Washington D.C., USA, 22-27 July 2012www.aids2012.org
Non-positive allies & health providers promoting GIPA/MIPA in marginalized PHA communities: Experiences and strategies for engagement, capacity building & leadership
Alan Li, M.D.Committee for Accessible AIDS Treatment
Toronto, Canada
July 25, 2012 Washington, D.C
www.hivimmigration.ca
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Committee for Accessible AIDS Treatment• Formed in 1999 to reduce
barriers faced by people living with HIV/AIDS (PHAs) who are immigrants, refugees or without status in Canada
• Coalition of over 40 health, legal and social service organizations plus individual immigrant/refugee PHAs
• Community Education, Research, Service coordination and Advocacy on issues related to HIV, Immigration and Access
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http://www.hivimmigration.ca
www.hivimmigration.ca 2
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Canadian Context• HIV movement in Canada initiated through
community activism from mainly gay communities
• Many prominent gay men/PHA (& some LGBT allies)have been in leadership positions within HIV sector in Canada
• Over the years HIV movement has become more professionalized and service oriented (vs. activist & community based)
• Populations affected/living with HIV also changed over the years
www.hivimmigration.ca
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Canadian Context (cont’d…)• Immigrant, refugee and non-status PLWHAs are
mostly from racialized communities, make up 20% of new HIV cases in Canada each year
• Many face major access barriers in health care, support, settlement needs, access to trade/professions
• Many face multiple challenges in navigating the immigration system, racism in mainstream Canadian society and compounded HIV stigma in own ethno-racial communities
• Many are unable to self advocate due to precarious status
www.hivimmigration.ca
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Translating needs to community action
Needs/Challenges Objective Strategy
Lack status & unable to self
advocateBuilding trust &
giving voice
Build equitable partnership via joint projects
Access barriers in treatment &
supportAttending to care needs
Build services & health literacy
Multiple systemic
discrimination
Community Empowerment &
Succession
Capacity Building and cross-sector
interventions
www.hivimmigration.ca
Washington D.C., USA, 22-27 July 2012www.aids2012.org
http://www.hivimmigration.ca
From Access to Equity Think Tank (2006)
KTE: Mobilizing Knowledge into Action (2008)
MEL: Mobilizing Ethnoracial Leaders Against HIV Stigma & Discrimination (2009)
Legacy Project: Structured Mentorship (2009 – ongoing)
Mental Health Service for IRN-PHAs Research (2007)
www.hivimmigration.ca6
CHAMP: Community Champions HIV/AIDS Advocates Mobilization Project (current)
Improving IRN-PHA Treatment Access Study (2001)
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Engagement & Building Trust
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Engagement & Building Trust:2001: Action research to improve
treatment access for PHA with no health coverage
• Create safe space to give voice to lived experience
• Engage diverse legal, health, social service stakeholders & PLWHAs to collaborate in solving problems
• Build diverse ongoing coalition (CAAT)• Ensure meaningful outcomes to
address needs:• Develop compassionate drug
program• Develop training program on HIV &
Immigration• Set up immigration legal service at
HIV legal clinic
TransformationThrough
Collective Action
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Washington D.C., USA, 22-27 July 2012www.aids2012.org
Collaborate to address care needs
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Improving Mental Health Service Access for I/R/N-PHAs
Methodological & Structural InnovationsCommunity
identify research priority
Participate in Research
Co-investigate evidenceCo-develop best
practice recommendations
TranslateKnowledge
to Action
Conceptmapping
KTEATraining
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Community Empowerment & Succession
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Legacy Project: Capacity Building Through ‘Structured’ Mentorship
(2009 - ongoing)
www.hivimmigration.ca
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Washington D.C., USA, 22-27 July 2012www.aids2012.org
Addressing systemic inequities, stigma and discrimination
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Champ Study (2011 – 2014)
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Community Champions HIV/AIDS Advocates Mobilization Project –
An intervention study to:
•Engage & mobilize newcomer PHA and Non-PHA leaders (faith, media, social justice)
•Pilot and evaluate 2 interventions:– Acceptance Commitment Training &– Social Justice Capacity Building
Training
Hivimmigration.ca
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Key Principles in building equitable & empowering partnership
Success Failure
Mutual trustShared valuesShared power
Shared leadershipShared resources
Shared knowledgeTransparency
Equity & FairnessPragmatism
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Washington D.C., USA, 22-27 July 2012www.aids2012.org
Framework on collective empowerment• Accountability
• Respect• Promote equity &
access
• Engage in capacity building
• Structural commitment• Plan community
succession
• Ensure PHA voices counted, meaningfully engaged in all processes
• Value lived experiences• Recognize inequities & invest to
remove barriers to participation & access
• Mutual learning: cultural competency/health literacy
• Organizational structure, policy & practice
• Mentoring to support progressive engagement, know when to retire
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Collective EmpowermentCommunity succession: Passing the torch to affected
communities
From a service provider driven network at inception, CAAT is now a primarily PLWHA driven network governed by majority PLWHA leadership
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Greater Involvement of People Living with HIV/AIDS
www.hivimmigration.ca
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Access & Equity Award, City of Toronto 2009
18CAAT 2012
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Casey Award 2012
19CAAT 2012
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Think Tank 2012: Working Together
Washington D.C., USA, 22-27 July 2012www.aids2012.org
Contact Information:
Maureen OwinoProgramme Coordinator
Committee for Accessible AIDS Treatment (CAAT)
Email: [email protected] [email protected]
Phone: 416.364.2261 ext 2277www.HIVimmigration.ca
facebook.com/HIVimmigration
@HIVimmigration