Creating Pathways to Resilience Amongst Asian and Ethno-racial MSM

1. Creating Pathways to Resilience Amongst Asian and Ethno-racial MSM Alan Li, Christian Hui of the AMP2R Team BC Gay Men’s Health Summit 2013

2. Acknowledgement • Paying respects to the traditional lands of The Coast Salish People which are are on.

3. Acknowledgement • All our research participants • Our research team • Funding Partner: CIHR

4. Session Objectives • Share our research learning on the needs, issues, and resiliency responses of Asian MSM; • Engage participants in exploring pathways to resiliency; • Explore application of strength-based strategies in our practices

5. Agenda • Introduction, check in/ground rules (10 minutes) • Presentation of Research Study and Findings (20 minutes) • Small Groups Interactive Exercise (30 minutes) • Large group debriefing (30 minutes)

6. Check-In • Your Name • Your Work Title/Organization • Communities/Population(s) you work with • What you hope to gain out of this session

7. Our Project • Asian MSM Pathways to Resiliency (AMP2R)

8. Our Research Team • Principal Investigators: • Alan Li (Committee for Accessible AIDS Treatment), • Richard Utama(Asian Community AIDS Services), • Maurice Poon (York University) • Co-investigators: • NoulmookSutdhibhasilp (Asian Community AIDS Services), • Y.Y. Chen (University of Toronto), • Constantine Cabarios (Asian Community AIDS Services), • Josephine Wong (Ryerson University), • Barry Adam (University of Windsor), • James Murray (AIDS Bureau, Ontario Ministry of Health) • Staff:Christian Hui; AlviDandal

9. Our Research Team • Advisory Committee: • Peter Ho (Regent Park Community Health Centre), • Darrell Tan (St. Michael’s Hospital), • Kenneth Fung (University Health Network), • David Yeh (Central Toronto Youth Services), • Kenta Asakura (University of Toronto), • OkjnOhinoo (Queer Asian Youth), • Aries Cheung (Asian Community AIDS Services), • HywellTuscano (CATIE), • Kenneth Poon (Asian Community AIDS Services), • Andrew Miao (Asian Community AIDS Services)

10. Background • Literature suggests that Asian & Pacific Islander MSM has similar level of risk behaviors as other MSM yet the HIV prevalence is lower….. (Wei, et. al) • Most research on MSM and Asian MSM have focused on risks and challenges vs. resiliencies and strengths • Through needs identified via community health promotion forum and research think tank, Asian Community AIDS Services (ACAS) developed the community-based research study: Asian Men Pathways to Resiliency (AMP2R), funded by CIHR CBR Catalyst Grant

11. Our Project: Asian MSM Pathways to Resiliency (AMP2R) • 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

12. Method • Resiliency: "Our ability to cope with life events and recover from adversity“ • Six focus groups: • 5MSM groups: (N=51) • 3 mixed MSMs • 1 MSM Youth (Age <29) • 1 PHA (12 Asian PHA MSM) • 1 Service provider Focus group (N=12)

13. Our Participants • Age: 20-29 (25), 30-39 (9), 40-49 (10), 50-59 (5), 60+ (1) • Born in Canada: 11 • Born outside Canada: 40 (China/HK/Macau, Philippines) • Years in Canada: 20+yrs (15), 1-5yrs (5) • Immigration: Citizen (25), Landed/PR (9), Students/Other TRP (6)

14. Our findings: Key Critical Life Events that Impact Sexual Health of Asian MSMs • Coming Out • Migration • Sex, Dating & Relationships • Experience with HIV • Aging as MSM/Aging as PHA

15. A model for understanding Resilience: What we’ve learnt

16. Life event: Migration • Underlying issues • Getting away from homophobic environments • To foster sense of independence and new identity as a gay/bi person/MSM • “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.” - 62 year old Japanese gay male who relocated to Canada 37 years ago.

17. What we’ve learnt: Migration • Prohibiting barriers/conditions • Loss of support from family and friends • Loss of employment, professional credentials, material assets • Loss of cultural identity • Language/Service Access Barriers • Sexual racism • "...when I came to Canada, I had a hard time. I gave up a lot of things in my home country. I had a good job. I was a financial consultant. I had a lot of money, I got a lot of things. I moved to Canada, because to pursue a different life here. But when I was here, I couldn’t find a job. I went through a very hard time. I was depressed…” – Mainland Chinese HIV poz participant moving from Beijing to Toronto

18. What we’ve learnt : Migration • Facilitation conditions • Mental readiness& carefulmigration planning • Financial security/resources • Physical distance and separation from toxic environment and family • Access to new sources of social support: friends, chosen family, new partners, community agencies, etc. • “Luckily I, I saved a lot of money when I was in Asia, so I was fine financially. I also…was removing myself from my family and my church and even though I was put in that situation, but mentally I have to go through that to actually forcing myself to remove myself from them mentally…they are really important to me but I feel my family’s toxic to me…” – Vietnamese MSM participant from US to Canada

19. What we’ve learnt : Migration • Resiliency (traits, responses, strategies) • See migration as process for growth • Gain transferrable skills through migration experience • Foster resiliencies amidst multiple losses & challenges • Staying connected to cultural roots and values • Reconciling conflict between supportive and oppressive aspects of one’s culture and identity • “…and I found that I’m a stronger person and deal with a lot more…you know a new country and barely any relatives over here for the past twenty years already. So I think um I’ve done quite well for myself.” -36 year old Chinese male who had lived in Canada for 21 years

20. What we want to learn more • How do MSMs navigate through the various barriers and facilitating conditions to develop resiliency? • The actual path they take • The factors that affect decision making at each stage/point along the pathway

21. What we want to learn more ? ? ? ?

22. Small Group Exercise • Purpose: • Share your thoughts and experiences to inform resiliency responses to specific life challenge • Exploring the pathway to resiliency for specific life event/challenge • Time: 30 minutes • Report Back: Summarize key insights in your small group and share with large group in 5 minutes

23. RESILIENCE LIFE EVENT(S)

24. COMMUNITY AGENCY JOINING COMMUNITY GROUPS

25. HOMOPHOBIA STIGMA

26. Small Group Exercise • Discuss and add to the cards that correspond to • Prohibiting factors/barriers (Orange) • Facilitating conditions (Green) • Resiliency responses/strategies (Pink) • Identify the most significant factor(s) that affect the resiliency response: • Negative (Thunder) • Positive ( Sun) • Draw and map out the connections amongst these factors/conditions and the specific pathways you use to navigate through them

27. Report Back (5 minutes each group) • Please describe your key challenges and resiliency responses • What are the key insights from your group’s mapping journey?

28. More group reflections • What are some knowledge/insights that may be useful in your work or personal life? • What strategies we may want to work together on? • Questions? Comments?

29. A Parting Thought • “…what I had learnt from this event [testing HIV+] is that I became stronger emotionally and…. psychologically as well. I felt like I saw that moment as a chance of being reborn. A rebirth.” –Canadian Chinese HIV poz participant from Hong Kong

30. Contact Us • Christian Hui AMP2R Research Study Coordinator Asian Community AIDS Services research@acas.org