Reducing HIV vulnerabilities: resilience promoting strategies for Asian men who have sex with men in Toronto, Canada A. Li , M. Poon , N. Sutdhibhasilp , C. Hui , R. Utama , J. Wong 1
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Regent Park Community Health Centre, Clinical, Toronto, Canada, 2York University, Social Work, Toronto, Canada, 3Asian Community AIDS Services, Toronto, Canada, 4Asian Community AIDS Services, Community-Based Research & Community Engagement, Toronto, Canada, 5Asian Community AIDS Services, Men's Program, Toronto, Canada, 6Ryerson University, Nursing, Toronto, Canada
1
www.acas.org
Key Resiliency promoting interventions identified:
Background:
Results:
Asian men who have sex with men (MSM) in diaspora communities face complex challenges related to the compounding impact of racism, homophobia and HIV stigma. Most research has focused on MSM's vulnerability but little is known about their resilience that enables them to navigate through these challenges. To develop an evidence-informed approach to strength-focused programming, Asian Community AIDS Services (ACAS) in Toronto conducted the Asian MSM Pathways to Resiliency (AMP2R) community based research study.
Key Life Events that Impact Asian MSM”s sexual health: ! ! ! !
Coming Out Migration Experience with HIV Sex and relationship
Skill development to increase psycho-flexibility and capacity to navigate through intersecting minority stressors.
They also described complex challenges, facilitating conditions and resilience strategies for each of these issues.
Cross-cutting resilience strategies identified include:
Project Objective: Explore critical life events that impact Asian MSM's sexual health, and the pathways and strategies that support successful life transitions and resiliencies.
! Planned migration away from oppressive environments, ! Resisting cultural and societal oppression to achieve self-affirmation ! Accessing culturally competent services and support ! Accessing or developing safe cultural space for support and capacity building
“Mentorship … would be a very key piece. I certainly heard this sentiment from other Asian gay and or MSM just say like you know, what the generations before us is like so that we're not feeling lost, so that we have idea, so we are not reinventing stuff, right. So how do we access these mentors, why are only certain people being mentored, how, how could it be more widely accessible to a variety of the next generations.”
“As an Asian man, we have been taught since we were a kid, family first. Oh, God's first, family second, you are last….This whole process of migrating as a positive person, for me…. Forget what your culture teaches you to think, take care of yourself first…or…Don't forget your roots. Don't forget your culture, don't forget your loved ones. But at the same time, always put yourself first so that you don't become a victim. Stop being a victim and start take control of your life. “
Mentorship programs to foster community succession and promote positive role-models.
Methods:
Age
! This study engaged 66 participants in six focus groups
Year <30 (n= 25)
! 5 groups of Asian MSM: 1 for MSM living with HIV/AIDS; 1 for Youth, 3 mixed MSM groups (Total N=51) ! 1 focus group of service providers from different sectors: health, settlement, HIV/AIDS (n=12) ! Participants were asked to identify major life events that impacted on their sexual health and then shared experiences on their responses ! Focus group interviews were transcribed and coded using N-Vivo based on key themes generated through team discussion
(M = 33.78)
30-39 (n= 9)
40-49 <50 (n= 10) (n= 6)
Country of origin
! Acquiring awareness and skills to transfer resilience strategies across life challenges
Creative art-based projects and culturally safe spaces to promote dialogues and reflections on resilience strategies.
3% Korea 3% Malaysia 3% Taiwan 3% Singapore 6% Peru 6% Japan
Length in Canada
6% Vietnam
“What that has taught me is to be more empathetic to understand others who are marginalized because it helps me want to understand you instead of just ignoring you. It makes me want to search for or have better understanding of your journey and how you got there and what I can do to, to help you, instead of just turning a blind eye.”
8% West Indies 20% between 1-10 years
22% Canadian born
9% <1 year 71% >10 years
42% China, Hong Kong, Macau
Faith 14% Buddhist
Resiliency Promoting Intervention development:
31% Christian 12% Mixed faith 43% Agnostic
22% Philippines
Results were presented back to participants in follow up sessions to engage them in experiential narrative to identify key strategies for program intervention development. Ideas generated were further refined through critical discussion amongst community advisory groups, research team, agency staff and broader community stakeholders.
Presented at AIDS 2014 - Melbourne, Australia
“Learning… the value of adversity, without adversity you don't have resiliency and it's usually the other way around, they believe that “Oh let's focus on the strengths”, no the strength comes with a challenge. So if you are able to create spaces for that resiliency to come up, meaning the power of listening to their own story and working through the trauma, in a long term base aspect, not a one shot thing and that'll be great.”
Cross cultural and cross generational dialogues to share life experiences and to build community support.
Conclusions: This research generated important insights to inform resilience-based interventions that address complex life challenges faced by Asian MSM. Translating research findings into action will advance new knowledge with real life application. Community-driven research to evaluate cross-cultural applicability of resilience interventions will contribute to improving the health of racialized MSM beyond the Asian communities.
Design: Aries Cheung at TransMedia9 Inc.
! Ability to prioritize self care