Access to HIV/AIDS treatment services among urban aboriginal peoples in Vancouver, B.C.: a cultural safety perspective

Disparities in health care access need to be addressed to help reduce health inequities among Aboriginal Canadians. A literature review examines the role cultural safety can play in reducing access barriers among urban Aboriginal peoples living with HIV/AIDS. Despite its aim to address power dynamics and structural inequities within the health care system this concept lacks methodological application at an institutional level. Key organizational initiatives to provide culturally appropriate health care in Vancouver are discussed in the context of this literature. While cultural competency terminology predominates, efforts exemplify some support and value in moving towards the concept of cultural safety that is well positioned to address the underlying mistrust and negative experiences that dissuade many Aboriginal people from accessing care. A preliminary organizational self-assessment tool is developed to invite discussion and application of cultural safety to strengthen best practice in providing culturally appropriate health care that ensures equitable access.