Aboriginal populations suffer a disproportionate burden of infectious disease in Canada; including high rates of sexually transmitted infections (STIs). These disparities cannot be adequately understood without a rooted focus on the social determinants of health. This paper examines the effects of social exclusion on STI rates in Aboriginal populations. Evidence suggests the social exclusion of Aboriginal peoples is rooted in the structures and norms of Canadian society and has substantial effects on risk taking behaviour, health seeking behaviour, and general life chances in this population. Interventions developed to counter social exclusion and STIs among Aboriginal peoples will be discussed, and what remains to be done.