Aboriginal people in Canada are infected with HIV/AIDS at a rate more than three times that of the rest of the population -- and without addressing the root causes like poverty, substance abuse and domestic violence, it's only going to get worse.

That was the message at a panel discussion in Vancouver this morning, held to kick of Aboriginal AIDS Awareness Week and recognize World AIDS Day.

But stigma, and lack of access to health services, makes it difficult for many aboriginal people to get the help they need, said Art Zoccole, chair of the Canadian Aboriginal AIDS Network.

"Of all the topics we've ever had to talk about, this is one of the hardest," said Zoccole, who is also president of a Toronto-based organization that serves gay, lesbian, bisexual and transgendered aboriginal, or "two-spirited", people. "I've been discriminated against for being aboriginal and for being gay," said Zoccole. He said that, while gay men used to be one of the most at-risk groups in First Nations communities, today it's women.

Mika Ekomiak, who has been living with AIDS for nine years, contracted the disease through unsafe sex. Her partner didn't tell her he was positive, and her judgement was clouded by alcohol, she said. "There were a lot of times people were putting me down. I wasn't taking care of myself," she said. "Those were dark days."

Ekomiak said she quit drinking when was diagnosed and now feels "very wonderful, very healthy."

"I want to share my experience and help other people" she said.

Dr. Howard Njoo of the Public Health Agency of Canada listed a number of factors that determine risk of infection: poverty, sex work, incarceration and substance abuse.

These are all major concerns in Vancouver's Downtown Eastside, said Jenny Kwan, MLA for Vancouver-Mount Pleasant. She used her address at the panel to criticize the federal government's attempts to close Insite, a centre that provides clean needles and a safe place for heroin users.

The federal government is currently appealing a May, 2008 B.C. Supreme Court decision that has allowed Insite to remain open temporarily.

"We have a federal government that wants to turn back the clock," said Kwan. "This is a harm reduction initiative. It's an opportunity for people to connect with health services...so people have a chance to perhaps one day be drug free."

Dr. Thomas Kerr of the B.C. Centre for Excellence in HIV/AIDS recently told the Canadian Medical Journal he finds it "shocking" that some commentators still say that needle exchanges don't reduce infection rates, and said scientists have a duty to challenge government policies.

Colleen Kimmett reports for The Tyee.