Towards anti-colonial approaches in social work: Enhancing culturally safe HIV care for Indigenous communities in Manitoba and Saskatchewan

The social work profession, with historical ties to colonial harm, must adopt decolonizing and anti-colonial approaches to promote culturally safe HIV care for Indigenous communities. This study examines how the COVID-19 pandemic disrupted health and social services throughout Manitoba and Saskatchewan, significantly limiting access to essential services and traditional practices for Indigenous peoples living with HIV. Using a Two-Eyed Seeing approach, this study integrates Indigenous and Western research approaches. Community-based participatory research and Indigenous Storywork comprised the overall research design. An Indigenous Elder, a cultural knowledge holder, and a community guiding circle of Indigenous peoples living with HIV helped guide the project. Qualitative interviews were conducted with 51 participants, recruited through community organizations, social media, and peer networks. The pandemic's impact on health, access to services, and ceremonies were explored. Data was analyzed using thematic analysis grounded in Indigenous Storywork principles. The pandemic significantly impacted traditional ceremonies, vital for the spiritual and communal well-being of Indigenous peoples living with HIV. Participants displayed resilience by adapting spiritual practices amidst restrictions. Social workers and other service providers acknowledged the crucial role of ceremonies in offering spiritual and cultural connection but showed varying levels of knowledge in connecting Indigenous clients to ceremonial practices, some facing organizational and systemic barriers. This study advocates for a systemic shift in social work to adopt decolonizing and anti-colonial practices that integrate Indigenous knowledge, ceremonies, and medicines. Such an approach advances culturally safe HIV care that respects Indigenous sovereignty, promotes wholistic well-being, and actively addresses structural colonial violence.