'Experience talks, resilience shapes' revisiting historic trauma: impact on treatment in indigenous males living with HIV/AIDS in British Columbia
Bibliographic record
Abstract
There is an over-representation of HIV incidence, prevalence and mortality rates in the Indigenous population of Canada. Further, many do not adhere to HAART partly because of unresolved historic trauma (HT). Most research on HIV/AIDS therapy has focused on “maladaptive” characteristics of Aboriginal males and less on their adaptive, life-maintaining practices. This study explored the impact of HT on treatment among Indigenous males living with HIV/AIDS in BC, with a focus on adaptive/life maintaining practices, i.e., how the experience of HT positively affects male survivors’ ability to adhere to treatment, and the HT impact on treatment outcomes across age groups and residential school survivor status. Using interpretive description incorporating a cultural safety lens as the methodological framework, data was collected through one-to-one interviews, a focus group, and a few Life Story Board sessions. Thirty-six HT survivors told their lived experience stories, discussed how HT affected their adherence to HAART, and explained how they build resilience. Three main themes resulted from data analysis: 1) facilitators of choice or actions leading to HAART adherence; 2) factors leading to HAART non-adherence; and 3) comparative survivor responses on health, services, stigma and the historic trauma effect. Adherence choices and actions are promoted by psychological support, cultural services, religion and spirituality, structural services, resilience, strictness and discipline metered on indirect survivors through their parents. Negative choice or actions resulted from; personal reasons, cultural restrictiveness, lack of structural support and services, spiritual and religion-related factors, and intergenerational historic trauma effects. Finally, comparative responses of survivors’ views noted included the view of health with respect to resilience, availability of and access to services on-and off-reserve, stigma and confidentiality, and the effect of historic trauma through generations and across survivor status. The findings demonstrate how complex the experience and expression of HT is and that most Indigenous men can be resilient to stay on HAART and have better health and wellbeing. Cultural-safety informed recommendations are offered to better address HT, improve treatment-adherent behaviour and resilience, foster healing and reduce deaths due to HIV/AIDS. This study suggests promising resilience factors that have implications for both research and practice.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.019 | 0.007 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".