Migration as a critical life transition and resiliency strategy among Asian MSM in Toronto

Migration as a critical life transition and resiliency strategy among Asian MSM in Toronto Richard Utama, Alan Li, Maurice Poon, Alvi Dandal, Christian Hui, Josephine Wong, Noulmook Sutdhibhasilp

No Conflict of Interest

Acknowledgement 

All our research participants

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Our research team

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Funding Partner: CIHR

Our Research Team 

Research Team:

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Principal Investigators: Alan Li (CAAT), Richard Utama (ACAS), Maurice Poon (York University)

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Co-investigators: Y.Y. Chen (U.Toronto), Constantine Cabarios (ACAS),Josephine Wong (Ryerson University), Barry Adam (University of Windsor), James Murray (AIDS Bureau, MOH), Noulmook Sutdhibhasilp (ACAS)

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Advisory Committee: Peter Ho (RPCHC), Darrell Tan (SMH), Kenneth Fung (UHN), David Yeh (CTYS), Kenta Asakura (UT), Okjan Ohinoo (QAY), Aries Cheung (ACAS), Hywell Tuscano (CATIE), Kenneth Poon (ACAS), Andrew Miao (ACAS)

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Staff: Alvi Dandal, Christian Hui

Background 

Literature suggests that Asian & Pacific Islander MSM has similar level of risk behaviors as other MSM yet the HIV prevalence is lower…..

(Wei, et. al)

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Most research on MSM and Asian MSM have focused on risks and challenges vs. resiliencies and strengths

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Through needs identified via community health promotion forum and research think tank, Asian Community AIDS Services (ACAS) developed the community-based research study: Asian Men Pathways to Resiliency (AMP2R), funded by CIHR CBR Catalyst Grant

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Objectives are to explore participants' critical life events and factors that affect their sexual health and resiliency strategies.

Method 

Resiliency: "Our ability to cope with life events and recover from adversity“

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Six focus groups:

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5 MSM groups: (N=51) 

3 mixed MSMs

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1 MSM Youth (Age <29),

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1 PHA

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1 Service provider Focus group (N=12)

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Key Discussion Questions: 

Significant life events

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Strategies to navigate and circumvent these events

Results 

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Demographics: 

Age: 20-29 (25), 30-39 (9), 40-49 (10), 50-59 (5), 60+ (1)

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Born in Canada: 11

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Born outside Canada: 40 (China/HK/Macau, Philippines,

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Years in Canada: 20+yrs (15), 1-5yrs (5)

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Immigration: Citizen (25), Landed/PR (9), Students/Other TRP (6)

Key Themes: 

Coming Out

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Sex, Dating & Relationships

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HIV

 Migration

Migration 

The movement of people from one place in the world to another for the purpose of taking up permanent or semi-permanent residence, usually across a political boundary – National Geographic

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Why do people move?

(images courtesy of college.holycross.edu)

Results

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Migration increases vulnerability to HIV/STIs among ethno-racial MSM (Myers et al., 2001) (Poon, M.K.L. and Ho, P.T., 2002)

+ Migration fosters resiliency and sexual health efficacy. 

Intrapersonal

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Interpersonal

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Community

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Systemic/Structure

Results 

Intrapersonal

"...when I came to Canada, I had a hard time. I gave up a lot of things in my home country. I had a good job. I was a financial consultant. I had a lot of money, I got a lot of things. I moved to Canada, because to pursue a different life here. But when I was here, I couldn’t find a job. I went through a very hard time. I was depressed; I couldn’t find a job....So I went back to school, to study another degree. A master’s degree. That’s why I landed a job as a social worker right now. So I am very happy. But not because HIV thing, well, I don’t say that’s a bad thing to me.“ – Mainland Chinese HIV poz participant moving from Beijing to Toronto

Results 

Intrapersonal/Interpersonal

“Luckily I, I saved a lot of money when I was in Asia, so I was fine financially, but I have no support from them since then, like my family.

And so that’s the second part that I came up, I came out being a gay person and I also put the other one was removing myself from my family and my church and even though I was put in that situation, but mentally I have to go through that to actually forcing myself to remove myself from them mentally…they are really important to me but I feel my family’s toxic to me…I changed my phone number because sometimes my dad and mom call and they would just leave messages” – Vietnamese MSM participant from US to Canada

Results 

Community

“Actually I was quite happy here as a gay man because it’s more open, especially in Toronto. So I was very lucky to be here, I think. Then I met my boyfriend and my life was pretty good in the beginning when I was here. And so, I have no complain. So, it is the same as HIV+. I was diagnosed in the 1990’s, and at least I am here and I have all the services and information and support group and I was younger and healthier to enjoy life. That’s why it was good for me. It’s not easy but it’s not bad. It’s pretty good actually. And I am still here, after 23 years.”

– Hong Kong Chinese HIV Poz participant from Hong Kong moving to Toronto

Results 

Systemic/Structural

“In Canada there is more information about LGBT group available, so I receive more information about like my own identity but in China people don’t generally talk about it. Like we refuse to even put a word gay in the media until two years ago, so that was like a topic never been mentioned and it’s like a black hole in this culture thing that you just never hear about.

– Mainland Chinese MSM participant moving from Beijing to Australia (Perth) then to Toronto

Reflections ď ľ

For many Asian MSM, migration represents a proactive effort to seek refuge from homophobia and social oppression, explore gay identity, greater self independence from family, access to treatment/support, build new community

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Migration process is also linked to many losses (economic, social, cultural) and new barriers and discrimination (language, racism, professional)

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Many Asian MSM able to utilize migration as a process for self motivation and growth; gain transferrable skills and foster resiliencies amidst multiple losses and challenges

Next Steps ď ľ

Detailed thematic transcript coding and In depth data analysis to better understand the specific pathways and factors to resiliency

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Engage participants and stakeholders to translate findings to develop full scale research study to identify and evaluate resiliency intervention(s)

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Knowledge transfer exchange to share lessons learnt with other MSM, racialized and other marginalized communities to explore collaborative initiatives

Parting Thought "The grass is green where we water it," Asian, female, 19 - The Cultures, Identities, and Voices Study