.
• Acupuncture is a technique through which needles or laser beams are applied to the body’s important energy points. It is used to block out the pain.

Loss:

People living with HIV/AIDS are often faced with loss. Not only do they have to live with the thought of dying, but they also have to deal with losing control over their body, physical capacities, self-image, work capacity, mental functions, social role, as well as family and friends. All of
these types of loss are hard to cope with and give rise to a tremendous amount of grief for people living with HIV/AIDS. HIV/AIDS infected people faced with loss don’t always react the same way.
Most common reactions include fear, anxiety, guilt, denial, anger and depression, all of which are
completely normal in these circumstances.

Hope:

People living with HIV/AIDS need to know they won’t be abandoned, that they will always have someone to talk to and that there is always hope. This is what keeps us alive and helps us to keep on going, even in times of great loss and grief. Hope also helps people take care of themselves. Throughout their journey, people living with HIV/AIDS can express hope in many different ways. First of all, people hope that a cure will be found and that they will be spared by the perspective of death that comes with the diagnostic. Afterwards, when they realise that a cure won’t be found in time, they often hope that a treatment will help them live as painlessly as possible and in the best intellectual conditions. When death is at close hand, they hope to live until Christmas or until a loved ones birthday. Finally, some wish for a peaceful death. Not every person living with HIV/AIDS expresses hope in this order or in this way. However, it is important for everyone to keep on hoping.

Discrimination:

Everyone who is physically or mentally different risks facing discrimination. Ignoring, making fun of, insulting, avoiding, pushing, denying a person his or her rights or excluding them from a community or group are all types of discrimination. People act this way through lack of understanding, fear or
ignorance. Discrimination is sometimes hidden. For example, an employer may cite false reasons for
firing an HIV-positive employee. Discrimination can be very difficult for people infected by HIV/AIDS, who need to feel supported by their community and loved ones. People faced with discrimination can feel rejected, angry, sad, disappointed, guilty, lost, helpless, lonely and terrified. Some people lose their self esteem and may even develop suicidal thoughts.

People living with HIV/AIDS who are drug addicts, sex-trade workers or bispiritual may face even greater discrimination. They may feel even more guilt and regret. Being Native also has its share of
prejudice and discrimination. Being Native and having the HIV/AIDS infection can be even harder when living in a community that is unaware of the facts or when social ties have been broken. Fear and misunderstanding can lead Band Councils to force HIV/AIDS infected person to leave the community. This type of rejection is dramatic given the native concept of community and solidarity. Discrimination and all the feelings that come with it make it even harder for HIV/AIDS infected people to fight for their life.

Experiencing Major Distress

Some living conditions lead to major distress. In the case of people living with HIV/AIDS, it makes it even harder for them to find a certain balance in a situation that is already difficult and painful.

4.5.1. Prison

Living in prison is a difficult experience. Different living conditions, the restrictions on personal and intimate contacts, the resurgence of feelings of guilt, of rejection, misunderstanding and affective disassociation can greatly disturb many people. There is a high level of stress amongst people living in prison. In addition to the emotional dimensions of prison, there is a high risk of disease transmission.

The main purpose of prison is to place people who break the law in confinement. Confinement is imposed to protect society from criminal acts. However, the State is still obliged to respect every inmate’s rights. Everyone is entitled to adequate health services and to a lawyer. On the other hand, people living in prison aren’t protected from HIV and other diseases, like Hepatitis C. As a matter of fact, numerous people seem to have contracted HIV/AIDS while they were in prison. About 1 out of 600 people in the Canadian population is infected with HIV/AIDS (not counting the people who are unaware they have contracted the disease). In Canadian prisons, 1 of every 100 people lives with
HIV/AIDS. Studies9 have shown that in some parts of prison, 1 out of 9 people is infected by HIV/AIDS. As we have already seen, the number of Native people as compared to the general population is even higher. The same situation seems to apply in prisons. Women are also highly at risk of being infected while in prison. Inmates are offered very few means to protect themselves even though it is widely known that many engage in unsafe homosexual encounters or use injection drugs. By turning a blind eye to such situations, very little is done to help inmates protect themselves who consequently engage in even greater risks. The Canadian correctional system is more and more open to visits from community members, healers or even elders. It makes the whole ordeal of living with the disease in prison a little more bearable.

Stress:

Living with HIV/AIDS implies several changes and physical, psychological, spiritual, social, emotional and mental ordeals, all of which can be very stressful. One of the most difficult challenges is the financial aspect of HIV/AIDS. Medication is expensive; people often have to stop working because of the symptoms and side effects, and therefore live in poor economic conditions. HIV/AIDS and poverty are both part of the same vicious circle. Stress is a normal feeling whenever the body or mind perceives danger. However, intense and constant stress can be harmful. It can weaken the immune system of People living with HIV/Aids. Several things can be done to reduce stress.

Alternative and complementary therapies are interesting because of their relaxing aspect. Exercise, humour and hobbies can also reduce stress. Some people prefer to be directly confronted to stress to reduce its impact. Relieving stress can lead to the end of an oppressing relationship, a new job or moving from an uncomfortable apartment.

Substance Abuse:

The use of narcotic substances such as drugs, alcohol, solvents or medication alters our physical,
psychological, emotional and mental state. That is often why people use them. However, because drugs alter a person’s state, the body and mind are also perturbed.

Coping with HIV/Aids

An altered state of mind can expose people to dangerous situations. Because of substance abuse, some may engage in unsafe sexual encounters or share an injection needle. Furthermore, it can also lead people to forgetting their appointments or medication. Substance abuse is disruptive to all aspects of everyday life. These habits reduce the quality and life expectancy of people living with HIV/AIDS, especially when opportunistic infections appear. Because of their substance abuse, people may not allow others to help them. They may have low self esteem,
very little group support or feel they don’t deserve a better life, and therefore refuse to take care of themselves. Substance abuse or the struggle with quitting can lead to mood swings and uncomfortable side effects. Even though complete withdrawal may seem like the best solution, in several cases it is impossible. When drugs are used to escape or to find comfort, the situation may lead to change after the diagnostic. However, some people manage to take control over their consumption. The most important thing to do for people who abuse substances such as narcotics is to help them gain control over their life and increase their self-esteem. This can be done by letting
them make their own choices, telling them how to reduce the risks associated to their substance abuse and by bringing them moral support.

Alcoholism:

Alcoholism is a major problem in some communities. Prolonged alcohol abuse is physically, mentally, emotionally and spiritually harmful for a person. As for any other substance abuse, it alters the person’s state of consciousness. It often leads to fighting with their loved ones or the loss of trust in others. It can also leads to broken or damaged support networks. As they are faced with an involuntary and misunderstood solitude, alcoholics often tend to consume even more to forget the pain it causes. The vicious circle of alcohol or substance abuse weakens a person’s strength and will to fight against HIV/AIDS.

Emotional Dependency:

Most people have to cope with some kind of emotional dependency. We are all more or less attached to our loved ones and to our spouse. However, some people express unhealthy attachments. They are unable to make any decisions without the other person’s consent; they abandon everything for the other and sacrifice themselves to fulfill the other person’s needs. Emotional dependence can lead to very difficult situations, especially because this type of person often ends up with a dominating spouse. Consequently, the dominating person imposes everything and the dependant one complies by fear of losing the other’s affection.

Someone may accept to have unprotected sexual relations in order to please the other. When being
subjected to another person’s will, a person forgets her own feelings and opinions and loses all self-respect. Unfortunately the person is at risk of contracting a disease such as HIV/AIDS. An emotionally dependent person living with HIV/AIDS may go through a difficult period. Not only is the
person faced with the fear of losing the other’s affection but must also cope with discrimination, guilt and reject. The resulting tension can lead to a point of no return and force the person to choose between herself and others. Even though some cases have reported for men, it seems that women are the ones most affected by emotional dependence. They are often unable to leave their husband even if they are victims of violence or abuse because they are incapable of existing outside the other. This reality can also be seen in native communities. In some cases, economic and social dependence are also part of the emotional dimension. Helping a person to pick up the pieces,
to discover her own tastes and to make her own choices can show the person that she can take charge of her life. A person can assume her own identity by regaining self-esteem and control over her life.

Violence:

Violence can be verbal, physical, sexual and emotional and exists in every social and ethnic group, as well as in native communities. Every type of violence is harmful, both for the victim and the person perpetrating it. A violent environment leads to higher insecurity, high levels of stress, constant mistrust, violent attitudes, prompt responses, which are usually inappropriate, fear, humiliation and so on. Violence harms not only the body but also the mind, the heart and the soul.

Death and Funerals:

People living with HIV/Aids often die from diseases related to the virus. Although death is predictable, death does not follow any prescribed order or sequence. However, certain signs can be seen in a person at the approach of death: loss of appetite, spasms through the whole body, difficult or intermittent breathing, tense muscles and different skin colour. These signs can wax and wane and aren’t all present at the same time. Death comes when the person feels ready to die. The person might wait for the presence of a pet or loved one before leaving. Dying people don’t always seem to be aware of what is going on around them. Some are in a coma or semiconscious state, while others sleep most of time and awaken every once and a while. It is often hard for them to recognize time and space and they don’t always recognise the people at their side. However, it is important for them to experience peace, calm and affection so they can die as peacefully as possible. Some people believe that although someone is in a semi-coma, the person can feel and
hear what is going on. It is not easy to lose a loved one or someone we’ve taken care of. People take it differently and there is no single best way to react. Witnessing someone’s death can be experienced as an anticipation of what our own death will be like. It is important to respect our emotions and those of the others. Some people will want to touch the dying or dead person, while others can’t even bear to look. Everyone should try to say goodbye in their own way. Death is also part of our life cycle.

Caring for the caregiver

Caregivers are those who take care of others. Their responsibility implies giving a tremendous part themselves, love, respect, generosity, having an open mind, understanding, listening and having a warm heart. Taking care of others also brings a lot to the caregiver, such as feeling useful, earning recognition and self-esteem. However, the caregiver must be able to take care of him or herself in order to be useful. There are several difficult challenges that come with taking care of others, especially for people living with HIV/AIDS. Although there has been medical progress and despite all the efforts invested by the caregiver, people living with HIV/Aids ultimately end up dying. Even though they know this, caregivers can exhaust themselves by trying to beat the odds.

Taking Care of Yourself

The caregiver’s best tool is himself, as a human being with his strengths and weaknesses, courage and generosity. In this frame of mind, taking care of yourself means you can take care of others. It also implies that you have to take care of every dimension of your person, the same as you do when taking care of others. There are several ways to take care of yourself. The caregiver has to take time for himself, to rest and to renew his energy. Such moments can be taken in the enjoyment of an
activity or in spending time with close and loved ones. Humour and communication are important when taking care of yourself or of others. Relaxation, exercise, communication, self-expression through music, arts and crafts as well as hiking are good ways to take time out for yourself, to unwind and to evacuate whatever feelings you may feel as the result of attending at the bedside of a sick person.

Talking about your experience with the health care team, health professionals, family or volunteers can help to put things in perspective and to find group support. It is very important to find ways to take care of yourself so that you are able to take care of the patient.

Burn Out and Depression:

Sometimes the caregiver can no longer take care of himself. In some cases, people choose to take care of others to amend for past mistakes. When taking care of a dying person, the suffering we put behind us may resurface. If the caregiver already feels like a failure, the patient’s death can be seen as another personal failure. Exhausted caregivers often fall into two states, either burn-out or depression.

Burn-out

When the caregiver can no longer take care of himself, his strength weakens, which usually leads to exhaustion. He keeps on going because he considers that the other person is more important. Not only can this lead to physical exhaustion but also to emotion, mental and spiritual exhaustion. When this point is reached there is no longer any energy left, neither for the caregiver, nor for the patient. This is known as burn-out.

Here are some of the symptoms:

• Constant fatigue;
• Working more hours or being absent more often;
• Feeling useless except when working;
• Feeling unusually pressured when friends or family ask for a favour;
• Feeling emotional or angry towards the patient;
• Feeling depressed or indifferent towards the patient;
• Headaches or sleep disorders.

Depression

Depression sometimes appears when the caregiver takes whatever is happening to the patient personally. Highs and lows become harder to deal with. The person feels sad, guilty, useless, depressed, edgy, overwhelmed, and unable to be happy. The person may lose interest in his
sexuality and may have sleep disorders. Depression also has an impact on the person’s mental dimension. It becomes harder to concentrate, make decisions, see the positive side of things, and easier to criticize and blame yourself for everything. When the symptoms of depression and burn-out appear, the person is clearly unable to take care of others. It is therefore important to prevent these states by taking care of yourself for example, by taking part in a sharing circle.

Sharing Circles:

A Sharing Circle is a group in which people can express their feelings, thoughts and emotions; it is also a where people listen to others. Empathy, listening and respect and acceptance are at the heart if this experience. Unconditional acceptance and understanding are the Circle’s great strength. It lso allows people to regain the energy they have lost. Each circle is unique because it takes shape from the people who are part of it and is therefore different from one nation to the next because each nation has its own concept of the Sharing Circle.

Mental Dimension

from: coping with HIV-AIDS, The path for Aboriginals living with HIV/AIDS

The mental dimension of life is what allows a person to communicate and put experiences, feelings and beliefs into words. We understand the world and reality with our mind. This dimension should not be neglected when living with HIV/AIDS.

Communication

Communication can be developed. Even though we learn to express our needs from early childhood on, some people communicate more easily than others. Some become great speakers while others who are shyer only express their emotions when faced with strong emotions. Communication is at the heart of every relationship. Friendships are born when people talk to each other, understand what the other person is saying and feel they are listened to. On the other hand, sometimes relationships are ruined or contacts become more difficult because of communication. Communication is either verbal or nonverbal. When words are exchanged, it is verbal. When body language is used, it is nonverbal communication. These movements show us how to understand words. For example, when a person says that everything is fine with hunched shoulders and a forced smile, you might feel that the person isn’t that fine. A lot of important information is expressed through nonverbal communication. Even silence is a type of communication. Interpreting the message received is also part of communication. This message can be distorted by surrounding noise, a hearing problem or the inability to listen. Our mind quickly makes sense of all the words and movements it perceives within a given context. We give the interpretation a personal sense with our emotions, through our understanding of the person’s experience and the history of our relationship. Our interpretation therefore isn’t always right. This is why tension and conflicts sometimes appear between people. Here are some obstacles that prevent good communication:


Good communication takes practice and requires being aware of the other person’s experience and f our own inner self. Paying attention and taking the time to listen without prejudice can make the difference between good and bad communication. Here are a few tricks for good communication:


Avoid using negative communication, like promises, judgement, denial and testing. Paraphrasing, confirming, encouragement, recognition and acceptance are much more respectful and efficient. Good communication skills can be acquired. They can really make a difference in difficult situations. People living with HIV/AIDS may be faced with conflict and new relationships will be created with external caseworkers. As with family and friends, good communications are essential, as they help to relieve suffering and avoid misunderstanding.

Communicating with the Medical Team

The medical team is often composed of people who are unknown to the person living with HIV/AIDS put in time they become familiar. These people will see a very private dimension of the patient so it is important to establish clear and honest communications. This helps people living with HIV/AIDS to set their limits and for others to respect them. Health professionals are often seen as holding the key to every question. We are sometimes afraid to ask them questions or to explain the complicated words used by the medical team. However, people living with HIV/AIDS must learn to understand disease and infections, to know their body and to be aware of the steps ahead in order to make the
right choices. We should always remember that health professionals are there to help people and do the best they can for their patient’s wellbeing. Don’t be afraid to ask as many questions as you need to before making the right decision. Like everyone else, these people are human beings. They are just as affected by courtesy and gratitude as they are by arrogance and mistrust. In every relationship, a good sense of humour is precious.

Communicating with People around us

We use the same communication skills with the people around us. The only difference is the context and the emotional dimension of the relationships we have with others around us. The people in close
proximity to an HIV/AIDS patient are especially affected by the situation. Several strong emotions may come to surface during the whole process. Some may be linked to the past or to unresolved conflicts. In these cases communication may be more difficult. It may be wise to consult a professional who is skilled in helping relations, to start resolving the conflict and to establish some kind of better communication.

Confidentiality

Confidentiality is important for people living with HIV/AIDS and their family environment. Because of the stigmatization and discrimination surrounding HIV/AIDS, it is important to keep the diagnostic and person’s lifestyle confidential. As a member of the support team, you are in close contact with the patient and are therefore aware of personal information. Unless the patient gives his consent, you must not reveal any information. It’s a question of respect and dignity. The person’s living environment and support team deserve the same respect.

Native Languages

Everybody has the right to speak their own and language. It can be comforting, especially when the
person is fragile. Because other people take care of them, people living with HIV/AIDS need to express what they think without being handicapped by language. When the medical team and interveners don’t speak the person’s native language, a translator should be hired. This person should be able to translate and explain all the medical terms in the person’s language.

Legal Issues

Several legal issues must be considered after the patient’s death. This can be a difficult situation
especially when the person doesn’t accept the diagnostic. People living with HIV/AIDS will have
to make several decisions concerning their health and finances before their death. They will have to designate a person to be responsible for their health and finances in the case they are no longer apt to do so themselves. They will also have to choose the person or persons to whom they wish to bequeath their personal belongings, in what circumstances they wish to die and how they want to be buried. After the person’s death, these decisions will have an impact on the persons who were close to the deceased. Conflicts can arise because some people were not included in the will. In order to avoid any family drama, it is important to draw up a proper and legal will.

Creating a Support Team

As you may have seen in this manual, people living with HIV/AIDS face many challenges. As the infection progresses and as the person weakens, several new difficulties come up. People often choose to spend their last days at home and need a support team to help them physically, spiritually, emotionally and mentally.

Support Team

It is basically up to the patient to decide if he wants the help of a support team. However, some people have a hard time seeking help because they are afraid to loose their independence and privacy and fear what is ahead. Before making such a decision, the person may speak to health professionals or to people with experience in home palliative care. Loved ones may also be asked to give their opinion. When the medical team is created, it is important to remember that the person living with HIV/AIDS is the one making all the final decisions about the health services. Communication is the team’s best resource. Several measures will have to be taken to respect confidentiality and to make sure everyone’s job is well done. The support team sometimes becomes a family member for the person and loved ones. The support team also needs the help of external resources.




Path to Healing

from: http://www.visionpositive.ca/e/V11I2/Healing_e.htm

Path to Healing: Full Circle on the Prairies

Among Aboriginal people on the Prairies, HIV has forced its way into a circle of tradition and culture broken by years of mistreatment. Yet, as Kim McKay-McNabb describes, Aboriginal people are mending that circle, individually and together.


AS A FIRST NATIONS WOMAN whose family has been touched by HIV, I have seen firsthand how our communities in Canada are being affected by HIV/AIDS. In my various roles as a woman, a sister, a mother and a researcher, I see every day how the impact of HIV has become a huge health challenge for Aboriginal people in Manitoba and Saskatchewan.

Aboriginal people are overrepresented in the HIV epidemic. In Canada in 2007, 21 percent of all new cases of HIV that contained information on ethnicity were in Aboriginal people. Aboriginal people make up only 4 percent of the Canadian population. The impact is even more profound in Saskatchewan and Manitoba. During the same year, 38 percent of all new cases in Manitoba were among Aboriginal people. The number was higher in Saskatchewan, where Aboriginal people accounted for nearly half, 49 percent, of all new cases. This is staggering, given that Aboriginal people made up only 15 percent of the population in these provinces.

Women, youth and people who inject drugs are carrying the burden of the epidemic in our communities. In Saskatchewan, injection drug use was at the root of nearly two out of every three HIV infections (63 percent) among Aboriginal people in 2007. Women accounted for 60 percent of Aboriginal infections that same year, and young women are particularly vulnerable: Of Aboriginal HIV diagnoses in the 15 to 19 age group, 85 percent were in women, and in the 20 to 29 age group, 59 percent were in women.

Specific social, economic and behavioural factors contribute to the disproportionate rates of HIV infection in Aboriginal people in Canada. Poverty, substance use (especially injection drug use), sexually transmitted infections and lack of access to health care services increase our vulnerability to HIV/AIDS. One of the main social factors contributing to our vulnerability is related to our communities’ experience of residential schools and the “Sixties Scoop,” two traumatic events grounded in The Indian Act, 1876, which gave the Canadian government almost complete control over Aboriginal people and their lives. The damaging story of residential schools is well known. The Sixties Scoop refers to the period from 1960 to the mid-’80s when First Nations children were removed from their homes, taken from their parents, siblings, kokums (the Cree word for grandmothers) and mooshums(grandfathers) and adopted into homes outside of their community and often into non-Aboriginal families.

My family endured both the residential schools and the Sixties Scoop. My mother attended a residential school and this had an impact on our experience as a family. Before children were forced to attend residential schools, First Nations communities discussed sexuality — it was an important part of life. But during this period of forced institutionalization, the parenting skills that would have been passed on from mother to daughter and father to son were lost.

We are just beginning to heal from this piece of the history of our peoples. And part of that healing is to address the HIV epidemic among us. Margaret Akan, chief executive officer of All Nations Hope AIDS Network (ANHAN) in Regina, points out that rebuilding connections to our culture is part of mending the circle: “ANHAN is using the teachings of our Elders and our culture to build stronger individuals, families and communities. This is the only way we are going to move forward with the multitude of health and social issues impacting the Aboriginal population.” ANHAN is the Aboriginal AIDS service organization (ASO) in the two provinces, though all the ASOs in the region have many Aboriginal clients and offer services specifically for Aboriginal people with HIV/AIDS (APHAs).

Saskatoon HIV Aboriginal Reduction of Harm Program (SHARP) is another example of Aboriginal people leading the response to HIV. Started in 2008, the program, a collaboration including Saskatoon Tribal Council, AIDS Saskatoon and local health agencies, brings a holistic view of health to APHAs and those at risk in Saskatoon’s inner-city neighbourhoods. The goal is to reduce the number of new cases of HIV and other sexually transmitted infections by helping both HIV-positive and HIV-negative Aboriginal people in the community.

Healing is also occurring one person at a time. I had the honour of sitting down with three APHAs from Manitoba and Saskatchewan. These strong, resilient people who walk with their heads held high on their own journey shared their stories with me… and here I share them with you.

Krista Shore

Krista Shore is a 27-year-old First Nations woman, originally from Peepeekeesis First Nation in Saskatchewan. She currently lives in Regina with her partner and two children. Krista was diagnosed with HIV in 2006.

Krista was involved in the child welfare system from a young age. “I experienced a lot of violence at a young age: drug and alcohol abuse, sexual abuse, physical abuse. By the age of 12, the year my mother was murdered, I had my first experience with alcohol and drugs.”

A life of addiction affected Krista’s ability to parent, and in 2006 and 2007, her children were taken into care. She felt desperately alone without them and so began to work on getting them back. Krista had been sober for nearly three months when she learned that her children were going to be placed in care permanently.

“I had lost my kids for good. I really believed that. The following year I tried to commit suicide, I overdosed, I was stabbed and I ended up homeless. I had a real deep self-hatred. I used drugs. I liked the needle. Then I met a man involved in a gang. During that period, I lost my dignity, my pride, my looks and my self-respect. I’m lucky that I am still alive. I got a diagnosis of HIV within half a year of the last time I was with that man. In February of 2006, 10 years to the day that I learned my mother was murdered, I found out I was HIV positive. How I got my diagnosis was harsh. I resent the way I was told by the doctor, so blankly and bluntly: ‘I got something to tell you. You are HIV positive.’ Luckily, my sister was there with me and I knew the nurse. I didn’t go back to using.”

In order to get her life back on track, Krista developed ties with a few community agencies in Regina. She found a place to stay and got back in touch with her children. “I prayed to God the Creator to help get me through this. I just kept thinking of my kids. I slowly started doing the work to maintain my recovery.” And she succeeded — her children came home in 2008 and 2009.

“I reached out for help. The more I tried to move forward, the more help I received. I got in contact with All Nations Hope AIDS Network (ANHAN) and they really supported me. I didn’t realize all the support that they could offer a person living with HIV. I feel grateful for it. Through All Nations Hope, I applied to attend a women’s retreat. I didn’t even include my HIV status on the application. I was afraid to tell people. But at the retreat I felt inside of me that it was all right to tell them.”

Through the ANHAN retreat, Krista was put in contact with another APHA, Ron, who was attending the retreat as a speaker. “Meeting Ron really soothed me inside. It diminished the shame, the pain. I wasn’t alone. He lit a fire inside me and I felt that I needed to find a space within the circle. I started to stand up for myself and say, ‘This is me. This is my story.’ ” She adds, “All Nations Hope and the Canadian Aboriginal AIDS Network have been a great part of my journey. It feels like family being surrounded by other APHAs.”

Krista and her partner are expecting their third child. Though she has built a strong community to assist her, she is now facing another challenge in her journey: trying to access support during her pregnancy. “I have a good doctor, but we need more resources for pregnant women and mothers with HIV.” In Regina, there is no assistance to access costly baby formula for HIV-positive mothers, who cannot breastfeed due to the risk of passing HIV to the baby. “I would like to start a baby formula program here, not only for myself, but for our communities.”

Post script: Since the time of the interview, Krista and her partner have welcomed a healthy baby girl into their family.

Lana Bear

Lana is a 42-year-old First Nations woman from Muskoday First Nations in Saskatchewan. After spending 28 years on the street and being incarcerated for long stretches of time, she was diagnosed with HIV in 2006.

“I never knew about HIV until about five years ago when everybody on the streets started talking about how bad it was. But I didn’t really care because I was on drugs and I didn’t take the time to listen. I thought I probably already had it. Then I got really sick and was hospitalized. After I was told that I have HIV, I didn’t feel sad or anything. Now, although I have emphysema and asthma and have been on home oxygen for a year, I am taking my HIV pills every day and I’ve been keeping all of my regular appointments. It’s been about one year since I used anything. I am happy for myself.”

“I have a lot of support in my immediate family — my six children and my partner. Then there are the people at my AA meetings. I have the nurses who work at the STD centre. And the health representative from Muskoday First Nation, Rhonda, has helped me through thick and thin.”

“The Prince Albert Sexual Health Clinic and the health committee here on reserve have HIV workshops, but there isn’t enough counselling. We need more activities and support groups. I think that people with HIV should be heard more. We should have HIV support groups to talk about our issues confidentially and openly, like at an AA meeting. Then people might come out of their shells more and talk about it. I feel it’s very important for people on reserve to have more services, more activities for children and more support for people like myself.

“For me, it’s helpful having everyday things to do, a little of everything… praying, house cleaning, going for walks and visiting my children. I never really looked after my kids; my mother did. I couldn’t take care of them. I had a lot of anger. Now I try to spend as much time as I can with them. I spent a lot of time on the streets and I want to make up for that. My prayers are now answered. I am on my healing journey. Thank you, Jesus.”

Kinzie

Kinzie is a 47-year-old First Nations gay man from Cross Lake First Nation in Manitoba. He was born in The Pas and currently lives in Winnipeg with his partner and his cats.

Kinzie is a child of the Sixties Scoop, the practice of removing First Nations children from their homes and communities and giving them over to non-Aboriginal families. His adopted family raised him in Texas (Kinzie still has contact with them today). Once he learned about his biological family being from Canada, he moved here and started to come to terms with his identity as a First Nations man. Kinzie has been living in Canada for five years and has reconnected with his family, an experience he says has been both rewarding and challenging.

When Kinzie learned he was HIV positive, he was living on the streets, prostituting, drinking and using drugs. “When I first found out, I felt dirty and gross and I wanted to rub off my skin. There was so much stigma in the ’80s. I felt that people were looking at me like I was a disgusting faggot. So I delved more into drugs to cope.”

But coming to Canada started his journey of healing, which involved identifying himself as a gay First Nations man who has HIV. “My experience of living with HIV in Canada has been better than in the States. My story with HIV really starts in Canada. Now I feel healthy. I am not ashamed of who I am.”

“I have my Aboriginal God behind me, my Caucasian God behind me and my Christian God behind me. I call my mom every morning for prayer before I go to school. I get a lot of my strength from God, my family, my partner and my kitties. And I have a lot of support through my aunty and uncle, who assisted me to meet the rest of my biological family at a family reunion.”

Kinzie described some of the supports that he was offered through agencies in Winnipeg. The Aboriginal Support Centre helped him get his identification, including his social insurance card. He also saw an ad in the paper about the Nine Circles Community Health Centre. “At Nine Circles, I walked in and asked for the gay men’s health centre, and I got what I needed there. I met my nurse, who I confide in a lot. She’s like my surrogate mom. That’s our little joke.”

“I take care of myself. I am healthy. I’m staying well because of school, my partner and because I love my three cats. They give me strength, hope and courage.”

Kim McKay-McNabb is a First Nations Cree woman from George Gordon First Nation in Saskatchewan. She is a wife, a mother to four sons and one daughter, a PhD clinical psychology student at the University of Regina and an assistant professor at the First Nations University of Canada. She has a passion for working with Aboriginal communities who are affected by HIV/AIDS in Canada.

Leah Dorion is a Métis artist currently living in Prince Albert, Saskatchewan. Her work incorporates many symbols, teachings and stories from her First Nations and Métis community. For more information about Dorion’s artistic vision and practices, check out her website.

Painting, “Contemplation Medicine,” by Leah Dorion

Photograph: Keith Moulding


Issues around Pregnancy and Responsibility

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

When do I know when I'm ready for sex for the first time?

For example, just because a female can become pregnant, it does not mean she wants or needs to. As for males, just because they can make a child, this does not mean the male is mature enough to take responsibility and help raise a child.

Pregnancy

What are some reasons why youth may have unprotected sex even though they know it can cause various infections or unplanned pregnancies?


The point is that it is not so simple to know what goes on in the minds of individuals who decide to go ahead and practice unsafe sex. While there is really no such thing as 100% safe sex, (condoms can break, different things can happen) there is such a thing as safer sex, which is knowing what risks go with certain behaviors and taking steps to protect you and your sexual partner(s).

Here are some facts on teen pregnancies:


What we can take from this one study, and there are other studies who describe more local or regional information across the country, is that teenage pregnancies are a reality for significant numbers of young adults. Most single parents get shocked into the full reality of being a parent which carries a lot of responsibility and commitment, if you want to be a good parent and care properly for your child(ren). This is not an issue of being a good or bad parent, nor is it about good or bad decisions. What needs to be the focus of this section, in terms of HIV/AIDS, is this statement: for every unwanted pregnancy, in reality, it could be an unwanted STI, including HIV.

Becoming pregnant is not something that just happens. It takes two people to make the baby. An unplanned pregnancy also shows that condoms were likely not used, unless the condom broke or was not used correctly (for example, it was put on wrong). So evidence shows that with Aboriginal teen pregnancies, it is more likely that the parent will be raising the baby by themselves. A young parent can expect to have little or no money because raising a child is expensive. $12,000 might sound like a lot for a young person, but in reality, after you pay rent, food, diapers, clothes, medicine, and all the other living costs such as laundry, cribs, walkers, furniture, etc. then the money simply will not go far.

Sexually Transmitted Diseases

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

Sexual orientation is about who we are attracted to. It is not about choices, except whether we act on our attractions. Sexual orientation can include straight, gay, or bisexual. Gender identity is about whether we identify as male, female or transgendered which is now also known as Inter-sexed. It is easier to identify the physical gender of someone (a boy has a penis, a girl has a vagina) but some people are born one gender at birth yet feel trapped in the wrong body. So someone can be born female yet feel they are more male and vice versa. Thus they likely will go through life facing many struggles and turmoil, causing some to have a sex change operation.

Concept of Two-Spiritedness:

In many, if not all First Nations, there would have been words in the various languages which would have described what is now commonly called Two-Spirited. It refers to people who may also call themselves gay, lesbian, bisexual or transgendered in today's society. Traditions may vary, yet it appears that before European contact, First Nations would have accepted individuals who were Two-Spirited because they were viewed as being different for a reason. It was not so much their sexual behaviors, but more the fact they were believed to have insight into both sexes (male/female), thus being Two-Spirited.

There is a wide diversity of sexual expressions, and it really is a matter of getting to know yourself and your partner(s) in a truly intimate way. It is about knowing what you like and do not like. Your sexual identity has much to do with how you choose to express yourself sexually. For example, if you are Two-Spirited (gay, lesbian, bisexual or transgendered), then your identity means you are attracted to certain types of people.
However, even within a category or group, individuals can have different types of sexual expressions. These choices relate directly to who you are and what you find satisfying.

NEGOTIATING SAFER SEX

This is where safer sex comes into play. Safer sex is about knowing what risks there are with certain sexual practices and finding ways to reduce these risks. The only true safe sex is to have no sex - which for many people is not a reality. Some sexual acts are less risky or have no risk, such as masturbation or breast sex (rubbing penis between the breasts).

Unless there is a deep open sore or cut, sperm which lands on the outside of the body is generally no risk. It is important to recognize that not having sex is as much a part of this section, as is teaching about safer sex. Everyone, whether they have never had sex before, are currently having sex, or are exploring new areas, are included and their individual choices need to be recognized and respected. This manual is not about telling youth what they must do or encouraging anyone to have sex. It only wants to teach that if you are going to have sex, that you be aware of all consequences and responsibilities, and that you can always change your mind about whether you act on your sexual energies. Negotiating safer sex is about making sure you talk with your sexual partner(s) about how far you are willing to go sexually. If you have knowledge of your body, how it functions sexually, your desires and what safer sex practices there are, and if you have motivation (to finish high school or to stay disease-free to avoid becoming sterile so you can have babies) then you need skills. These skills help you negotiate, communicate, and assert yourself, and putting on a condom if you are to have sex can mean you have the tools to make what are called healthy decisions. Only you can protect yourself, and only you can express what really is on your mind and in your heart. People cannot read minds, so if you can find the courage to speak about these issues with your partner(s), then you can feel safer. Although it is not easy, with skills, practice and the right partner you can learn to express yourself and make sure you take steps to stay healthy. It is important to have boundaries and to learn ways to let others know not to cross your boundaries.

Sexual Abuse/Assault

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

Sexual assault means any non-consensual sexual activity ranging from: unwanted touching, to forced oral, anal or vaginal intercourse, to sexual violence in which the victim is wounded or maimed or his/her life is endangered.

If peers have experienced any of the above, they can recognize that it is assault. Since first contact with Europeans, sexual assault has become far more common in our First Nations communities. When we grow up as boys and girls there can be adults who do sexual things to us. People who do this are most often adult but can also be other children. Most often the abuser is a male but sometimes they can be a female too. Most often the abuser is well known to the child; a family member, friend of the family or someone who is in charge of children.

Here we are not talking about consensual sex play between peers. Why would someone do this to a child? Two reasons: partly because they can control children easier than they could an adult; or they have an abnormal sexual preference for children. Often there is a connection between sexual abuse/assault and substance use, especially alcohol. But being drunk or using does not cause someone to abuse. They might use it as an excuse but the reasons go far deeper than being high or drunk. Also, not everyone who sexually abuses is under the affects of drugs or alcohol. How does someone become like this? There's a lot that we don't understand about people who abuse children but people who were themselves physically and/or sexually abused are more likely to become sexually abusive later on in life. And sometimes they also were victims who have not come to terms with their past. The good news is that if a child starts into this sexual assault behaviour and is discovered, intervention at an early age is quite effective in stopping the abusive behavior. As communities we must not hide our heads in the sand.

Even the suspicion of sexual assault and abuse should be reported. We must remain vigilant and educated as young people so that we can create and maintain a healthy community. What does this mean to someone who was sexually abused or assaulted when they were growing up? Accept that this is in no way their fault. Healing and forgiveness can take place. Seek out help from counsellors and healers. If a person does not deal with these past experiences of abuse then it can have a very negative effect on our holistic health (especially sexual). Some common effects of sexual abuse can be: depression, questioning sexual identity, addictions, lack of personal boundaries, avoidance of sexual contact, fear of intimacy, physical/sexual problems, etc. As a result, some may become street involved, run away from home, be sexually exploited like in the sex trade, feel suicidal, or face increased violent behavior, etc. This does not mean that everyone that has been sexually assaulted or abused will experience any or all of these effects and results. Nor does it mean that all sex-trade workers have been sexually abused. As a teenager it is more likely that girls will be taken advantage of, but teen boys can be victims of sexual assault as well. As the definition of sexual assault above states this is not just about forced penetration or "rape" but any kind of uninvited sexual contact. For teen girls this often happens with a boy that they are going out with. The young man usually does not see himself as the aggressor but somehow convinces himself that even though it seems she's not clear about wanting to do something sexual, it's ok to pressure her into it. This is called coercion and it is sexual assault. It's called date rape even though penetration may not be involved.

Why wouldn't girls resist, fight back or tell? Sometimes they do. Often they blame themselves, they're embarrassed or they think others will blame them. If it's a young man it may be even more difficult for him to tell anyone that he has been assaulted. If a person is living in a small community it's even harder to tell because everyone knows
everyone and sometimes we're afraid to rock the boat. The ripple effect can be huge.
When we're working with other youth as Youth Peer Educators this complex issue must be kept in mind with every group we work with. The Peer Educator is not a counsellor but they can offer friendly support. If a troubled youth feels ready to talk to someone, it's important that the Peer Educator has a good list of resource people to refer them to. (See the local resource contact form in the toolkit section which can help to create a list of support people for referrals or many other needs).

Sex, Drugs and Alcohol

from: YOUNG EAGLES’ CHALLENGE: A Peer Education Training Manual for First Nations Youth on HIV/AIDS and Related Issues

The role of various substances can have a direct impact on whether a person can make a choice about whether to use protection or even say no to sex. Alcohol is a common drug that is legal in Canada and most other countries, yet when misused, can cause injury or even death. Alcohol along with other drugs, and what some call party or club drugs, can cause individuals to not have full control over their bodies. As stated earlier, there are also some people who use what is called the date rape drug to take advantage of individuals. There are also stories of girls who pass out at a party only to be taken advantage of by one or more guys.

Injection drug use is a very common cause of many of the HIV cases among First Nations people. The problem with injection drug use is that many of the drugs used (cocaine or heroin) are very easy to become addicted to. Some say that one try may be enough to get someone hooked. Trying to stop these types of drugs can be a very hard thing to do, and many people die from overdoses, violence and other things when they use hard drugs. Harm reduction is one way to try and support people to kick their habits or to not cause as much harm to themselves.

For some First Nations people who spend time in prison, they may try injection drugs while inside. The problem later, is that they may have HIV or Hepatitis and not know it, which has consequences for sexual partners. Sharing needles, as stated earlier, is a very high risk activity for HIV and Hepatitis C. Both of these have no cure. So the issue with substance use and HIV prevention is to have dialogue about the risks and to find ways to reduce or remove the risks for you and your partners, if you decide to use substances. As Youth Peer Educators, this section and manual is not about encouraging anything but options and accurate information to support better health for other youth. The approach is to confront reality and open dialogue so that all these issues can be better understood and youth will be armed with solid information which will hopefully lead to healthier choices.

The main purpose of this section was to raise awareness of related issues that affect whether or not youth will make healthy choices about what they do with their bodies. It is not enough to teach about HIV/AIDS and not consider all the things that may be going on in a youth's life. Peer pressure, puberty changes, substance use, childhood traumas and self-esteem issues all factor in. The issues raised in this section can be used to open up dialogue and give youth opportunities to talk about what really matters. It is important to realize that these can be very emotional and sensitive topics. Use your best judgment and it is strongly recommended that Youth Peer Educators make sure they have counsellors and/or teachers or parents from either the Steering Committee or through trusted organizations to help lead these discussions. Having professional counsellors is very important because Youth Peer Educators are not expected, as stated at the front of this manual to be trained counsellors.