Meck Chongo1, Josée Lavoie1, Henry G. Harder1, Robert Hogg2,4, Eric A. Roth3
Vancouver Native Health Society
1-University of Northern BC, 2-Simon Fraser University, 3-University of Victoria, 4-BC-CfE HIV/AIDS
Purpose of Study
Discussion
Key ingredients in the beginning stages of study build-up:
To explore the impact of historic trauma (HT) on treatment in Aboriginal
males living with HIV and AIDS in British Columbia
• Recognition of “survivors” as those who attended residential school
and, secondary and subsequent generations of Aboriginal people
affected by the original trauma through various means (Bombay,
Matherson, & Anisman, 2011).
Research Questions
•
•
•
What role does the experience of HT play across generations, and
between direct and indirect survivors, in the treatment of HIV/AIDS?
What role can resilience play in the treatment of HIV/AIDS with respect
to HT?
What information or services can support healing from HT and
improve treatment-seeking behavior in a culturally safe way?
Methods
• Qualitative study over two years (2013 – 2015)
• Method of Interpretive Description (Thorne, 2008) and a Cultural Safety
lens will be used (Smye et al., 2010)
• 1 community: Vancouver
• Tri-Council Policy Statement provisions on ethical conduct for research
involving humans will be followed
• Ethics approval from Research Ethics Board at UNBC and letter of
approval from the Vancouver Native Health Society (VNHS ) research
committee
• Purposive and theoretical sampling (King & Horrocks, 2010) will be
used to recruit Aboriginal males, 15-64 years of age, who are on
HIV/AIDS treatment
• In-depth open-ended interviews with twenty-four participants and one
focus group will be conducted
• Interviews will be analyzed and themes developed.
• Rigor and credibility will be attained through triangulation, the criteria of
moral defensibility, disciplinary relevance, pragmatic obligation (Thorne,
2008), and through constant comparative & iterative analysis by
knowledge experts (i. e., supervisors & peer-researchers)
• Results will be brought back to knowledge users at VNHS and the
community for discussion and disseminated through various media for
advocacy efforts, policy and decision-making.
Year One: Starting the Process of Growth
Building with Community: Working from History
• Explicit integration of social context analysis, including the relations
of inequality - a shift away from conceptualization of “historical
trauma” as static & “historical,” to emphasis that HT in Aboriginal
people’s lives remains contemporary & current (Haskell, 2009).
• Drawing on literature on resilience (Ledogar & Fleming, 2008) &
posttraumatic growth (Triplett et al., 2012).
Building from a Relationship of Trust
• 2009 to date - Built a relationship with the VNHS
• Conducted research for master’s thesis - brought the realization that HT may
have both positive and negative effects on one’s health and wellbeing. Current
study builds on this.
• Engaging in informal conversations with males living with HIV/AIDS,
other service users, and co-researchers at the VNHS.
• Building, drawing on and extending relationships of trust
Reflecting on Community and Tradition
Next Steps in the Research
• “We are still here. We are not just survivors; we are the architects of our
survivance. We carry our Native philosophies into an ever-changing modern
world. We work hard to remain Native in circumstances that challenge or
threaten our survival. Our Lives is about our stories of survivance, but it belongs
to anyone who has fought……..discrimination, or stereotypes” (Alivizatou,
2012, p120).
• Year 2: September 2014 - August 2015
• Development of interview questions
• Application for ethics approval
• Data collection – interviews and focus group
• “I grew up knowing my cultural traditional practices and to me I find that, if my
spirit is low, I’ll not take my medication, any kind of medication or medicines
didn’t work or they don’t work as well” (Aboriginal male living with HIV/AIDS)
[Chongo et al., 2012].
• Analysis and writing dissertation
• Reporting to participants and knowledge users
Considering Daily Lived Experience
Materials Cited
• “It happens quite a bit. Stigma down here. There’s a lot of things out here to
make a person angry. A lack of recognition for me as a human being, okay,
that’s one of the things that I sadly don’t like at all. I hate it that they just, I’m just
a tool. I don’t have any connection in the community. I’m on the outside and so,
I don’t take medication” (Aboriginal male living with HIV/AIDS) [Chongo et al.,
2012].
Building on Strengths
• “But there’s an upside to everything,….well we don’t have anything to eat, ‘well I
spent lots of time where I didn’t eat for five days when I’d run away’ - so that’s
the upside - it makes you really tough. So it’s not just one way, plus am really
smart at the street level, but tougher in a way, so” (Aboriginal male living with
HIV/AIDS) [Chongo et al., 2012].
• Alivizatou, M. (2012). Intangible Heritage and the Museum: New Perspectives on Cultural Preservation.
Walnut Crek, CA: Left Coast Press.
• Bombay, A., Matheson, K., & Anisman, H. (2011). The impact of stressors on second generation Indian
Residential School survivors. Transcultural Psychiatry September, 48(4), 367-391
• Chongo, M., Lavoie, J. G., Hoffman, R., & Shubair, M. (2012). Determinants of Adherence to HAART in
Aboriginal Men in the DTES of Vancouver. Canadian Journal of Aboriginal Community-based HIV/AIDS
Research (CJACBR) (4).
• Haskell, L., & Randall, M. (2009). Disrupted attachments: A social context complex trauma framework and
the lives of aboriginal peoples in Canada. Journal of Aboriginal Health, November, 48–99
• King, N., & Horrocks, C. (2010). Interviews in Qualitative Research. London: Sage.
• Ledogar, R. J., & Fleming, J. (2008). Social Capital and Resilience: A Review of Concepts and Selected
Literature Relevant to Aboriginal Youth Resilience Research. Pimatisiwin: A Journal of Aboriginal and
Indigenous Community Health, 6(2), 25-46.
• Smye, V., Josewski, V., & Kendall, E. (2010). Cultural Safety: An Overview. First Nations, Inuit and Métis
Advisory Committee, Mental Health Commission of Canada.
• Thorne, S. (2008). Interpretive Description. Walnut Creek, CA: Left Coast Press.
• Triplett, K. N., Tedeschi, R. G., Cann, A., Calhoun, L. G., & Reeve, C. L. (2012). Posttraumatic growth,
meaning in life, and life satisfaction in response to trauma. Psychological Trauma: Theory, Research,
Practice, and Policy, 4, (4), 400-410
Funded by:
1) UNBC Graduate Entrance Research Award 2012-2015
2) Canadian Institutes of Health Research (CIHR) Doctoral Research Award 2012-2015
Conflict of Interest Disclosure: “I have no conflicts of interest”