Asian Community AIDS Services Asian MSM Pathway to Resiliency Study Alan Li, Richard Utama, & Christian Hui of the AMP2R Team AIDS 2014 Conference Melbourne,

Asian Community AIDS ServicesAsian MSM Pathway to Resiliency Study

Alan Li, Richard Utama, & Christian Hui

of the AMP2R Team

AIDS 2014 Conference

Melbourne, Australia

July 21, 2014

Two Cultures Collide:Sexual Wellbeing Promotion Among Asian Men Living in Western

Societies

Session Objectives

1. To develop awareness and knowledge of cultural characteristics in the context of sexuality and holistic well-being.

2. To develop pragmatic skills and best practice by reconciling two or more cultural values

3. To increase knowledge in exploring/identifying individual and community resiliency strategies through CBPR (community-based participatory research)

Part 1: Community-based Research

Asian MSM Pathways to Resiliency (AMP2R) Study

Key Research Questions

What are the critical life events that impact the sexual health of Asian MSM?

What affect resiliency responses to these life events/challenges?

How can we change our practices and policies to improve the sexual health of Asian (and other racialized) MSMs?

Methodology: Resiliency: "Our ability to cope with life events and

recover from adversity“

Six focus groups: 5 MSM groups: (N=51)

3 mixed MSMs 1 MSM Youth (Age <29) 1 PHA (12 Asian PHA MSM)

1 Service provider Focus group (N=12)

Our findings: Key Critical Life Events that Impact Sexual Health of Asian MSMs

Coming Out Migration Sex, Dating & Relationships Experience with HIV

• Testing HIV+

• Living with HIV

A Model for Understanding Resilience:

Underlying Issues

Prohibiting Barriers and Conditions

Facilitating Conditions

Resiliency Responses

Complicating factors that intensified the challenges included: o exclusion from traditional support system

o multiple losses

o stigma and discrimination

o sense of shame and failure to family

o barriers in accessing services

o increased risk behaviours as a result of the above factor

Common Factors Affecting Resilience

“When I was eighteen when I, nineteen when I came out to my parents, that the risk was they would disown me. And um I spent three days thinking about, if I wanted to take that risk and um, because I feel like my parents did have very high esteem for me and they loved me and all that and I felt like, but that relationship is not really real because they don’t know who I am, let’s see if they really love me if they really know who I am.” -32 y.o. Vietnamese Gay Man on challenges around Coming Out

Conditions that support resiliency included: o access to cultural specific safe spaces, peer, family

and professional service providers,

o financial security,

o capacity building opportunities

o gay positive social environment

Common Factors Affecting Resilience

“I think it all comes back to the support system. Um and I think what ACAS or similar organizations have already done and maybe expand on is, something similar to what we have tonight, like discussion groups, like times like where there’s small sort of group of people just who knows, who gets to know each other and then just uh sort of check up on things for each other on a regular basis. That would be a, I think that would be paramount just in terms of navigating through the, I guess the maze and as a gay or men having sex with men Asian community.” - 29 y.o. Gay Man from Hong Kong

Increase external resources (inter-personal/community/societal):o access support (cultural specific safe spaces, community-based &

professional services)

o create social network (family, friends and peers of chosen family )

o migrate to less oppressive environment etc.

Cross-cutting Resilience Strategies

“I think my immigration to Canada is umm – I was 25 when I came here. And then I think I couldn’t keep it by myself in Japan. And when I came here, there was lots of coming out group. I learned some of them through ‘Body Politics’ at that time. You know, as long as I hide my being gay, I was very comfortable life in Japan, but as soon as I say that, then everybody would be talking behind my back and so I didn’t tolerate for that. I just wanted to be honest to myself, so that’s one of the reason for me to come to Canada.”

- 50+ y.o. MSM who emigrated from Japan to Canada

Increase internal resources (intra-personal): o Accessing cultural strengths,

o Learn to prioritize self care,

o Reconciling conflict between supportive and oppressive aspects of one’s culture

o Undoing societal oppressive conditioning

o Transfer strategies across challenges

Cross-cutting Resilience Strategies

“My message is basically very simple. Don’t forget your roots. Don’t forget your culture, don’t forget your loved ones. But at the same time, while maintaining your roots, maintaining your culture, your loved ones, you know, always put yourself first so that you don’t become a victim. Stop being a victim and start take control of your life. Put yourself first so that you can take care of your loved ones better.”

- 40 y.o. Southeast Asian Bi HIV+ Man

Planned migration away from oppressive environmentReconciling conflict between supportive and oppressive

aspects of one’s culture and identityUndoing societal oppressive conditioningAccessing cultural strengths

Ability to access cultural specific safe spaces, community-based and professional services

Ability to create/develop supportive community networks with family, friends and peers (chosen family)

Learning to prioritize self-careAbility to learn from and transfer resiliency strategies across

life challenges

Key Cross Cutting Resiliency Strategies

Group Interactive Exercises

Group Agreement / Ground Rules

• Respect Diversity of Experience and Opinions• Confidentiality• Use “I” Language• Share the Air• Please turn cell phone on vibrate

• Have fun!

1. What is Culture?

1. What is Culture?

Individual

Collective/Community (Ethnicity/Family; Immediate vs. Extended)

Specific Groups/Populations (e.g. Gay; Substance User)

2. Strengths and Barriers of Cultural Traits

2. Strengths and Barriers of Cultural Traits

Internal/Intrinsic factors External/Extrinsic factors Results of acculturation/assimilation/integration/appropriation

What are the cultural strengths and barriers?

3. Pathway Mapping Exercise

A Model for Understanding Resilience:

Underlying Issues

Prohibiting Barriers and Conditions

Facilitating Conditions

Resiliency Responses

3. Pathway Mapping Exercise

1. Identify a life challenge (the WHAT)

2. Identify a cultural barrier or challenge that kept you back

3. Identify a cultural strength or facilitator that helped you move forward

4. Describe your journey in how you overcame your life challenge

(the PROCESS)

5. Share with your group. Take note of commone key strenghts or what stood out for you…

LIFE GOALS &

DESTINATION

Double

Disclosure

MSM SUPPORT

GROUP

TESTING HIV+

Report Back & Reflect

Please Share

One of the ‘most’ effective, practical, and transferrable approaches and methods

Protective/strength-based factors

Resiliency process/outcome/traits

Discussion questions on follow up action

Of the study’s findings and the reflexive exercise:

What stands out for you? Any surprises? What findings you find to be helpful and applicable to

your work? (short term and long term)

Our Follow Up Strategies…

Ideas for follow up action:Programming

Skill Building Programs:

o Dealing with cultural issues, transferring life skills

Mentoring programs:

o Role models, Intergenerational learning and collaboration

Community social support programming:

o Age-specific, cross generations, specific projects (e.g. creative/arts)

Ideas for research to action

Research:

1) Framing program ideas into resilience building interventions for research evaluation

2) More in-depth exploration of specific queer Asian experiences (e.g. Aging, e.g. Sexual racism)

3) Joint research with other racialized groups (cross cultural strategies/interventions)

Final Remark:

“A Conscious Being Uses Everything!”

Find out more about our study: Poster MOPE306

Contact Us

Christian Hui

AMP2R Research Study Coordinator

Asian Community AIDS Services

[email protected]