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u of r professor aims to indigenize cognitive therapy for people with hiv
"it's incredibly important that the approach and the way you evaluate it is done in a culturally sensitive manner, especially when working with groups that have faced a lot of marginalization or discrimination."
aug 26 2024
3 minute read
dr. andrew eaton, an associate professor of social work at the university of regina, is shown on aug. 26, 2024 in saskatoon. he is conducting research on cognitive remediation group therapy (crgt) for middle-aged to older people living with hiv in saskatchewan indigenous communities.
michelle berg
/
saskatoon starphoenix
with saskatchewan having the highest rate of hiv diagnosis in the country, a university of regina professor is working to mitigate the cognitive challenges that people living with the virus develop later in life.
andrew eaton, an associate professor of social work at the u of r for the past three years, has been engaging with first nations and métis communities that are affected by hiv.
in 2021, the regional medical health officer for indigenous services canada, dr. ibrahim khan, said saskatchewan first nations had an hiv transmission rate of 45.4 new cases per 100,000 people. the provincial transmission rate was a nation-high 19 new cases per 100,000 people, as of 2022 (manitoba was next at 13.9). the national rate was 4.7.
“hiv continues to be a chronic health condition for which there is no cure and it can cause exacerbated or accentuated health issues,” said eaton in an interview monday. “one of the most prevalent is cognitive impairment.”
over the last decade, eaton’s research has centred around developing strategies to remediate cognitive issues caused by hiv-associated neurocognitive disorder (hand) amongst adults 40 and up.
hand has three forms: 1. asymptomatic; 2. mild to moderate; 3. dementia.
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“with middle-aged and older adults living with hiv, the prevalence is really high amongst the mild-to-moderate form and that can make it more difficult to live a daily life, maintain employment, to remember to take medications,” explained eaton. “it can be a real barrier to daily living when people are still very active.”
he adds that hand diagnoses can be difficult to access, particularly for those living in remote communities.
eaton has developed a group therapy tool coined cognitive remediation group therapy (crgt) that involves brain training strategies to keep the mind sharp. half of the program is mindfulness-based stress reduction, which is an approach to cultivate calmness and reduce stress and anxiety. that’s combined with brain training activities to practice memory, processing speed or other cognitive areas to build coping skills associated with cognitive impairment.
the program is designed to run over eight weekly sessions, in person or online.
within the last five years of the crgt being offered, 50 people have participated, displaying “good” results. but eaton is looking to adapt the program for indigenous communities that are hit the hardest by the hiv epidemic in saskatchewan.
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currently, eaton and the u of r are consulting with elders and knowledge keepers in first nations and métis communities to better understand how crgt could be adapted in a way that resonates with indigenous cultural practices.
“people living with hiv in saskatchewan have been identifying that, while there is an hiv crisis here, sometimes there’s a big focus on prevention and testing while there isn’t really a focus on care, greater quality of life or better longevity,” explained eaton.
through his work with aids programs south saskatchewan (apss), eaton said people were expressing a need for more peer support programs, specifically involving cognitive impairment.
“a lot of the people living with hiv that i work with at apss are first nations and métis,” he added “whenever you’re designing a therapeutic or psychological approach, it’s incredibly important that the approach and the way you evaluate it is done in a culturally sensitive manner, especially when working with groups that have faced a lot of marginalization or discrimination.”
shiny mary varghese, the executive director of apss, says about 80 per cent of the people who use their services are indigenous.
“it is definitely needed because the people are facing a lot of health issues as well as social and psychological issues, so they need to have some support, especially if it is culturally appropriate,” said varghese.
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eaton anticipates the consultation portion of the research to go into 2025. by this time next year, he believes they’ll have a good plan for “indigenizing” crgt and be able to offer it to communities next fall.
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