A2 Promoting Awareness and Prevention of Diabetes and HIV

Promoting Awareness and Prevention of Diabetes and HIV: A Faith-based community Approach

Vivia McCalla–Diabetes Nurse Educator Racquel Bremmer- Health Promoter AOHC Conference

- June 5th 2013

Where are we located?

Women’s Health in Women’s Hands Community Health Centre 2 Carlton Street, Suite 500 Toronto, ON M5B 1J3 Phone: 416-593-7655 Fax: 416-593-5867 www.whiwh.com

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Outline of Presentation • Mandate and Service Delivery Framework of WHIWH • How Principles of Access and Equity can inform program development • Development of initiatives to engage faith-based organizations in chronic disease prevention programs for ethno-racial communities across the GTA • Issues to consider during intervention development

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Promoting Awareness and Prevention of Diabetes and HIV: A faith-based community approach

This workshop highlights initiatives used by Women's Health in Women's Hands to engage faith-based communities in Toronto.

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Mandate • Feminist, Pro-choice, anti-racist, and multilingual health center for women.

• We are committed to working with women from diverse backgrounds, particularly immigrant and refugee black women and women of colour, young women, women with disabilities and women over the age of 16.

• We prioritize women from Africa, Caribbean, Latin America & South Asia.

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Framework of Service delivery •

Services are framed within an anti-oppression framework

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Recognizes the role and impact of multiple oppressive systems

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Acknowledges: –

The necessity of allies, limitations and boundaries required when working with marginalized communities

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Need to understand the effects of religion, power 6 and privilege.

Implications for Service Delivery An Anti-Oppression healthcare framework includes: • Involving marginalized groups in decision making at all levels of the healthcare organization • Ensuring that healthcare providers are representative of client populations • Offer integrated multidisciplinary services where clients can make one visit for more than a single purpose • Be willing to take healthcare services to the community • Develop services based on client definitions of accessibility, cultural acceptability and availability of services

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Canadian Diabetes Statistics • In Canada, more than 3 million Canadians are living with diabetes and this number is expected to reach 3.7 million by 2020.

• Approximately 90% of people with diabetes have type 2 diabetes.

• The number of people with type 2 diabetes is increasing dramatically due to a number of factors: • The population is aging.

• Obesity rates are rising. 1 in 4 Canadians adults are overweight or obese • Canadian lifestyles are increasingly sedentary 8

Canadian Diabetes Statistics • Aboriginal people are 3-5 times more likely than the general population to develop type 2 diabetes.

• Almost 80% of new Canadians come from populations that are at higher risk for type 2 diabetes.

These include:  Aboriginal,  Hispanic  Asian  South Asian  People of African descent.

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Overweight and Obesity Rates in Canada

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The Cost of Diabetes

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HIV and its effect on African, Caribbean and Black communities across Ontario

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WHIWH HIV Program: Determining Need • In 1999 the centre undertook a needs assessment • Consulted with stakeholders/constituents to determine the direction to be taken in providing HIV Services • The Process involved: – focus groups with women from the communities we work with – Service providers who were providing HIV/AIDS prevention, support and care services particularly to the black communities – policy makers – Women living with HIV/ AIDS.

• Our current model is based on findings that emerged from the consultation • Program integrated within a larger health framework 14 • Community and membership driven

GOAL: REDUCE VULNERABILITY AND IMPACT OF HIV/AIDS AMONGST CENTRE’S CLIENTS AND THEIR COMMUNITIES WOMEN’S HEALTH IN WOMEN’S HANDS HIV/AIDS COMMUNITY INITIATIVE The program has six areas of specialization which fully integrated into the broader health programs offered at Women's Health in Women's Hands

HIV/AIDS RESEARCH RESOURCE DEVELOPMENT: Develop HIV/AIDS educational materials e.g. posters, booklets/manuals and brochures that are culturally and linguistically appropriate.

Initiate and/or participate in research studies to improve prevention education, support and care of women in our target populations infected and affected by HIV/AIDS and their communities.

ADVOCACY/NETWORKS/ PARTNESHIP BUILDING

PREVENTION EDUCATION AND OUTREACH To increase knowledge, awareness and skills at the individual/client and community/agency/ and institutional level of: HIV\AIDS, Safer sex attitudes and behaviors and Risk reduction tools, strategies, etc.

CARE AND SUPPORT OF WOMEN OF COLOR INFECTED AND AFFECTED BY HIV/AIDS. Provision of counseling, support, care and treatment for women living with HIV/AIDS and their care givers, families, etc.

Advocate/Develop linkages/networks and/or partnerships with: Different levels of government/AIDS service organizations, HIV clinics, Social service agencies, Universities, ethno specific organization, etc for information and resource sharing, to ensure inclusion of issues of black women and women of color in HIV/AIDS policies and programs.

TRAINING AND SKILLS DEVELOPMENT Increase the skills of staff of the centre and others in HIV/AIDS and related Issues for effective delivery of service.

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HIV tests and proportion HIV tested HIV-endemic, Ontario 2008 Health Region

Estimated HIVendemic population

HIV tests in 2008

Proportion HIVendemic population tested in 2008

Toronto

109,740

3,381

3.1%

Ottawa

15,690

1,094

7.0%

Central East, other

90,900

911

1.0%

Central West

21,650

269

1.2%

Southwest

7,080

356

5.0%

Eastern, other

1,760

408

23.2%

Northern

1,020

74

7.3%

247,840

6,493

2.6%

TOTAL, ONTARIO

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HIV and the ACB Communities • Women accounted for an estimated 22% of all people living with HIV/AIDS in 2008.

• African and Caribbean people make up 4% of Ontario's population with 76% us living in Toronto.

• Over 20% of all Canadian HIV diagnosis in 2011 were attributed to the African Caribbean and Black communities.

• Over 59% of HIV infections occurred after settlement in Canada .

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Proportion of HIV diagnoses of HIV-endemic by age in Ontario, 1985-2009 35

Proportion of HIV Diagnoses ( %)

30 1985-1989 25 1990-1994 1995-1999

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2000-2004 15

2005-2009

10 5 0 <15

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54

55+ 18

YEAR

Report on Sexually Transmitted Infections in Canada, PHAC 2009

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Social factors that increase risk of contracting HIV • • • • • • •

HIV Related Stigma, Discrimination and Denial Racism Gender Inequality Sexual Violence Homophobia Attitudes Towards Health and Well-being Attitudes Towards Sex: Sex as a Taboo Subject • Unprotected sex with multiple Sex Partners • Poverty 20

How Principles of Access and Equity can Inform Program Development:

The Ambassador Program:

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Highlights • 76 Diabetes Ambassadors trained as peer educators • 149 Workshops delivered • 1394 Participants reached • Over 200 new clients enrolled in our diabetes program

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Collaborating faith settings:

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Taric Islamic Temple True Church of Jesus Fellowship Toronto SDA Faith United Church

• New Hope Tabernacle • Council of Imams (Ontatio) 23

Group activity â&#x20AC;˘ The Diabetes Jeopardy Game

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THANK YOU • Question and Answers • Group Discussions

• Additional Resources available at: www.whiwh.com

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