Washington D.C., USA, 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

Washington D.C., USA, 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

Washington D.C., USA, 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

Washington D.C., USA, 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

Washington D.C., USA, 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

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

Washington D.C., USA, July 2012www.aids2012.org Engagement & Building Trust

Washington D.C., USA, 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 8

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

Washington D.C., USA, 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

Washington D.C., USA, July 2012www.aids2012.org Community Empowerment & Succession

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

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

Washington D.C., USA, 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

Washington D.C., USA, 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

Washington D.C., USA, 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

Washington D.C., USA, 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

Washington D.C., USA, July 2012www.aids2012.org Access & Equity Award, City of Toronto CAAT 2012

Washington D.C., USA, July 2012www.aids2012.org Casey Award CAAT 2012

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

Washington D.C., USA, July 2012www.aids2012.org Contact Information: Maureen Owino Programme Coordinator Committee for Accessible AIDS Treatment (CAAT) Phone: ext