Title: The Developing World Epidemic in the Developed World
1The Developing World Epidemic in the Developed
World
- The AIDS Epidemic Among African and Caribbean
Communities and other Black Canadians - Presenter Esther Tharao
- Womens Health in Womens Hand CHC/
- African and Caribbean Council HIV/AIDS in
Ontario - August 16th, 2006
2Introduction
- African and Caribbean people of African decent
have become an important component of the
Canadian epidemic - In Ontario they constitute the fastest growing
category of groups affected by HIV/AIDS (13.8 of
all people living with HIV/AIDS) - African and Caribbean women constitute
approximately - 33 of all HIV infections among women in Ontario
- 66 of all women living with HIV/AIDS in Toronto
- Rates of infection have increased by 87 between
1999 and 2004 with annual increase of 13.3
(Remis 2006).
3Introduction (contd)
- In 2004, 18.5 of all new diagnoses in Ontario
were among African and Caribbean people - Substantial HIV transmission is occurring in
Canada - It is estimated that 22-59 of HIV infections in
Ontario occur after migrating to Canada (Remis
2006) - 12.2 of prevalent infections in Canada are among
black people
4An Emerging Epidemic
- Community mobilization among black populations
started in Ontario - What were the signs of a growing epidemic?
- Rising numbers of those seeking support and care
in the mid 90s - Emerging data in 1997/98
- 70 of children born with HIV involved mothers
from Africa and the Caribbean (1994-96) - 10 of all people diagnosed with AIDS in 1996
were African and Caribbean people - African women constituted 32 of AIDS related
deaths in Ontario in 1996 - Researchers produced numbers without context
((CAHR 1997) - Lack of data on extent of epidemic and driving
factors
5Engaging African and Caribbean communities
- 1997
- 1st HIV/AIDS forum organized by the two African
AIDS Service Organizations (ASOs) - Aim of forum highlight status of epidemic and
facilitate community discussion and mobilization - 1998
- 2nd HIV/AIDS forum organized by an expanding
circle of providers and also included government - Aim - To share information and strategize with
other providers on how to deal with HIV/AIDS
issues in African and Caribbean communities - 2000
- Working conference on Creating Strategic
Partnerships to Address HIV/AIDS in African and
Caribbean Communities - Aim
- strengthening existing partnerships, identify new
partnership opportunities in African and
Caribbean communities - Develop strategies for prevention and support
services in context of the determinants of health
6Emergence of a Strategic Plan and coordinated
Actions
- An HIV Endemic Working Group (HEWG) with expanded
membership was formed in 1998 (ASOs, CHCs,
government) - Commissioning of an epidemiologic report to
quantify the epidemic in Ontario completed in
1999 - Working group expanded to become the HIV Endemic
Task Force - Role of Task Force - spearhead development of a
strategic plan
7Emergence of a Strategic Plan and coordinated
Actions (contd)
- Strategy to Address Issues Related to HIV Faced
by People from Countries where HIV is Endemic
completed in Dec. 2003 - Jan. 2004 - the HETF became the African and
Caribbean Council on HIV/AIDS in Ontario (ACCHO).
- March/April 2005 ACCHO, the Strategy and
Strategy for Life Campaign launched
8Role of ACCHO
- ACCHO has three major roles
- Coordination and support of Strategy
implementation, revision/renewal, monitoring and
evaluation. - Advising and advocating on HIV/AIDS issues
affecting African and Caribbean communities. - Promote the greater involvement of African and
Caribbean people living with HIV/AIDS in the
response to HIV/AIDS. - Goal of African and Caribbean HIV/AIDS Strategy
- To reduce the spread of HIV among African and
Caribbean people in Ontario and improve the
quality of life for people infected and affected
by HIV
9Strategy Guiding Principles
- Service delivery must be based on an antiracism,
gendered and anti-oppression framework - Must be grounded in community based,
participatory action and leadership - Must foster self determination for African and
Caribbean people - Services must meet the needs of a range of people
and groups (e.g., youth, women, gay men and other
MSM, lesbians, trans people and IDUs).
10Strategy Objectives and strategic directions
- Coordination
- Service delivery within different settings
- Accountability of mainstream organizations to
African and Caribbean Communities - Advocacy
- Community Development
- Empowerment and capacity building
- Increasing awareness and being a voice
- Supporting local action
- Community engagement
- Research
- Setting research priorities and policies
- Promoting self determination through research
- Promoting research that is respective respectful
and recognizes autonomy
11Activities to move strategy forward
- Setting a research agenda
- Research conference (ACCHO/OHTN) April 28-29th,
2006 bring together researchers and community
members to discuss and develop priorities - Working with Public Health Agency of Canada to
improve Epi and Surveillance reporting and Epi
Update report production - Undertaking research
- stigma and discrimination project partnership
between ACCHO and the HIV Unit, University of
Toronto - Black MSM project
- Optimizing HIV prevention
- Expansion of prevention activities across the
province - HIV prevention campaign
12Activities to move strategy forward (contd)
- Capacity Building
- Prevention guidelines for service providers and
organizations that work with African and
Caribbean communities - Training manual and training activities to be
done in Toronto, Ottawa and Montreal March 2006
13Creating a National Platform
- Have undertaken preliminary work to lay the
groundwork for a National Strategy for Black,
African and Caribbean communities in Canada - Done through the National Spring-boarding project
14Creating a National Platform (contd)
- Funded by the Public Health Agency of Canada
through the Interagency Coalition on AIDS and
Development (ICAD) and overseen by a national
steering committee. - Project Objective to conduct preliminary
research that will contribute to the development
of a national HIV/AIDS strategy for Black
Canadian, African and Caribbean communities. - Project developed in response to
- the disproportionate number of Black people
testing HIV positive - the need identified, Canada-wide, by AIDS service
organizations on how to best respond to the
increasing number of Black people testing
positive/seeking HIV/AIDS services.
15Creating a National Platform (contd)
- Work completed to date
- Environmental scan
- National consultation to build strategy
framework. - Next Phase consultation with all stakeholders
across the country
16Lessons learned from ACCHOs Experiences
- Need to move from Epidemiologic terminology to
the reality of who is affected AND needed to be
included in the Strategy - Move from populations from HIV Endemic countries
to African and Caribbean communities - Shift away from being the HIV Endemic Task Force
to ACCHO - New shift to include all black people living in
Canada Springboard Project - Creating room to facilitate voices within the
African diaspora living in Canada - Need to engage Intersectionality based on
gender, race, sexual orientation, colourism,
classism etc. within an anti-racist,
anti-oppression framework