Background

Canada has a long-standing history of being perceived as a desirable destination for potential students to travel to for their studies, as the country is perceived to be safe and welcoming, and the prestigious education system a orded to its students(1). In 2018, it was estimated that there were over 495,000 international students in Canada, with more than half (over 250,000) being in Ontario alone(2). Canada also has an incredibly diverse population of international students, with representation from over 186 countries(3). East and Southeast Asian countries in particular make up over one-third of all international students residing in Canada, with China alone making up 28% of all international students(3) .

The Canadian Bureau of International Education (CBIE), estimated that, in 2017, Toronto hosted approximately 168,730 international students, which was a 23% increase from 2015(3). However, it is worthwhile to note that even greater increases in enrolment have occurred in other cities, including Windsor (54% increase), Kitchener-Waterloo (39% increase), and St. Catherines-Niagara (27% increase)(3) .

With the upward trend of international students enrolling and attending Canadian universities or colleges, it is imperative that sexual health and HIV resources are not only available but must also be accessible (e.g. linguistically, culturally sensitive) to these demographics. However, a preliminary review carried out by the Ontario HIV Treatment Network (OHTN) found that resources on these subjects were limited on post-secondary school websites and resources. Additionally, resources about HIV provided by governmental bodies and a liated agencies focused more on HIV non-disclosure laws and took a criminal punishment tone, contributing to the entrenched stigmas already in many of these communities.

In Toronto, there is a high incidence and prevalence of HIV among international students who identify as gay, bisexual, or men who have sex with men (ISgbMSM). In the first half of 2018, 15% of people diagnosed with HIV at the Toronto Hassle Free Clinic, were international students; nearly 40% of all positive diagnoses at the clinic during this time were people on student, visitor or work visas, or who did not have immigration status (e.g. short-term ESL students). Young ISgbMSM face many unique barriers when trying to access healthcare and HIV prevention resources, including ineligibility for OHIP and limitations in their school insurance to access laboratory testing costs and medication coverages.

ACAS also reported that amongst the clients accessing our support services for people living with HIV, 22 were either current or former ISgbMSM. From our existing work with East and Southeast Asian international students, it has become clear that there is a lack of culturally competent and accessible sexual health resources for newcomers, especially those that address the intersecting stigmas of homophobia and HIV within the Asian communities. Additionally, ISgbMSM also face issues pertaining to racism, language barriers, social isolation, lack of HIV awareness, and risk factors, all of which contribute to additional challenges faced by this group.