Social Justice Capacity Building Training for HIV Stigma ...

Social Justice Capacity Building Training for HIV Stigma ...

Happy in my own skin: Impact of anti-stigma interventions on people living with HIV in Toronto, Canada Presented by Christian Hui & Henry Luyombya July 19, 2016 Durban, South Africa Authors: J.P. Wong, K. Fung, S.S.C. CHAMP: Community Champions HIV/AIDS Advocates Mobilization Project (2011-2015) Study Purpose To pilot and evaluate the effectiveness of two interventions in reducing HIV stigma and developing HIV champions in the African, Caribbean, Asian, and Latino communities in the Greater Toronto Area. The two interventions are: Acceptance and Commitment Training (ACT) Social Justice Capacity Building

2 Therapy: To increase psychological Say as one word: flexibility ACT Accept thoughts & feelings, including unwanted ones Choose directions - focus on what really matters Take action toward realizing valued life goals 3 Social Justice Capacity Building (SJCB) social justice stigma and discriminati on

privilege & exclusion interrogatin g power relations resistance against oppression Dialogue Critical Reflectio n SJC B Experien tial Learning Collabora tive Learning

lived experiences previous strategies to overcome challenges collective strategies to address stigma and social injustice 4 Mixed Methods: Data Collection Pre-intervention: focus group, demographic questionnaire, intervention measurement survey Reflections and field notes during intervention sessions, 3-month & 9-month reconnection sessions.

Immediate post-intervention: intervention measurement surveys Post-intervention: monthly activity logs (email or telephone) x 9 months 9-month-post intervention: focus group & intervention measurement survey 5 Results: Participants A total of 104 PLHIV and non-PLHIV were recruited to take part in CHAMP Over recruitment in anticipation of attrition associated with time demand and health issues related to HIV 65 completed the CHAMP interventions 62 completed all research activities at 9month post-intervention. Non-PLHIV PLHIV TOTAL SJCB only ACT + SJCB 14 15 17

16 31 31 TOTAL 29 33 62 6 CHAMP Overall Results Reduced HIV stigma: o Increased self acceptance o Disclosure of HIV status to family members and friends Increased individual empowerment: o Increased self-efficacy, skills development & capacity building (e.g., return to school, job search, skill building, etc.) Increased collective empowerment: o Greater participation in community events (e.g. Pride, Caribbean festival (Caribana), AIDS Walk) o

7 Survey results HIVS gmaReduc on&ChampionshipReadiness 10 ** 8 6 4 ** ** ** Pre-Int + Immed Post 9-month post 2

0 Internalized Enacted 1 2 S gma S gma Valued 3 Living Knowledg 4 e Talkingto 5 Others + - p = 0.07 * - p < 0.05 ** - p < 0.01 8 PLHIV Champions in

Action Champions activities carried out by PLHIV (n=33) over nine months after completion of CHAMP interventions. Championship activities Number # Advocating for social justice 102 Support for PLHIV 55 HIV education 59 Addressing HIV stigma 109 Community building 101 Total 575 9 Reduced Self Stigma Stigma and discrimination had caused

me a lot of grief. I never told my sister who live here that I am gay or bisexual. Now that I told her my story, I found that she is also bisexual I realized that I need to step up. Since my kids got here, I told my daughter who is 13, This is your dad; I am bisexual. My wife also knows I am bisexual. (Caribbean man, PLHIV, SJCB only) 10 Increased HIV Disclosure I am more comfortable with myself through For example, have The activity thatACT. really encouraged me was theIbus driver exercise. my husband

died, it was in 2009, and I was still beenSince dating different guys, and inwhenever fear and anger, and I didnt want to to talk about it, but when we I was going meet a guy, did that activitytell I manage to open up and it took

my fear andInmy I would them I am HIV positive. anger and everything out of me I have been hiding them in the past I wouldnt be as firm to me and it was killing me slowly; when I let it out, thats when I disclose them. But now I am, even felt free. (Africanto woman, PLHIV, ACT+SJCB) though I dont know them. (East Asian man, PLHIV, ACT + SJCB ) 11 Reduced Stigma + Increased HIV Championship

CHAMP made me realized how important it is to take stigma out of my life. I learned to break that wall; now stigma is not in my vocabulary. Its been 9 month since I became open as HIV positive I put it in my resume that I am HIV positive. When an ASO invited me to speak [to PLHIV], I told them, You know you are HIV+ but you are not lesser than anybody; you can be better than anybody else. (Latino Transwoman, PLHIV, ACT + SJCB) 12 Increased Empowerment I saw that I was not alone CHAMP kind of gave me confidence that life does get better and I am the one to make it better, nobody else will make it better for me at the end of the day [community participation] makes me feel good in my own skin I can do this, I can achieve what I want to achieve.

(Caribbean woman, PLHIV. ACT + SJCB) 13 Increased HIV Championship After doing the CHAMP study, I travelled to my country. Before, I was afraid to go there to face my people; especially with my husbands people. But when I got there, I shared a lot about myself, and I helped some of my family members who were sick and did not want to come out (African woman, PLHIV, ACT + SJCB) 14 Beyond CHAMP KTE and other initiatives driven by CHAMP participants (e.g. HIV stigma reduction video project) Adapt CHAMP curriculum for partner agency staff training

Adapt and apply model to address other health issues (e.g. mental illness stigma; addiction and substance use; supporting PLHIV in service provider roles, etc) 15 Acknowledgements Research participants, Project Advisory Committee & key informants Funding support from CIHR: Canadian Institutes for Health Research (CIHR) Technical support: Ontario HIV Treatment Network (OHTN) Regent Park Community Health Centre Co-principal Investigators Alan Li, Regent Park Community Health Centre Kenneth Fung, Toronto Western Hospital/University Health Network Josephine P. Wong, Ryerson University Co-Investigator and Research Associates Alex Ciro Bisignano, Committee for Accessible AIDS Treatment Amanuel Tesfamichael, Committee for Accessible AIDS Treatment

Christian Hui, Committee for Accessible AIDS Treatment Dale Maitland, Committee for Accessible AIDS Treatment Eleanor Maticka-Tyndale University of Windsor Fanta Ongoiba, Africans in Partnership Against AIDS Henry Luyombya, Committee for Accessible AIDS Treatment Jack Kapac, University of Windsor Kenneth Poon, Committee for Accessible AIDS Treatment Mateusz Zurowski, Toronto Western Hospital/University Health Network Omer Abulghani, Alliance for South Asian AIDS Prevention Rene Lopez, Centre for Spanish-Speaking Peoples Richard Utama, Asian Community AIDS Services Shannon Ryan, Black Coalition AIDS Prevention CONTACT: Maureen Owino: [email protected] +1.416.364.2261 ext 2277 16

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