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Polyvalence: Research objectives

Conjunctures of theory, method and studies in sexuality: explaining the absence of HIV prevention for bisexuals in Canadian state policy - Viviane Namaste, T. H. Vukov, Nada Saghie, Joseph Jean-Gilles, M. Lafrenière, Jacky Vallée, M. Leroux, Andréa Monette, Robin Williamson.

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Polyvalence: Research objectives

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  1. Conjunctures of theory, method and studies in sexuality: explaining the absence of HIV prevention for bisexuals in Canadian state policy - Viviane Namaste, T. H. Vukov, Nada Saghie, Joseph Jean-Gilles, M. Lafrenière, Jacky Vallée, M. Leroux, Andréa Monette, Robin Williamson

  2. Polyvalence: Research objectives • determine the HIV prevention and sexual health needs of people who have sexual relations with both men and women • create and distribute relevant educational material • educate service providers, policymakers, researchers and public health workers

  3. Questions why is there no HIV education that explictly addresses bisexual behaviour in Canada, more than 25 years into an epidemic? how is it that bisexual men and women cannot access sexual health information relevant to their lives, at the same time that they are blamed for the spread of HIV into « the general population » in the mass media? what can be done about the lack of HIV education for people who have sex with both men and women?

  4. Theories and methodologies • critical studies in epidemiology • (Raymond Massé, Culture et santé publique • J. Breihl, Epidemiología Crítica, • James Trostle, Epidemiology and Culture) • institutional ethnography (Dorothy Smith) • participatory action research

  5. Relations between theory and method • historically, traditional epidemiology informs social science research in the field of HIV/AIDS (Gould, The Slow Plague) • social scientists focus on behaviour with regards to risk-taking vis-à-vis HIV

  6. Relations between research, policy and education • social policy based on research – « evidence-based medicine » • social policy in turn informs what kinds of HIV prevention and services are available on the ground. It outlines the programmes and mechanisms for funding. • research informs policy which in turn informs education

  7. The cultural construction of epidemiological categories • the “Men who have sex with men” category • -- absence of female partners • -- reinscription of certain cultural stereotypes • -- gay male frame of reference concerning sexuality (Myers et al 1993, The Men’s Survey) • existing research in HIV/AIDS literally makes bisexual men and women disappear

  8. Canadian state policy on HIV/AIDS and a « priority population » model • Aboriginal people • gay men • people living with HIV/AIDS • people who use injection drugs • people from countries where HIV is endemic • prisoners • women at risk • youth at risk

  9. « Stakeholder consultation » in Canadian state HIV/AIDS policy • definition of community based organizations and AIDS Service Organizations as « community » • transformation of community organizations in a context of neo-liberalism (from grassroots mobilization to service provision)

  10. Community organizations were faced with the dilemma that greater recognition and funding actually diminished their autonomy and reinforced a service agenda. With this orientation, groups shifted from a membership or social movement base to a client focus. This redefinition is inherently depoliticizing. Clients are to be served and have a less active – or no – role in either the organizations’ internal processes or on wider social issues. At best, they are represented rather than mobilized. Thus, the form of political representation became lobbying by coalitions of community organizations promoting the needs of a particular population. - Eric Shragge, Activism and Social Change, 55.

  11. Polyvalence: An Action Research Project • • recruitment: 87 interviews • • 3 different groups: bisexual women; swingers; people with bisexual practices who do not necessarily identify as bisexual • • focus on information needs, not sexual behaviour • a community-based Advisory Committee to oversee project • • analysis and methods drawn from participatory action research and grounded theory (Glaser & Strauss) • • creation of educational material with the Advisory Committee

  12. Methodological considerations • concern with sexuality, but not from a « queer » or LGBT perspective • strategies which, while on the surface are « inclusive » (e.g., an LGBT model) do not reach many people who have sex with both men and women • What I liked about the ad, it says, you know, « people that have sex, » you know,  « with women and men. » They didn’t say « bisexual » or « people, queer. »

  13. Research findings, Polyvalence • avoid fear-based campaigns • include both male and female partners in education • address women’s health needs, including woman-to-woman transmission of HIV and STDs • avoid a technical, specialized vocabulary (e.g., « seropositive, » « STIs ») • include relevant information on protection with multiple partners • offer practical information in terms of sexual practices • improve access to condoms in swinger clubs and saunas • link HIV education to health services • offer education and services in mainstream (not lesbian/gay) settings

  14. Results: adapting education for swingers « Because me, well I wouldn’t necessarily think about it. Sure, in thinking about this for 2 minutes, of course it’s true. But I had never thought about having to change a condom, you know, before you change partners, that too, you know? …What happens with, I don’t know, an evening of six people, for instance. You’re not going to think about bringing, you need at least six condoms per man. This isn’t something that’d I had thought about from the get go. It’s totally logical, it’s just that … since all of the information available is … based on exchanges between two people, it’s not the kind of detail … that I had heard about before. »

  15. Results: reaching non-gay MSM I’m going to tell you what I don’t like. It’s these photos here. Because me, it’s like when we use, when sex is put there, it’s always anal sex that is used. And I mean, there are other positions than that! It’s not because we’re two men that there isn’t something else… I don’t like that very much. Q: Hmmmm-hmmmm. Why? R: Well, first of all, when I have a homosexual relation, I don’t ever have a relation like that. It looks like a man who is fucking another man. Well (laughs), I don’t like that, I don’t like that.

  16. Results: Gender bias in education and services Most times when there were problems, it’s that, the documentation that they gave me was for men. There wasn’t any for women, they told me, well you know, take this, read this, it pretty much applies to women as well. But it wasn’t, it was for men. It was for men, you know. It didn’t apply to me. That’s the only trouble I’ve had. And here in Montréal at a certain time we asked to do an evening, so that we could learn more about contraceptives. And the guy who came from Séro-Zéro only gave us contraception for men, only.

  17. www.polyvalence.ca

  18. Concluding thoughts and questions • need for critical analysis of relation between research, policy and education – and the gaps therein • good reflection on theoretical underpinnings of research can help us identify appropriate choice of methodologies (e.g., focus on information needs rather than behaviour; need to rethink relation between race and sexuality in MSM and public health research; lines of fault in knowledge) • now more than ever, need for a critical analysis of the limits of community based organizations and their relations to the state

  19. Concluding thoughts and questions • can we imagine « community » that isn’t funded by the state? • profound limits of an identity-based response to HIV education (need for mainstream education which incorporates messages about same-sex relations, not necessarily making « bisexuals » a new target population) • if an identity-based response is limited, what are the challenges of creating mainstream education? • what are the limits of organizing our response to HIV/AIDS according to priority populations (ie identities)?

  20. Concluding thoughts and questions • our empirical work, but also our theoretical reflections, are strengthened to the extent that they occur in a comparative manner. Moreover, rigourous comparative work cannot occur only using the English language as a basis for knowledge • a critical agenda on HIV/AIDS research includes one wherein social science inquiry informs epidemiology and public health • is « interdisciplinarity » even possible? • what counts as knowledge, and what realities get left out of the equation when only certain forms of knowledge are considered?

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