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The Need to Know: Advancing a Research Agenda for Effective Work on AIDS –The case of African and Caribbean peoples in Canada.: 

The Need to Know: Advancing a Research Agenda for Effective Work on AIDS –The case of African and Caribbean peoples in Canada. Clemon George, Ph.D. St. Michael’s Hospital, Toronto August 11, 2006


Overview African and Caribbean Council on HIV/AIDS in Ontario (ACCHO) A brief history MSM and other sexual minorities within the purview of ACCHO Challenges – HIV research and beyond Programmatic development Involvement of funders, decision makers, and NGO’s

Development of ACCHO: 

Development of ACCHO Goals/Objectives of ACCHO Coordinate work of agencies providing HIV services to African and Caribbean peoples Facilitate community development with respect to HIV Identify research needs, priorities and opportunities ACCHO Development HIV endemic task force (bringing together epidemiological evidence and community knowledge) Black MSM needs and priorities within Black Communities in Ontario and Canada

A social history of the African Diaspora: 1492 – 1900’s: 

A social history of the African Diaspora: 1492 – 1900’s Africa, the Middle Passage, the “New World” Violence. How long does it take for obliteration of agency? The birth of a new society European subjugation and African resistance Precepts of Survival – How did they shape perceptions and community and individual behaviour?

A Social History of the African Diaspora: Current ideological thoughts: 

A Social History of the African Diaspora: Current ideological thoughts Homosexuality – a thing of the Western world Sexual acts between men are illegal in many Caribbean and African countries Society condemns homosexuality Homosexuality goes against the principles of many faiths HIV. Theirs, not ours Various theories that HIV originated in Africa Blacks seen as reservoir for disease Blackness in itself becomes equated to disease

MSM Research among African and Caribbean peoples in Ontario and Canada: 

MSM Research among African and Caribbean peoples in Ontario and Canada Socio-political environment - Race, Racism and Immigration Language barriers Difficulty in assimilating into society Often seen as outsiders Unequal access to health care and services Racism The triple whammy (Black, Gay and HIV)

Black, MSM and Research: 

Black, MSM and Research HIV Stigma and Discrimination Rooted in Power and Culture Maintains social inequality Experienced at individual and community levels Individual Experienced stigma – perceptions, attitude, reactions expected leading to self deprecation/discrediting Enacted stigma – actual experience of discrimination and stigma Community Negative impact since individuals usually rely on communities for support/services. Compounded by racism, non status, alternative lifestyle, etc.

Overcoming Adversities: 

Overcoming Adversities Recognizing our Allies AIDS Bureau Gay Men’s Strategy Working with other sexual minority groups (Ethno-racial working group) Black Civic groups Knowing our Detractors When moral values prevent us from working with sexual minority communities

From Knowledge to Action: 

From Knowledge to Action HIV Stigma Study (collaboration with the Univ. of Toronto) HIV Prevention Guidelines 1st African and Caribbean Summit on HIV in Canada Targeted HIV prevention campaign ( Black MSM Study Public Health Agency of Canada – Epi-updates


© Copyright 2006, Ontario's Gay Men's Strategy Working Group, All Rights Reserved. Creative and Design by art of design (AOD Group), Photography by Paul Rosario, Website by Hyperweb Communications

Action Research: Black MSM Study: 

Action Research: Black MSM Study Ideas originated with ACCHO Adheres to the principles of Community Based Research (CBR) Objectives Characterise BMSM + Correlates of risk behaviour Examine their experiences and sexual decision making process Understand how they interpret HIV social marketing campaign and its influence on their behaviour

Current Challenges: 

Current Challenges Funding CBR (Favourable) Federal, Provincial and other bodies Ethical (unfavourable) Few REBs for CBR Institutions see CBR outside of their scope if the Principal Investigator is not affiliated with institution Homophobia still exists Sexuality research seen as scatological, and/or in conflict with institutions mission and values

Programmatic Development: 

Programmatic Development Involvement of funders/decision makers Public Health Agency of Canada (Federal) Ontario Ministry of Health (Provincial) City of Toronto and Ottawa Public Health (Municipal) Collaboration with other HIV bodies Ontario HIV Treatment Network Non Governmental Organisations Immigrant and settlement services AIDS Service Organisations


CONCLUSION HIV researchers must be cognizant of the historical, cultural and political context of doing research among sexual minorities HIV research among sexual minorities is political and researchers should be advocates for these communities, recognizing the power imbalance in society Culturally specific and targeted research (and intervention) is needed in order to reach those groups most at risk for HIV Public Health interventions are facilitated through a richer understanding of risk behaviour Public policy and programs must be influenced by good community based research


Acknowledgement Clemon George is an OHTN Postdoctoral Fellow at St. Michael’s Hospital, Toronto.

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