Māori women are disproportionately affected by HIV/AIDS in New Zealand. While making up only 14.6% of the population, Māori account for 7.2% of all recorded HIV cases in 2008 and 11.5% in 2007. Social and economic factors increase Māori women's vulnerability, including poverty, stigma, discrimination, lack of access to healthcare, and high rates of other STIs. Cultural taboos also prevent open discussion of sexuality and prevent women from disclosing their status. More research is needed to understand the impacts on Māori women and develop interventions to reduce infections and stigma.

1. INA (Māori, Indigenous & South Pacific) HIV/AIDS Foundation Māori Women and HIV/AIDS

2. What we know Data collection is flawed and inaccurate - In 2002 epidemiology report stated only 5 Māori women were infected but a HIV Futures survey conducted in the same year had 7 Māori women were recruited to complete survey. Māori women make up one third of all women diagnosed with HIV in NZ since 1996 Māori children have borne a greater burden compared to the European child population. Eg. 1.0 – European ref., Māori – 4.5. Māori women are at a higher risk of infection in New Zealand compared to European Women with the incidence ratio of Women infected in NZ is 1.0 – European ref., Māori – 2.8. Māori have the fourth highest infection ethnic group in Āotearoa More AIDS or CD4<200 late testers with 40.6% Māori Social and cultural taboos prevent women from disclosing, as does the impact of stigma and discrimination.

3. Poverty and low socio economic backgrounds Lack of political or social power Fragmentation of Whānau, Hapū & Iwi Geographic islolation Urbanisation Low literacy and numeracy Misinformation on HIV risks, no access to culturally appropriate information Poor general health – limited access to health care and resources Highest STI’s recorded population with repeat infections The discrimination within our own communities towards sexual diversity and the stigma attached to diversity. What makes Māori Women vulnerable!

4. How are Māori Women Marginalised? Men that have sex with Men are identified as “the exact group most at risk of infection” in Āotearoa. With a NZ Crown Agency stating “HIV in NZ continues to be almost exclusively a disease of white men who have sex with white men” Māori have lower rates of testing – test trials showed 3.9% tested identified as Māori The Treaty of Waitangi has been excluded or removed from national provider’s policies. The Ministry of Health 2003 HIV Strategy acknowledges Māori as a vulnerable group, yet key national service providers bases all statements on the HIV epidemiology and claims that this shows that “Māori are not adversely affected by the epidemic”. a NZ Crown Agency have stated “Māori and other ethnic groups hardly feature on the radar....” Cultural determinants or Whakapapa and the impact of HIV on Whānau, Hapū, and Iwi are not considered.

5. New Zealand/Āotearoa numbers of HIV infection[1] Māorimake up 14.6% of New Zealand’s population but account for 7.2% of all HIV cases as recorded end of 2008 and 11.5% in 2007. [1] Issue 62 – November 2008 AIDS – NEW ZEALAND AIDS Epidemiology Group [2] Statistics NZ Taturanga Āotearoa Māori Population/Te Momo Iwi Māori [3] Statistics New Zealand Taturanga Āotearoa Pacific Profiles 2006

7. HIV impact on Social & Economic Environment

8. Mental Health Impact

9. Understanding, Knowledge and acceptance

10. Mōteatea, Waiata, Pakiwaitara, WāhiIngoa - love, sex and procreation

12. Is there an impact?

13. How do Māori/PI cope differently? What role does Tikanga play?

14. Sex, Sexuality and illness - taboo's real or introduced?

15. Are we acknowledging our sex and sexuality on a daily basis?

17. Alternative methods of Social and Economic coping mechanisms

18. Reduced infections, stigma and discrimination

19. Reduced infections and raise awareness

20. Intervention less difficult once taboo's are identified as real or introduced.

22. Mahi oti Advocacy Mangai – International & National (Canada, Australia, Africa, Fiji, Rarotonga, Mexico, Asia) Wānanga delivered to Whānau, Hapū & Iwi Manaaki Whānau tautoko Research input by Māori for Māori Wānanga delivered to Health Professionals/Businesses

23. “If we do not take responsibility and start the dialogue between whānau, Hapū and Iwi at every Marae occasion, the impact of this new disease is going to be ten times worse. Don’t live in ignorance, because it has a cost. The cost is the impact on our whakapapa. We want to be able to protect our whakapapa. It’s about survival and about continuation.” Te AoterangiMcGarvery, 1994 Contact: Marama Pala inaf@ihug.co.nz www.ina.maori.nz 07 8839084 0272991535