Alan Li, M.D. Committee for Accessible AIDS Treatment Toronto, Canada

1. 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. 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 www.hivimmigration.ca http://www.hivimmigration.ca 2

3. Canadian Context • 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. 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. Translating needs to community action www.hivimmigration.ca

6. www.hivimmigration.ca Improving IRN-PHA Treatment Access Study (2001) From Access to Equity Think Tank (2006) Mental Health Service for IRN-PHAs Research (2007) KTE: Mobilizing Knowledge into Action (2008) MEL: Mobilizing Ethnoracial Leaders Against HIV Stigma & Discrimination (2009) Legacy Project: Structured Mentorship (2009 – ongoing) CHAMP: Community Champions HIV/AIDS Advocates Mobilization Project (current) http://www.hivimmigration.ca

7. Engagement & Building Trust

8. www.hivimmigration.ca • 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 Transformation Through Collective Action

9. Collaborate to address care needs

10. Improving Mental Health Service Access for I/R/N-PHAsMethodological & Structural Innovations Community identify research priority Participate in Research Concept mapping Co-investigate evidence Co-develop best practice recommendations Translate Knowledge to Action KTEA Training

11. Community Empowerment & Succession

12. www.hivimmigration.ca Legacy Project: Capacity Building Through ‘Structured’ Mentorship(2009 - ongoing)

13. Addressing systemic inequities, stigma and discrimination

14. Community Champions HIV/AIDS Advocates Mobilization Project – 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 Champ Study (2011 – 2014)

15. www.hivimmigration.ca Key Principles in building equitable & empowering partnership Mutual trust Shared values Shared power Shared leadership Shared resources Shared knowledge Transparency Equity & Fairness Pragmatism

16. Framework on collective empowerment • Accountability • Respect • Promote equity & access • Engage in capacity building • Structural commitment • Plan communitysuccession • 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. 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 Greater Involvement of People Living with HIV/AIDS www.hivimmigration.ca

18. CAAT 2012 Access & Equity Award, City of Toronto 2009

19. CAAT 2012 Casey Award 2012

20. Think Tank 2012: Working Together

21. 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