Aborigines and STDs
When Aboriginal people are asked what makes safe sex education difficult in their community, the answer is usually “shame”. The discussion of sexual issues is a very sensitive matter and is generally considered inappropriate. In particular, it is totally inappropriate for such discussion to take place between women and men. In addition, male homosexuality and lesbianism are not culturally acceptable, although they exist in Aboriginal communities.
Safe sex messages promoted within the non-Aboriginal community are often inappropriate for the Aboriginal community. For example, polygamy is sometimes practised in Aboriginal communities, and consequently safe sex messages emphasising the importance of limiting the number of sexual partners are often unacceptable. Language may also be inappropriate. English is not necessarily the first language of some Aboriginal people, and even where it is, terms used to describe sexual behaviours may be completely different. In addition, people may not be able to read, so that written material is inappropriate (although this can relate to many non-Aboriginal people too).
Another factor that influences many Aboriginal people, in terms of seeking help for existing health problems, is an acceptance of illness as a normal part of life. This is related to the fact that ill health is very prevalent among many urban, fringe, and rural Aboriginal people. Some STDs, particularly gonorrhoea and syphilis, are much more prevalent among Aboriginal people than non-Aboriginal.
There are also many barriers that may prevent Aboriginal people from consulting doctors or nurses. Health professionals are often non-Aboriginal, and people fear discrimination and unfamiliar procedures.
Western methods of contraception are foreign to traditional Aboriginal communities. Methods such as oral contraception may often be inappropriate because they are expensive, and the idea of taking a pill every day at the same time may be alien to people who do not necessarily live their lives by the clock. IUDs may be considered more reliable in these terms, but carry a risk of upper genital tract infection (i.e. pelvic inflammatory disease), especially given the prevalence of some STDs. In addition, there is often a deep-seated anxiety within Aboriginal communities about contraception. Having babies is often very important, and contraception can tap into fears about “wiping out the race”. Advocating the use of condoms (also a foreign concept) for protection against STDs, can intensify this fear.
Feedback from Aboriginal health workers and community members involved in the Northern Territory AIDS: A Story In Our Hands To Share Project (Department of Aboriginal Affairs, 1989), indicates that with appropriate information and support, provided by Aboriginal people themselves, condoms are becoming more accepted. Aboriginal people are finding culturally appropriate ways, such as this story-telling project, to spread safe sex messages in their communities. Based on the experience of Aboriginal health workers, it is also particularly important within Aboriginal groups that women work with women, and men with men.