1. Washington D.C., USA, 22-27 July 2012www.aids2012.org Non-positive allies & health providers promoting GIPA/MIPA in marginalized PHA communities: Experiences and strategies for engagement, capacity building & leadership Alan Li, M.D. Committee for Accessible AIDS Treatment Toronto, Canada July 25, 2012 Washington, D.C www.hivimmigration.ca

2. Washington D.C., USA, 22-27 July 2012www.aids2012.org Committee for Accessible AIDS Treatment Formed in 1999 to reduce barriers faced by people living with HIV/AIDS (PHAs) who are immigrants, refugees or without status in Canada Coalition of over 40 health, legal and social service organizations plus individual immigrant/refugee PHAs Community Education, Research, Service coordination and Advocacy on issues related to HIV, Immigration and Access 2 http://www.hivimmigration.ca www.hivimmigration.ca2

3. Washington D.C., USA, 22-27 July 2012www.aids2012.org HIV movement in Canada initiated through community activism from mainly gay communities Many prominent gay men/PHA (& some LGBT allies)have been in leadership positions within HIV sector in Canada Over the years HIV movement has become more professionalized and service oriented (vs. activist & community based) Populations affected/living with HIV also changed over the years www.hivimmigration.ca

4. Washington D.C., USA, 22-27 July 2012www.aids2012.org Canadian Context (cont’d…) Immigrant, refugee and non-status PLWHAs are mostly from racialized communities, make up 20% of new HIV cases in Canada each year Many face major access barriers in health care, support, settlement needs, access to trade/professions Many face multiple challenges in navigating the immigration system, racism in mainstream Canadian society and compounded HIV stigma in own ethno- racial communities Many are unable to self advocate due to precarious status www.hivimmigration.ca

5. Washington D.C., USA, 22-27 July 2012www.aids2012.org Translating needs to community action Needs/Challenges Objective Strategy Lack status & unable to self advocate Building trust & giving voice Build equitable partnership via joint projects Access barriers in treatment & support Attending to care needs Build services & health literacy Multiple systemic discrimination Community Empowerment & Succession Capacity Building and cross-sector interventions www.hivimmigration.ca

6. Washington D.C., USA, 22-27 July 2012www.aids2012.org http://www.hivimmigration.ca www.hivimmigration.ca 6 CHAMP: Community Champions HIV/AIDS Advocates Mobilization Project (current) Improving IRN-PHA Treatment Access Study (2001)

7. Washington D.C., USA, 22-27 July 2012www.aids2012.org Engagement & Building Trust

8. Washington D.C., USA, 22-27 July 2012www.aids2012.org Engagement & Building Trust: 2001: Action research to improve treatment access for PHA with no health coverage Create safe space to give voice to lived experience Engage diverse legal, health, social service stakeholders & PLWHAs to collaborate in solving problems Build diverse ongoing coalition (CAAT) Ensure meaningful outcomes to address needs: Develop compassionate drug program Develop training program on HIV & Immigration Set up immigration legal service at HIV legal clinic TransformationThrough Collective Action www.hivimmigration.ca 8

9. Washington D.C., USA, 22-27 July 2012www.aids2012.org Collaborate to address care needs

10. Washington D.C., USA, 22-27 July 2012www.aids2012.org Improving Mental Health Service Access for I/R/N- PHAs Methodological & Structural Innovations Community identify research priority Participate in Research Co-investigate evidence Co-develop best practice recommendations Translate Knowledge to Action Concept mapping KTEA Training

11. Washington D.C., USA, 22-27 July 2012www.aids2012.org Community Empowerment & Succession

12. Washington D.C., USA, 22-27 July 2012www.aids2012.org Legacy Project: Capacity Building Through ‘Structured’ Mentorship (2009 - ongoing) www.hivimmigration.ca 12

13. Washington D.C., USA, 22-27 July 2012www.aids2012.org Addressing systemic inequities, stigma and discrimination

14. Washington D.C., USA, 22-27 July 2012www.aids2012.org Champ Study (2011 – 2014) 14 C ommunity C hampions H IV/AIDS A dvocates M obilization P roject – An intervention study to: Engage & mobilize newcomer PHA and Non-PHA leaders (faith, media, social justice) Pilot and evaluate 2 interventions: – Acceptance Commitment Training & – Social Justice Capacity Building Training Hivimmigration.ca

15. Washington D.C., USA, 22-27 July 2012www.aids2012.org Key Principles in building equitable & empowering partnership Success Failure Mutual trust Shared values Shared power Shared leadership Shared resources Shared knowledge Transparency Equity & Fairness Pragmatism Mutual trust Shared values Shared power Shared leadership Shared resources Shared knowledge Transparency Equity & Fairness Pragmatism www.hivimmigration.ca15

16. Washington D.C., USA, 22-27 July 2012www.aids2012.org Framework on collective empowerment Accountability Respect Promote equity & access Engage in capacity building Structural commitment Plan community succession Ensure PHA voices counted, meaningfully engaged in all processes Value lived experiences Recognize inequities & invest to remove barriers to participation & access Mutual learning: cultural competency/health literacy Organizational structure, policy & practice Mentoring to support progressive engagement, know when to retire

17. Washington D.C., USA, 22-27 July 2012www.aids2012.org Collective Empowerment Community succession: Passing the torch to affected communities From a service provider driven network at inception, CAAT is now a primarily PLWHA driven network governed by majority PLWHA leadership 17 www.hivimmigration.ca

18. Washington D.C., USA, 22-27 July 2012www.aids2012.org Access & Equity Award, City of Toronto 2009 18CAAT 2012

19. Washington D.C., USA, 22-27 July 2012www.aids2012.org Casey Award 2012 19CAAT 2012

20. Washington D.C., USA, 22-27 July 2012www.aids2012.org Think Tank 2012: Working Together

21. Washington D.C., USA, 22-27 July 2012www.aids2012.org Contact Information: Maureen Owino Programme Coordinator Committee for Accessible AIDS Treatment (CAAT) Email: maureeno@regentparkchc.org coordinator@hivimmigration.ca Phone: 416.364.2261 ext 2277 www.HIVimmigration.ca facebook.com/HIVimmigration @HIVimmigration