What is Hepatitis C?

Pauktuutit’s sexual health program began in the late 1980’s when news of the first Inuk woman diagnosed with HIV became public.

Pauktuutit addressed the lack of information available to Inuit on HIV/AIDS by conducting the Lifesaver awareness campaign which included Inuk to Inuk knowledge transference, health fairs, a series of eight booklets on HIV, fact sheets, needs assessments of urban Inuit, symposiums, condom covers, a DVD, PSAs, puzzles, posters and various other public education tools.

The program is guided by the Canadian Inuit HIV/AIDS Network. The members provide Pauktuutit with updates on their respective regions in the areas of sexual health, Hepatitis C and HIV/AIDS. Pauktuutit sexual health program has grown to become a respected and leading edge partner and works with communities to provide community mobilization workshops, conferences, skill building workshops and other events.

The program also represents Inuit on a national and international level. Researchers believe that poor health, poverty, low education, limited housing, high unemployment, and sanitation problems are important factors that promote the spread of hepatitis A infections among Aboriginal peoples. Factors that increase the risk of hepatitis B and hepatitis C infections include the regular use of injection drugs and involvement in other high-risk activities at an early age.

Aboriginal prisoners in Canada’s jails may be at greater risk due to the high rates of infection among this population. As well, researchers have identified the previous widespread use of non-disposable medical equipment as a potential cause for hepatitis B and hepatitis C infections among Inuit. As a result, hepatitis B infections are about 20 times higher among Inuit than among non-Aboriginal Canadians and the risk of exposure is five times higher. Researchers believe that infection rates for hepatitis C are higher among Inuit and First Nations (1% to 18%) compared to other the Canadians (0.5% to 2%). Research suggests that the pattern of infections and the various factors that place Inuit at risk are different from other Canadians and therefore hepatitis prevention and health promotion should be different as well. What do Inuit know about Hepatitis C?

What do Inuit need to reduce the risk factors for Hepatitis C? Do Inuit have the right information in the right dialect to assist them in making informed decisions regarding their health care and empowering them to be active participants in the health care system? These are the questions that Pauktuutit’s most recent hepatitis C project will answer using a multifaceted and multi-sector approach. The project addresses the issues of health disparities, cultural relevancy, health knowledge and resources in relation to hepatitis C.

Effective programming between community members and health care providers/front-line workers may be challenging if not impossible where there are cultural and accessibility barriers. Health programs and services must address the gaps as well as cultural relevancy, ensuring accurate communication and comprehension of information that is available to Inuit on hepatitis C. Pauktuutit’s current hepatitis C project will identify what is presently being used in terms of specific Inuit language resources and services for Inuit across Canada, specifically in the four land claims regions and in urban centers. The needs assessment and focus groups conducted by Pauktuutit staff will aid health care providers and front line workers in communicating accurate information in a manner that is easily and accurately understood by all Inuit. Inuit require culturally relevant information on health issues.

Hepatitis C is a blood borne virus; it can sometimes be passed on through unprotected sex but is not the only risk factor. Injection drug use and home-made tattoos are often practiced within prisons and the communities. Inuit communities require significant amount of culturally relevant information of risks and factors in the area of blood borne infections. Sharing is an Inuit value and practice so there is a need to explain the hazards of sharing things like tooth brushes and razors which could have infected blood on them. Pauktuutit’s efforts to address hepatitis C amongst Inuit have been based on the logical and progressive development and implementation of highly successful prevention and education activities, which are guided and informed by Inuit and other experts in the field. This project will also build on the successful outcomes of the 2009/10 National Inuit Sexual Health Policy Forum, held in Iqaluit Nunavut.

Forum participants identified the need for hepatitis C intervention by and for Inuit. Pauktuutit Inuit Women of Canada provides leading edge information on prevention, education and community mobilization. Pauktuutit has provided Inuit communities with information fact sheets, program delivery and resource manuals to be used by front line workers on various topics.

Provincial/Territorial Ranking (Lowest to Highest) Rates of Acute and Chronic Hepatitis C Infections (2005 – 2009)

	2009			2008			2007			2006			2005
	Total	33.7		Total	36.1		Total	36.8		Total	37.2		Total	40.5
1	NU	15.5		NU	6.3		NU	6.4		NU	9.7		NL	16.3
2	NL	17.7		NL	19.5		NL	17.8		NL	19.6		NU	23.1
3	QC	22.2		QC	24.6		NS	23.9		NS	26.9		NS	23.5
4	PE	24.8		NB	28.8		QC	24.1		PE	27.6		QC	31.6
5	NB	26.2		MB	29.2		NB	27.5		MB	27.8		PE	31.9
6	NT	27.6		NS	30.0		MB	29.2		QC	28.8		ON	35.9
7	MB	28.4		NT	32.0		ON	35.0		ON	31.2		MB	35.3
8	NS	29.7		PE	33.0		PE	35.5		NB	33.8		NB	36.8
9	AB	30.6		AB	33.2		AB	36.7		AB	40.2		AB	46.0
10	ON	33.7		ON	36.4		NT	36.8		NT	44.0		NT	48.4
11	BC	54.9		BC	56.5		SK	60.9		SK	63.7		SK	65.8
12	SK	62.6		SK	69.7		BC	67.3		BC	69.2		BC	68.7
13	YT	107.0		YT	87.4		YT	113.6		YT	117.7		YT	116.0
Adapted from: Public Health Agency of Canada (2011). Reported Cases and Rates of Hepatitis C by Province/Territory and Sex, 2005 to 2009. Hepatitis C and STI Surveillance and Epidemiology Section, Community Acquired Infections Division, Centre for Communicable Diseases and Infection Control. Online data.

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