​HIV is a chronic disease that can be easily managed and treated, yet many people are still fearful of those living with HIV due to stigma and lack of education. For Soonats'ooneh Health Society in Prince George, they're challenging that stigma with the power of U=U: Undetectable equal untransmissible. This message is at the heart of their anti-stigma work that goes hand in hand with empowering First Nations communities with culturally safe care that heals both body and spirit.

Sustained antiretroviral treatment—also known as ART—reduces the amount of HIV in the body to undetectable levels. U=U refers to a person living with HIV who is on ART and maintains an undetectable viral load and therefore has zero risk of transmitting HIV to their sexual partners.

“If people understand that someone living with HIV who is undetectable cannot transmit the virus, that's huge. It's empowering and helps people realize they don't have to live in fear," says Jennifer Hoy, Neyoh-Bez Nats' ooneh Coordinator for Soonats'ooneh Health Society.

For more than 32 years, Soonats'ooneh has provided accessible health services to marginalized groups, including Indigenous people, people who use substances, those who are marginally housed or unhoused, and people living with HIV. Fourteen years ago, in response to rising HIV rates in the community, the Society launched specialized programming to provide comprehensive care across the cascade of HIV care including, testing, counselling, daily medication support, and advocacy.

“Indigenous people represent about 18 per cent of the people living with HIV in BC, [but] they're only five per cent of the population," said Jennifer Hoy, Neyoh-Bez Nats' ooneh Coordinator for Soonats'ooneh Health Society. “A clinic our size would typically see one or two HIV patients, but we have around 70." People living with HIV are prioritized for care at Soonats'ooneh due to our decolonizing and destigmatizing health care delivery model.

The disproportionate rate of HIV among Indigenous people is deeply connected to historical and ongoing trauma caused by colonization. Residential schools, Indian hospitals, disrupted family systems and cultural connections have a lasting impact on the health of First Nations peoples.

“People are forced to try and deal with the trauma they have experienced in different ways," said Jennifer. “Often that leads to substance use which increases HIV risk for anyone using needles. For people who don't have that connection to family, they may reach out for connection in ways of doing sex work, or for those with housing and food insecurity they may turn to survival sex work to make ends meet."

Stigma remains one of the greatest obstacles to care. Jennifer said shame and fear often prevent people from disclosing their status or seeking the care they need, particularly among Indigenous people who are subjected to racism and discriminatory stereotypes.

Stigma takes many forms:

• Internalized stigma, rooted in shame from historically stigmatized activities such as sex work, drug use, or men having sex with men.
• Intersecting stigma, experienced by people who hold multiple marginalized identities.
• Systemic stigma, perpetuated in healthcare settings, where Indigenous people, people who use substances, and those living in poverty are often treated as “less than."

Soonats'ooneh embraces a two-eyed seeing approach to HIV care, integrating Western medical practices with Indigenous ways of knowing. This means supporting health in all its dimensions: physical, mental, spiritual, and cultural.

Cultural programming is woven into care Clients are invited to learn from Elders, forage for traditional medicines, make drums, and reconnect with practices that restore identity and belonging.

“We have these medications, but we also want to connect our clients with cultural programming. Healing is about more than treatment—it's about reclaiming a life that was stolen."

To learn more about Soonats'ooneh Health Society, please visit soonatsooneh.org