Executive Summary

Asian Community AIDS Services (ACAS) conducted a community-based needs assessment to investigate the HIV prevention needs of East and Southeast Asian international students that identify as gay, bisexual, and/or men who have sex with men (ISgbMSM). The project’s activities include hiring and training ISgbMSM Peer Outreach workers, developing relevant community-based research knowledge and skills amongst the team, developing and executing individual semi-structured interviews and cross-sectional survey to explore ISgbMSM’s unique experiences of migration and settlement, various vulnerabilities for HIV and other STBBIs, overall experiences when accessing healthcare and other HIV/STI prevention resources. 11 East and Southeast Asian ISgbMSM participated in the semi-structured interviews and 100 participated in the survey, with most from Vietnam, China, South Korea, and Japan.

The average age of all participants was 25.1 years old, with 98% identifying as cisgender men and 2% identifying as trans men. The average duration of residency in Canada amongst participants was 3.6 years, ranging from four months to eight years. Most ISgbMSM participants (70.7%) reported having insurance through their school, only 5.4% reported having no insurance at all. Just over half of survey participants (53.3%) reported having a primary healthcare provider here in Canada. However, even though half (50%) of ISgbMSM participants felt like they would be comfortable speaking to a healthcare provider about sexual health, only 20% actually reported having spoken to their doctor about it, with a large majority (92.4%) reported preferring accessing sexual health information online.

Although a large majority of participants reported they were tested for HIV (85.9%), only about half (57%) of these participants reported having done so within the last six months. Amongst survey participants, we saw high self-reports of knowledge with respect to HIV risk factors (84.8%) and protection methods (83.7%). Participants also self-reported high confidence in suggesting the use of protection (76.1%) and reported feeling like they were at low risk for HIV (64.7%). However, fewer participants reported always knowing their sexual partners’ HIV status (22.8%) or reported remembering to use condoms when under the influence of recreational drugs or alcohol (20.7%).

Through the individual interviews with ISgbMSM participants, various themes arose that shone a light on their migration experiences and potential challenges that may impact their health and well-being. A large majority of participants spoke about their experiences of loneliness and isolation upon arrival into Canada, as well as the specific challenge of integrating into the 2SLGBTQ+ community in Toronto due to di erent expectations and racism. They also spoke about the lack of accurate and comprehensive sexual health education in their home countries, which was often associated with homophobia arising from rigid gender norms in their countries, the pervasiveness of HIV stigma, and general misinformation about sexual health. Additionally, substance use stigma was also discussed but many participants shared how they have since used di erent substances upon arrival to Canada due to the openness to share and discuss amongst peers. Lastly, participants also shared their di culty navigating their health insurance as well as the healthcare system due to a liated costs, language barriers, and di erent approaches to healthcare back in their home countries.

Based on the survey results and the rich stories shared by our participants, we conclude that earlier interventions that aim to support network building, sexual health and harm reduction education, and improving understanding of how to navigate health insurance and Canadian healthcare would greatly benefit Asian ISgbMSM. Additionally, educational resources created must be cognizant of the conservative social norms imposed upon Asian ISgbMSM, as well as the entrenched stigmas relating to HIV and substance use. Asian ISgbMSM would also benefit from community-based programming that simultaneously a rms their cultural, gender, and sexual identities.

Knowledge gained from this study will be used to develop community strategies and interventions that better reach, engage, and support East and Southeast Asian ISgbMSM studying in Toronto. With an improved understanding of social and structural challenges faced by Asian ISgbMSM, we will be able to extend formal partnerships and support to di erent agencies, community partners, and academic institutions, to create a more robust plan to include and address the specific needs of ISgbMSM, through knowledge translation and dissemination. A digital community forum for both Asian ISgbMSM community members and service providers was held to disseminate the findings in June 2020.