The impact of COVID-19 on services for Indigneous people who use substances and are living with HIV in Winnipeg, Manitoba

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Christianson, Tara
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Manitoba currently has the second highest rate of HIV in Canada. Among those recently diagnosed, Indigenous people and injection drug users are overrepresented. As the COVID-19 pandemic significantly impacted service delivery, Indigenous people living with HIV (IPLH) who use substances may have been disproportionality negatively impacted. This Master of Social Work thesis focuses on the stories shared within the Gigii-Bapimiin project by IPLH in Winnipeg, Manitoba who use substances and accessed health and social services throughout the COVID-19 pandemic. Stories from those with lived experience as well as service providers were gathered using semi-structured interviews to help facilitate conversation. The goal of the research was two-fold, firstly to advance the understanding of the impact COVID-19 had on service delivery. Secondly, to provide recommendations for change and inform post-pandemic service delivery and policies to optimally support IPLH who use substances in Winnipeg, Manitoba. A decolonizing Two-Eyed Seeing approach and Indigenous Storywork were used as overarching frameworks to guide this research. A community guiding circle comprised of eight IPLH, many of whom previously or currently used substances, were involved in the research from design to dissemination. Elder Albert McLeod and Knowledge Holder Gayle Pruden ensured the project remained grounded in Indigenous ethical space and helped incorporate ceremony into the research process. Due to its epistemological alignment with Indigenous knowledges, stories were analyzed using thematic analysis. Through this process, three common themes were identified. Firstly, the deeply engrained colonial practices within health and social services and the barriers individuals experienced pre-pandemic having been exacerbated throughout the COVID-19 pandemic. Secondly, neoliberal narratives and polices were the primary contributors to the harms linked to substance use rather than the personal drug use behaviours of individuals. Lastly, successful service delivery existed throughout the pandemic and was identified by participants as having been wholistic in nature and grounded within Indigenous knowledges. These organizations continued to offer support to IPLH in a meaningful way while adhering to public health orders. As a result, recommendations for social work practitioners, policy makers, advocates, and healthcare professionals are provided on how to enhance service delivery for IPLH who use substances.
HIV, COVID-19, substance use, Indigenous people, social work, health/social services