Tuberculosis infection in an Aboriginal (First Nations) population of Canada.

BACKGROUND: The incidence of active tuberculosis (TB) among the Cree, an Aboriginal population of Canada, is dropping, but it remains three times that of the general population. We analyzed data from tuberculin skin test (TST) surveys to determine estimates of prevalence of infection and annual risk of infection (ARI) in this population. METHODS: TST surveys targeting 12-year-old students were conducted annually from 1993 to 1998. Students with no record of previous positive TST (> or = 10 mm) were offered TST (5 TU PPD-T). Data collected included result of previous TST reading for all students, readings of TSTs performed (mm induration) and BCG (bacille Calmette-Guérin) vaccination status for those positive on TST. RESULTS: A total of 1274 children were screened (participation rate 94%). TST reaction size frequency distribution plots a bimodal curve. The prevalence of infection among 12 year olds was 15.3% over this period. ARI estimates range from 0.6 to 2.4% (average ARI 1.4%). A significant downward linear trend in ARI was observed over the period (P < 0.001). DISCUSSION: Calculated ARI may be over-estimated due to prior BCG vaccination; however, the trend in ARI confirms decreasing transmission of TB infection. Better knowledge of human immunodeficiency virus seroprevalence among pregnant women is needed to complete the evaluation of the BCG program.

Needs assessment for an urban native HIV and AIDS prevention program.

At the request of Native community-based organizations in Montreal, a needs assessment for an HIV and AIDS education and prevention program for urban Natives was initiated. A five-session focus group concerning HIV and AIDS was attended by nine Native persons over a 2-month period. Data was collected using the guidelines of the HIV/AIDS Rapid Anthropological Assessment Procedures (AIDS RAP) developed by the Social and Behavioural Research Unit of the World Health Organization's Global Programme on AIDS. We followed these up with in-depth semistructured interviews with five different members of the Montreal Native community. The data were reviewed by a steering committee to ensure validity. Findings highlight the potential explosive route of transmission of HIV along networks of sexual interaction between persons in urban areas and then to rural partners. Maintaining control over the AIDS program planning within the community permits issues such as traditional values and healing practices to be discussed and taken into account.

Youthful drug use and drug subcultures.

Drug involvement is such an intensely social behavior that it lends itself to the notion of a subcultural existence. The social aspects of drug involvement generate a value system that is different from the dominant order. Using a longitudinal sample of college students, the findings indicate two distinctively different types of drug use, marijuana-only versus illicit drug involvement, that correspond to a subcultural or contracultural phenomenon. The elements of a subculture or contraculture are amenable to empirical measurement and can be differentiated from the dominant value system. Marijuana use reflects a type of subculture activity that maintains ties to the conventional order. Illicit drug use, on the other hand, is a contracultural activity, representing a pronounced break with the dominant culture.