Community Champions HIV/AIDS Advocates Mobilization Project (CHAMPS): A CIHR-funded Community-based Research Study (2011 – 2014)
Ethno-racial minorities are at high risk of HIV: Ethno-racial communities represent a growing proportion of Canada’s overall population, and experience higher rates of HIV. Since 2005, immigrants and refugees from racial minority communities have comprised close to 20% of new HIV infections in Canada, while representing less than 1% of the total population1 and in Ontario they represent 18% of HIV cases while making up only 3.5% of the population3. Over 40% of people from ‘endemic’ countries of origin who test positive for HIV contracted the virus after their arrival in Canada2 Ontario data has shown that ethno-racial men who have sex with men (MSM), in particular Black (i.e. African/Caribbean), Asian (i.e. South, East and South East) and Latin American MSM, comprise an increasing proportion of HIV diagnoses in recent years3. Furthermore, AIDS service organizations in Ontario indicate that the most common ethno-racial groups served are African, Caribbean, Latin American, East Asian/Southeast Asian and South Asian4. As such, it is important to consider culturally relevant strategies for addressing HIV in these communities.
HIV/AIDS-related stigma undermines health, prevention, treatment and care: This proposal builds directly on the findings of recent developmental research led by this multi-disciplinary community-academic research team. The earlier study engaged people living with HIV and AIDS (PHAs), and faith, media and social justice leaders in the Greater Toronto Area (GTA) from Black, Asian and Latin American communities in a meaningful dialogue regarding barriers and strategies in addressing HIV/AIDS in their communities. The dialogue identified invisibility of ethno-racial PHAs and deep rooted homophobia within their respective communities as contributing to stigmatization, denial and marginalization of HIV. This undermines HIV education messages and heightens stigma and discrimination against ethno-racial PHAs. The negative effects of stigma on the health of PHAs and HIV prevention efforts have been well documented5. In ethno-racial communities, HIV/AIDS-related stigma prevents PHAs from accessing support and assuming advocacy or leadership roles within their ethno-racial communities. In turn, the invisibility of PHAs in ethno-racial communities further reinforces community denial and silence about the true impact of HIV and consequently undermines HIV prevention efforts6. Thus, the development of HIV champions is critical in these communities.
The proposed study will pilot and test two interventions aimed at developing community champions as key agents to advance HIV/AIDS work and address HIV/AIDS-related stigma in 3 ethno-racial communities (Black, Asian and Latin American) disproportionately affected by HIV in the GTA. Social Justice Capacity Building training (SJCB) is based on the principles of empowerment education and skills development and has been used widely to engage various communities in addressing different health issues. However, HIV/AIDS-related stigma continues to impede the extent to which affected communities can fully utilize SJCB to address HIV issues in their communities. Therefore, SJCB will also be piloted and tested in conjunction with Acceptance Commitment Therapy (ACT) – a psychological intervention which has shown potential for addressing stigma, but which has not been applied or tested in the context of HIV/AIDS-related stigma.
The specific objectives of the project are to: (1) Test the use of ACT to reduce stigma; and (2) Test the use of SJCB on its own and in combination with ACT to mobilize community champion development among the 3 ethno-racial communities. We will recruit 30 PHAs and 30 community leaders from the 3 ethno-racial communities to participate in SJCB only or ACT with SJCB. A pre- and post-test design will be used for this intervention research study to test the impact of SJCB alone or in combination with ACT in increasing the participants’ psychological flexibility to address HIV/AIDS-related stigma and their readiness to engage in HIV prevention and HIV/AIDS-related stigma reduction in their ethno-racial communities. This study will make an important contribution to our understanding of stigma reduction and cross-sector capacity building as critical approaches to HIV prevention, treatment and care within ethno-racial minority communities.
As part of CHAMP’s KTE activities, community members shared some of their experiences taking part in this intervention on HIV stigma reduction. A 2 min teaser is here: https://www.youtube.com/watch?v=0OJUXfQNjYs and a full interview on YouTube can be seen when you click here https://www.youtube.com/watch?v=X1-14-ZWjyM (17 minutes).