Transcript

ENGAGING COMMUNITY STAKEHOLDERS TO STRENGTHEN HETEROSEXUAL ACB MEN’S

RESILIENCE TO HIV IN ONTARIO

Presenters: Josephine Etowa, Josephine Wong, Winston Husbands, Francisca Omorodion, Isaac Luginaah, Solomon Lome, Bagnini Kohoun, Hugues Loemba, Paul Mkandawire, Zhaida Uddin

OHTN Endgame ConferenceToronto, ON

November 21-22, 2016

weSpeak program is funded by the Ontario HIV Treatment Network (OHTN) and Canadian Institutes of Health Research (CIHR)

Purpose• weSpeak is a 5-year program of research with a goal of reducing HIV vulnerabilities and promoting resilience through active engagement of self-identified heterosexual ACB men in community HIV responses, programs, research, and policy.

• This paper highlights the preliminary results of focus group discussions (FGD) with community stakeholders and service providers in the study four sites; Ottawa, Toronto, London and Windsor.

Preliminary Findings

Main themes include:

1. Issues associated with vulnerability

2. Access to health and social services

3. Resilience among ACB men4. Way forward

Issues Associated With VulnerabilityWhat makes ACB vulnerable include:• Social and economic barriers e.g. under and unemployment• Racism• Migration• Social determinants of health that create such incapacity to prevent HIV • Societal expectations including cultural and religion play a big role in how straight Black men

identify themselves to the society and others• Cultural values

• ACB men tend to not put their health first, family is their priority • Open discussion about sex and sexuality is a taboo

• Misconceptions about the populations that are most vulnerable to HIV• Straight Black men don’t necessarily see themselves as vulnerable population to HIV• Perception that HIV doesn’t exist in Canada• High risk performance without taking the right protection

• Stigma- people are afraid to come out and speak

Access to Services• Lack of targeted health programming for ACB men• No strategic collaboration among service organizations• No representation of ACB in policy development arenas • ACB men not a priority; services are predominantly for gay White men and women

• “The Provincial HIV prevention strategies, I sit and I look around the table and 80% of the people are women.”

• Available services include;• Services for the general community such as general counselling, clinical services.• Referral to different agencies • Services at AIDS Service Organizations (ASOs)• New comers information centres

• Environment is not conducive enough to access information• Lack of culturally appropriate services for ACB men

“…….That has to be essential, people need to feel that sense of dignity and respect.”

Resilience among ACB menManifestations of Resilience:• Being strong in terms of how one deals with challenges • ACB men value their independence e.g. . some ACB men consider being

on Ontario works (welfare assistance) as a shameful thing• Being hopeful - future will be better• Being able to adjust well to a new life or new environment

Challenges to Resilience:• Lack of resources to deal with challenges and adversities• Lack of information about ways of sustaining themselves

• Resorting to negative coping mechanisms/unhealthy choices – substance abuse and sex; alcohol, drugs and sex ; as ways of coping with life challenges.

• Under and unemployment, housing and poverty • Lack of social support

Way Forward• Involve more ACB men, and build their capacity as necessary • Promote volunteerism which opens doors for employment • Reach out to the community where they are; churches, schools, universities and ACB associations

• Create a platform to get people to talk about different topics• Develop strategic partnership to strengthen collaboration among community organizations

• Normalize HIV conversation e.g. including HIV messages in common topics like sports

• Employ creativity in services provision e.g. . • Integrate services and use a holistic approach that respects people’s individuality and their complex needs.

• Address Racism and discrimination • Build the capacity of ethnocultural community organizations including funding

Way Forward: Community voices•Strengthening social supports:1. “building and nurturing communities” “I think some of the ACB men that I’ve met they have strong ties to the faith community, they have a strong sense of family and community. That sense of community, that resilience comes from having those social supports and I’ve also met some people from the community that are really isolated. ….not being connected to the community creates a lot of problems with regard to resilience. We can address all these issue by building and nurturing communities.”

2. “a strong sense of family and community” “Those who have done really well are those who have got tremendous support from their family setting and knew education is important and have good cultural foundation, they also feel the need to contribute back to their community.”

Way Forward: Community voices….

•Create forum for open discussion“…being open to discuss this situation. We don’t open up to discuss. Black men go to church where a lot of families meet, but they won’t discuss this, we are not dealing with this and addressing it. Having an open conversation, it is very difficult to emphasize what is necessary or how to reduce vulnerability, So I think it is the lack of communication, the fear and stigma related to it that makes us more vulnerable.”

“…there are a lot of local radio shows in universities, a lot of shows and a lot of music play all the time, right, but no discussions about serious topics like this, serious conversation to the larger community. We are kind of running away from these conversations which we can’t avoid, we have to deal with it sooner or later. …

Implications: So what?• HIV research, programming and policy in Ontario have not been well aligned with the needs and interests of heterosexual ACB men

• Health agencies have been slow to meaningfully engage ACB men. 

• There is a need for :• Creativity in the design of outreach programs e.g. conduct HIV testing outside traditional health facilities‐ academic settings and other social events. 

• Strategic collaborative partnership between existing ACB community organizations and AIDS service as well as formal health care organizations especially public health.

Acknowledgment

weSpeak Program is funded by the Canadian Institutes of Health Research and the Ontario HIV Treatment Network

AcknowledgmentWe give thanks to

weSpeak Participants, Team, LAC and Collaborators

Thank you


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