Integrating Indigenous Knowledges and Ceremonies for Anti-Colonial Social Work Practice with Indigenous Peoples Living with HIV

Background and Purpose: Indigenous peoples across Turtle Island have been subjected to long standing systemic and anti-Indigenous racism within the mainstream health system. In Canada, disproportionate health outcomes, including higher rates of HIV, among Indigenous peoples stem from ongoing settler colonialism and abuse. Furthermore, the COVID-19 pandemic had a significant impact on the delivery of health and social services throughout Manitoba and Saskatchewan. Incorporating anti-colonial and decolonizing frameworks into social work research acknowledges the historical and ongoing impacts of colonization, including the disruption of traditional practices and ceremonies. Stories gathered throughout the community-based research project, Gigii-Bapiimin, have increased the understanding of social workers’ and other service providers’ capacity and/or skills to provide culturally safe services as a way of enhancing the care Indigenous people living with HIV (IPLH) receive.

Methods: Participants (N=57) living with HIV who self-identified as Indigenous (First Nations, Métis, or Inuit) residing in Manitoba or Saskatchewan Canada as well as service providers were recruited using printed flyers, social media, and peer recruiters. The Gigii-Bapiimin study was guided by the concept of Etuaptmumk (Two-Eyed Seeing) and utilized a community guiding circle throughout. With Indigenous Storywork as a guiding framework, participant stories were gathered using semi-structured interviews and analyzed using qualitative coding software (MAXQDA), utilizing thematic analysis methods. Participants were asked questions in relation to access to health and social services as well as personal experiences of receiving or providing services throughout the COVID-19 pandemic.

Results: Findings highlighted the significance of traditional ceremony and medicines in the overall well-being of IPLH. Several participants demonstrated resilience in maintaining spiritual practices through the incorporation of personal ceremony at home when traditional communal ceremonies were inaccessible. Service providers expressed the importance of ceremonial practices for IPLH as well as the challenges experienced due to the COVID-19 pandemic in accessing cultural components of health. The need for more cultural and spiritual encompassing dimensions of health is evident yet findings revealed varied understanding among service providers for how to facilitate these connections. While some actively help facilitate these connections, others expressed limited knowledge and comfortability of the inclusion of this within the scope of their roles.

Conclusions: These findings have amplified the significance of traditional ceremonies and medicines in the overall well-being of IPLH. As social workers help facilitate a more wholistic approach to care within a variety of health care settings, there is an urgent need to apply decolonizing and anti-colonial approaches to practice. This information can be leveraged by social workers working with IPLH as a point of advocacy regarding programming needs within their agencies. Those within positions to enact change at a program or policy level can utilize the knowledge shared throughout this study to do so. Future research should focus on the evaluation of long-term outcomes of the incorporation of decolonizing and anti-colonial frameworks into social work practice to ascertain their effectiveness in reducing health disparities among IPLH. Furthermore, studies should investigate the scalability of these models to other regions, enhancing the wholistic support network for IPLH across Canada.