The Developing World Epidemic in the Developed World

1. The Developing World Epidemic in the Developed World The AIDS Epidemic Among African and Caribbean Communities and other Black Canadians Presenter: Esther Tharao Women’s Health in Women’s Hand CHC/ African and Caribbean Council HIV/AIDS in Ontario August 16th, 2006

2. Introduction: • African and Caribbean people of African decent have become an important component of the Canadian epidemic • In Ontario they constitute the fastest growing category of groups affected by HIV/AIDS (13.8% of all people living with HIV/AIDS) • African and Caribbean women constitute approximately: • 33% of all HIV infections among women in Ontario • 66% of all women living with HIV/AIDS in Toronto • Rates of infection have increased by 87% between 1999 and 2004 with annual increase of 13.3% (Remis 2006).

3. Introduction (cont’d) • In 2004, 18.5% of all new diagnoses in Ontario were among African and Caribbean people • Substantial HIV transmission is occurring in Canada • It is estimated that 22-59% of HIV infections in Ontario occur after migrating to Canada (Remis 2006) • 12.2% of prevalent infections in Canada are among black people

4. An Emerging Epidemic • Community mobilization among black populations started in Ontario • What were the signs of a growing epidemic? • Rising numbers of those seeking support and care in the mid 90s • Emerging data in 1997/98 • 70% of children born with HIV involved mothers from Africa and the Caribbean (1994-96) • 10% of all people diagnosed with AIDS in 1996 were African and Caribbean people • African women constituted 32% of AIDS related deaths in Ontario in 1996 • Researchers produced numbers without context ((CAHR 1997) • Lack of data on extent of epidemic and driving factors

5. Engaging African and Caribbean communities • 1997 • 1st HIV/AIDS forum organized by the two African AIDS Service Organizations (ASO’s): • Aim of forum – highlight status of epidemic and facilitate community discussion and mobilization • 1998 • 2nd HIV/AIDS forum organized by an expanding circle of providers and also included government • Aim - To share information and strategize with other providers on how to deal with HIV/AIDS issues in African and Caribbean communities • 2000 • Working conference on Creating Strategic Partnerships … to Address HIV/AIDS in African and Caribbean Communities • Aim: • strengthening existing partnerships, identify new partnership opportunities in African and Caribbean communities • Develop strategies for prevention and support services in context of the determinants of health

6. Emergence of a Strategic Plan and coordinated Actions: • An HIV Endemic Working Group (HEWG) with expanded membership was formed in 1998 (ASOs, CHCs, government) • Commissioning of an epidemiologic report to quantify the epidemic in Ontario – completed in 1999 • Working group expanded to become the “HIV Endemic Task Force” • Role of Task Force - spearhead development of a strategic plan

7. Emergence of a Strategic Plan and coordinated Actions (cont’d) • Strategy to Address Issues Related to HIV Faced by People from Countries where HIV is Endemic completed in Dec. 2003 • Jan. 2004 - the HETF became the African and Caribbean Council on HIV/AIDS in Ontario (ACCHO). • March/April 2005 – ACCHO, the Strategy and “Strategy for Life Campaign” launched

8. Role of ACCHO • ACCHO has three major roles: • Coordination and support of Strategy implementation, revision/renewal, monitoring and evaluation. • Advising and advocating on HIV/AIDS issues affecting African and Caribbean communities. • Promote the greater involvement of African and Caribbean people living with HIV/AIDS in the response to HIV/AIDS. • Goal of African and Caribbean HIV/AIDS Strategy • To reduce the spread of HIV among African and Caribbean people in Ontario and improve the quality of life for people infected and affected by HIV

9. Strategy Guiding Principles • Service delivery must be based on an antiracism, gendered and anti-oppression framework • Must be grounded in community based, participatory action and leadership • Must foster self determination for African and Caribbean people • Services must meet the needs of a range of people and groups (e.g., youth, women, gay men and other MSM, lesbians, trans people and IDUs).

10. Strategy Objectives and strategic directions: • Coordination • Service delivery within different settings • Accountability of mainstream organizations to African and Caribbean Communities • Advocacy • Community Development • Empowerment and capacity building • Increasing awareness and being a voice • Supporting local action • Community engagement • Research • Setting research priorities and policies • Promoting self determination through research • Promoting research that is respective respectful and recognizes autonomy

11. Activities to move strategy forward: • Setting a research agenda: • Research conference (ACCHO/OHTN) – April 28-29th, 2006 – bring together researchers and community members to discuss and develop priorities • Working with Public Health Agency of Canada to improve Epi and Surveillance reporting and Epi Update report production • Undertaking research: • stigma and discrimination project – partnership between ACCHO and the HIV Unit, University of Toronto • Black MSM project • Optimizing HIV prevention: • Expansion of prevention activities across the province • HIV prevention campaign

12. Activities to move strategy forward (cont’d) • Capacity Building • Prevention guidelines – for service providers and organizations that work with African and Caribbean communities • Training manual and training activities – to be done in Toronto, Ottawa and Montreal March 2006

13. Creating a National Platform: • Have undertaken preliminary work to lay the groundwork for a National Strategy for Black, African and Caribbean communities in Canada • Done through the National Spring-boarding project

14. Creating a National Platform (cont’d) • Funded by the Public Health Agency of Canada through the Interagency Coalition on AIDS and Development (ICAD) and overseen by a national steering committee. • Project Objective: to conduct preliminary research that will contribute to the development of a national HIV/AIDS strategy for Black Canadian, African and Caribbean communities. • Project developed in response to: • the disproportionate number of Black people testing HIV positive • the need identified, Canada-wide, by AIDS service organizations on how to best respond to the increasing number of Black people testing positive/seeking HIV/AIDS services.

15. Creating a National Platform (cont’d) • Work completed to date: • Environmental scan • National consultation to build strategy framework. • Next Phase – consultation with all stakeholders across the country

16. Lessons learned from ACCHOs Experiences • Need to move from Epidemiologic terminology to the reality of who is affected AND needed to be included in the Strategy • Move from “populations from HIV Endemic countries to African and Caribbean communities” • Shift away from being the HIV Endemic Task Force to ACCHO • New shift to include all black people living in Canada – Springboard Project • Creating room to facilitate voices within the African diaspora living in Canada • Need to engage “Intersectionality” based on gender, race, sexual orientation, colourism, classism etc. within an anti-racist, anti-oppressionframework