“Happy in my own skin”: Impact of anti-stigma interventions on people living - PowerPoint Presentation

“Happy in my own skin”: Impact of anti-stigma interventions on people living with HIV in Toronto, Canada Presented byChristian Hui & Henry LuyombyaJuly 19, 2016 Durban, South AfricaAuthors: J.P. Wong, K. Fung, S.S.C. Hui,H. Luyombya, A. Bisignano, D. Maitland, K. Poon, & A.T. Li

CHAMP: Community Champions HIV/AIDS Advocates Mobilization Project (2011-2015) Study PurposeTo 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 (SJCB) 2

Acceptance Commitment Therapy: To increase psychological flexibility 3Say as one word: ACT

Social Justice Capacity Building (SJCB) social justicestigma and discriminationprivilege & exclusion interrogating power relations resistance against oppression Critical Reflection Collaborative Learning Dialogue Experiential Learning SJCB lived experiences previous strategies to overcome challenges collective strategies to address stigma and social injustice 4

Mixed Methods: Data Collection 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 HIV65 completed the CHAMP interventions62 completed all research activities at 9-month post-intervention.6 SJCB only ACT + SJCB TOTAL Non-PLHIV 14 15 29 PLHIV 17 16 33 TOTAL 31 31 62

CHAMP Overall ResultsReduced HIV stigma: Increased self acceptanceDisclosure of HIV status to family members and friendsIncreased individual empowerment: Increased self-efficacy, skills development & capacity building (e.g., return to school, job search, skill building, etc.)Increased collective empowerment: Greater participation in community events (e.g. Pride, Caribbean festival (Caribana), AIDS Walk)Greater participation in social justice activities 7

Survey results8

PLHIV Champions in Action 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 Champions activities carried out by PLHIV (n=33) over nine months after completion of CHAMP interventions.

Reduced Self Stigma10 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)

Increased HIV Disclosure11 The activity that really encouraged me was the bus driver exercise. Since my husband died, it was in 2009, and I was still in fear and anger, and I didn’t want to talk about it, but when we did that activity I manage to open up and it took my fear and my anger and everything out of me… I have been hiding them in me and it was killing me slowly; when I let it out, that’s when I felt free. (African woman, PLHIV, ACT+SJCB)I am more comfortable with myself through ACT. For example, I have been dating different guys, and whenever I was going to meet a guy, I would tell them I am HIV positive. In the past I wouldn’t be as firm to disclose to them. But now I am, even though I don’t know them. (East Asian man, PLHIV, ACT + SJCB )

Reduced Stigma + Increased HIV Championship12 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. It’s 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)

Increased Empowerment 13 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)

Increased HIV Championship14 After doing the CHAMP study, I travelled to my country. Before, I was afraid to go there to face my people; especially with my husband’s 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)

Beyond CHAMP KTE and other initiatives driven by CHAMP participants (e.g. HIV stigma reduction video project)Adapt CHAMP curriculum for partner agency staff trainingAdapt 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 informantsFunding support from CIHR: Canadian Institutes for Health Research (CIHR)Technical support: Ontario HIV Treatment Network (OHTN)Regent Park Community Health CentreCo-principal InvestigatorsAlan 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 WindsorFanta Ongoiba, Africans in Partnership Against AIDSHenry Luyombya, Committee for Accessible AIDS Treatment Jack Kapac, University of WindsorKenneth Poon, Committee for Accessible AIDS TreatmentMateusz 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 : coordinator@HIVimmigration.ca +1.416.364.2261 ext 2277 16