Marama Pala Ngātiawa ki Kapiti, Kaiwhakahaere/Executive Director (INA), an HIV positive Māori woman, plans to promote the visibility of Indigenous People’s HIV and AIDS issues; to increase the support from local, regional and international Indigenous people. “History shows us that HIV is not openly discussed at Indigenous conferences. It’s an issue that gets left off the agenda.” says Marama Pala, “Even though Indigenous Peoples experience high rates of HIV and AIDS, it needs to be made visible at all Indigenous conferences and gatherings. It’s time that all Indigenous peoples became aware that we are a marginalised community vulnerable to HIV” Indigenous people globally continue to under represented in HIV prevention, research, policy and funding initiatives, and this contributes to ongoing HIV disparities and resource allocation. The stigma within Indigenous communities further marginalises this health issue, making it difficult to discuss. “I hope am able to stress the importance of HIV, speaking openly about HIV and facing the stigma of HIV with my Indigenous and aboriginal brothers and sisters” urges Marama. “Silence No More...for the sake of my HIV negative children; we need to eliminate stigma and discrimination and make our people safe.”

1. Silence No More Marama Pala

2. Three Decades of HIV and AIDS Indigenous peoples globally are over-represented in the HIV/AIDS epidemic. Despite the astonishing diversity between and among us, indigenous peoples share a common experience of poverty, marginalization, and colonization that renders us acutely vulnerable to HIV. Indigenous peoples working globally have designed and delivered several community-driven initiatives to address their common concerns. However, the global epidemic of HIV among indigenous peoples continues to attract little attention domestically or internationally.

3. Social Determinants of Health for Indigenous Peoples - Vulnerabilities Colonisation Poverty Mental Health, addictions Health disparities, Discrimination, Racism Incarceration

4. What we know in Āotearoa Lack of accurate surveillance data Māori women make up one third of all women diagnosed with HIV in Āotearoa 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 Āotearoa compared to European women with the incidence ratio of women infected in Āotearoa is 1.0 – European ref., Māori – 2.8. More AIDS or CD4<200 late testers with 40.6% Māori Social and cultural taboos prevent Māori from disclosing, The impact of stigma and discrimination cripples HIV education.

5. Issues for HIV Positive Indigenous peoples Stigma and discrimination Lack of acknowledgment of the changing pattern of the HIV pandemic Lack of knowledge around social determinants of health and the vulnerability to HIV Limited community leadership on HIV No resourcing for culturally specific programmes Differing world views on HIV, sex and impact on whānau/fānau, hapū and iwi (Family and Community) Human and Indigenous rights?

6. Mahi Tōnu Work to date Health Canada supported an Indigenous project to respond to HIV & AIDS 2006 Three pre-conferences held before the International AIDS Conferences and one policy dialogue attended by Indigenous Peoples from Australia, Bolivia, Canada, Chile, Guatemala, Mexico, New Zealand and the United States. Toronto 2006, Mexico 2008, Ottawa 2009 and Vienna 2010. The Toronto Charter: An Indigenous Peoples’ Action Plan on HIV & AIDS 2006 A report was completed on the above held meetings The International Indigenous Working Group on HIV & AIDS was launched in Vienna 2010. www.iiwgha.com

7. International Indigenous Working Group on HIV and AIDS

8. Ngā Mea Tautoko UN Declaration on the Rights of Indigenous Peoples; Improve areas of health Right to determining and developing health programmes That programmes are supported by States to restore the health of Indigenous peoples Right to traditional Knowledge – medicines, flora, fauna, animals and minerals The Toronto Charter; We have shared experiences that the AIDS epidemic continues to have a devastating effect on our people. That we have the right to determine our own healthPriorities and HIV programmes Greater Involvement of people living with HIV & AIDS; Include meaningful participation of PLWHA in all decision making areas. Involve PLWHA in developing funding priorities and in the choice design, implementation, monitoring and evaluation of programmes

9. Ngā mea hanga Raise awareness of indigenous HIV & AIDS globally, regionally and locally Have decolonising, Indigenous research URGENTLY Engage international bodies, governments and NGO’s in the fight against indigenous HIV & AIDS Guide international policy and practice response to Indigenous HIV & AIDS Continue beyond 2011, with support and funding from the international community