1 National HIV/AIDS Commission, Barbados HIV/AIDS Research Symposium Researching who? Engaging communities in the response to HIV Winston Husbands, PhD AIDS Committee of Toronto African and Caribbean Council on HIV/AIDS in Ontario October 2007

2 Outline Community engagement in the response to HIV and AIDS recognizing the transnational dimension of Caribbean identity and relationshipsrecognizing the transnational dimension of Caribbean identity and relationships Issue # 1 community engagement as a guiding principle for framing the response to HIV/AIDS Issue # 2 implications of community engagement for HIV social and behavioural research

3 Community engagement: building critical understanding 1  Community engagement Mobilizing communities Mobilizing communities Engaging governments and institutions Engaging governments and institutions  Critical consciousness Social structure Social structure Community Community Family Family Individuals/agency Individuals/agency

4  14% of people living with HIV are Caribbean or African.  The number of Caribbean and African people infected with HIV increased by over 80% in HIV among Caribbean and African communities in Canada 2,3 Canada  7-10% of people infected with HIV are Caribbean or African  6-12% of new infections are among people from the Caribbean and Africa

5 HIV prevalence in the UK, ,5 Estimated % of each population group (16-44) infected

6 Global HIV prevalence, 2006 Adult (15-49) prevalence (%) 6

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8 Social context of individual behaviour Individuals CommunitySocial Structure Family

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11 Gay and bisexual men and MSM in Toronto Research at ACT and ACCHO,

12 Engagement and advocacy among Caribbean and African communities in Ontario  HIV Endemic Working Group formed in 1998 – apparent increase in numbers of people from Africa and the Caribbean becoming infected with HIV  Working Group advocates to AIDS Bureau, Ministry of Health to monitor HIV epidemic among people in Ontario from Africa and Caribbean  AIDS Bureau commissions epi report which was completed in 1999  Working Group becomes a Task Force to draft a Caribbean and African strategy – completed in 2003

13 Engagement and advocacy among Caribbean and African communities in Ontario  1997 – 2000: Working Group and Task Force organize public forums with Caribbean and African communities to discuss HIV/AIDS and mobilize communities  Jan the HETF became the African and Caribbean Council on HIV/AIDS in Ontario to coordinate the Strategy  April Strategy and ACCHO officially launched

14 Stigma Study Caribbean and African communities in Toronto

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16 Involving communities in the research agenda

17 Knowledge translation and exchange Pull efforts Facilitate user’s ability to identify (i.e., “pull”) relevant research when they need it to inform decision-making (e.g., website containing reports, fact sheets, reviews) Push efforts Actively disseminate research findings (i.e., actively “pushing” our research to those who can use it) (e.g., producing and distributing reports, summaries, etc.) Exchange Forums and meetings with various groups and stakeholders in various locations to discuss research (e.g., advisory committees, workshops, forums, etc.)

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20 References 1 Campbell, C. (2003). ‘ Letting Them Die’: Why HIV/AIDS Programs Fail. Oxford: International African Institute and James Currey. 2 Remis, R., C. Swantee, L. Schiedel, M. Merid and J. Liu (2006). Report on HIV/AIDS in Ontario Ontario HIV Epidemiological Monitoring Unit. 3 HIV in Canada Among Persons from Countries where HIV is Endemic (December 2005). HIV/AIDS Epi Update. (December 2005). Centre for Infectious Disease Prevention and Control. Public Health Agency of Canada. 4 UK Collaborative Group for HIV and STI Surveillance (2005). HIV and Sexually Transmitted Infections in the United Kingdom: Part 4 – Black and Minority Ethnic Populations. 5 UK HIV/AIDS FAQs. AVERT ( 6 UNAIDS (2006). AIDS Epidemic Update: December 2006.

21 Acknowledgements Lydia Makoroka Nicole Greenspan Sheila Thompson Erica Lawson Many thanks for your help and advice. Thank you. One love!