Migration as a critical life

transition and resiliency

strategy among Asian MSM

in Toronto Richard Utama, Alan Li, Maurice Poon, Alvi Dandal, Christian Hui, Josephine Wong, Noulmook

Sutdhibhasilp

No Conflict of Interest

Acknowledgement

All our research participants

Our research team

Funding Partner: CIHR

Our Research Team

Research Team:

Principal Investigators: Alan Li (CAAT), Richard Utama (ACAS),

Maurice Poon (York University)

Co-investigators: Y.Y. Chen (U.Toronto), Constantine Cabarios

(ACAS),Josephine Wong (Ryerson University), Barry Adam (University

of Windsor), James Murray (AIDS Bureau, MOH), Noulmook

Sutdhibhasilp (ACAS)

Advisory Committee: Peter Ho (RPCHC), Darrell Tan (SMH), Kenneth

Fung (UHN), David Yeh (CTYS), Kenta Asakura (UT), Okjan Ohinoo

(QAY), Aries Cheung (ACAS), Hywell Tuscano (CATIE), Kenneth Poon

(ACAS), Andrew Miao (ACAS)

Staff: Alvi Dandal, Christian Hui

Background

Literature suggests that Asian & Pacific Islander MSM has similar level

of risk behaviors as other MSM yet the HIV prevalence is lower…..

(Wei, et. al)

Most research on MSM and Asian MSM have focused on risks and

challenges vs. resiliencies and strengths

Through needs identified via community health promotion forum and

research think tank, Asian Community AIDS Services (ACAS) developed

the community-based research study: Asian Men Pathways to

Resiliency (AMP2R), funded by CIHR CBR Catalyst Grant

Objectives are to explore participants' critical life events and

factors that affect their sexual health and resiliency strategies.

Method

Resiliency: "Our ability to cope with life events and recover from

adversity“

Six focus groups:

5 MSM groups: (N=51)

3 mixed MSMs

1 MSM Youth (Age <29),

1 PHA

1 Service provider Focus group (N=12)

Key Discussion Questions:

Significant life events

Strategies to navigate and circumvent these events

Results Demographics:

Age: 20-29 (25), 30-39 (9), 40-49 (10), 50-59 (5), 60+ (1)

Born in Canada: 11

Born outside Canada: 40 (China/HK/Macau, Philippines,

Years in Canada: 20+yrs (15), 1-5yrs (5)

Immigration: Citizen (25), Landed/PR (9), Students/Other TRP (6)

Key Themes:

Coming Out

Sex, Dating & Relationships

HIV

Migration

Migration The movement of people from one place in the world to another for the

purpose of taking up permanent or semi-permanent residence, usually across

a political boundary – National Geographic

Why do people move?

(images courtesy of college.holycross.edu)

Results

- Migration increases vulnerability to HIV/STIs

among ethno-racial MSM (Myers et al., 2001)

(Poon, M.K.L. and Ho, P.T., 2002)

+ Migration fosters resiliency and sexual health

efficacy.

Intrapersonal

Interpersonal

Community

Systemic/Structure

Results

Intrapersonal

"...when I came to Canada, I had a hard time. I gave up a lot of things in

my home country. I had a good job. I was a financial consultant. I had a

lot of money, I got a lot of things. I moved to Canada, because to

pursue a different life here. But when I was here, I couldn’t find a

job. I went through a very hard time. I was depressed; I couldn’t find

a job....So I went back to school, to study another degree. A master’s

degree. That’s why I landed a job as a social worker right now. So I am

very happy. But not because HIV thing, well, I don’t say that’s a bad

thing to me.“

– Mainland Chinese HIV poz participant moving from Beijing to Toronto

Results

Intrapersonal/Interpersonal

“Luckily I, I saved a lot of money when I was in Asia, so I was fine

financially, but I have no support from them since then, like my family.

And so that’s the second part that I came up, I came out being a gay

person and I also put the other one was removing myself from my family

and my church and even though I was put in that situation, but mentally I

have to go through that to actually forcing myself to remove myself from

them mentally…they are really important to me but I feel my family’s

toxic to me…I changed my phone number because sometimes my dad

and mom call and they would just leave messages”

– Vietnamese MSM participant from US to Canada

Results

Community

“Actually I was quite happy here as a gay man because it’s more open,

especially in Toronto. So I was very lucky to be here, I think. Then I met

my boyfriend and my life was pretty good in the beginning when I was

here. And so, I have no complain. So, it is the same as HIV+. I was

diagnosed in the 1990’s, and at least I am here and I have all the

services and information and support group and I was younger and

healthier to enjoy life. That’s why it was good for me. It’s not easy but

it’s not bad. It’s pretty good actually. And I am still here, after 23 years.”

– Hong Kong Chinese HIV Poz participant from Hong Kong moving to Toronto

Results

Systemic/Structural

“In Canada there is more information about LGBT group available, so I

receive more information about like my own identity but in China

people don’t generally talk about it. Like we refuse to even put a word

gay in the media until two years ago, so that was like a topic never been

mentioned and it’s like a black hole in this culture thing that you just

never hear about.

– Mainland Chinese MSM participant moving from Beijing to Australia

(Perth) then to Toronto

Reflections

For many Asian MSM, migration represents a proactive effort to seek

refuge from homophobia and social oppression, explore gay identity,

greater self independence from family, access to treatment/support,

build new community

Migration process is also linked to many losses (economic, social,

cultural) and new barriers and discrimination (language, racism,

professional)

Many Asian MSM able to utilize migration as a process for self

motivation and growth; gain transferrable skills and foster resiliencies

amidst multiple losses and challenges

Next Steps

Detailed thematic transcript coding and In depth data analysis to

better understand the specific pathways and factors to resiliency

Engage participants and stakeholders to translate findings to develop

full scale research study to identify and evaluate resiliency

intervention(s)

Knowledge transfer exchange to share lessons learnt with other MSM,

racialized and other marginalized communities to explore

collaborative initiatives

Parting Thought

"The grass is green where we water it,"

Asian, female, 19 - The Cultures, Identities, and Voices Study