Cultural diversity and men who have sex with

men:

a review of the issues, strategies and

resources.

Maria Pallotta-Chiarolli

Advisory Committee

Sue Kippax

Paul Van de Ven

Edward Reis

Juliet Richters

Ken Wong

Garrett Prestage

Eamonn Murphy

Alan Thorpe

2

Contents

1. Introduction

2. Issues

Ethnic identity and community

Socio-cultural constructions of

masculinity

Gay identity and community

Location and position within the wider

Australian society e.g. age, class,

rural/urban, English literacy

Health services and organisations

3. Strategies in addressing issues

4. Conclusion: Beyond ‘problematising culture’

and ‘culturalising problems’

3

Appendix A. Existing projects and strategies

Appendix B. List of persons and organisations

participating in the audit

Appendix C. Annotated bibliography of

Australian texts and resources (includes cited

references)

Articles

Audio-visual and other resources

Books and monographs

Book chapters

Conference publications

Project reports

Miscellaneous

4

1. Introduction

Sexuality is socially constructed, inseparable

from its social, cultural and political

contexts. While sexual behaviours may be

superficially similar, the meanings attached

to these behaviours may be different across and

within cultures. Language which exists around

these behaviours often reflects these meanings.

Similarly, the meanings of and responses to

illness and health, particularly in relation to

sexual health, differ across and within

cultures. Factors such as class, gender,

religion, geographical location and level of

education affect cultural constructions of

sexuality and illness.

HIV/AIDS services, agencies and organisations

have recognised and acknowledged that

monocultural and monolingual strategies in

5

relation to the sexual health of men who have

sex with men from diverse cultural and

linguistic backgrounds are often limited in

application and effectiveness. A diversity of

strategies and resources are required to

address the differences inherent within broad

categories such as ‘non-English-speaking

background’ (NESB) and ‘men who have sex with

men’ (MSM).

If we consider that according to the 1991

Census, 22% of Australians were born overseas

or had at least one parent who was born

overseas, and that 58% of those people born

overseas come from non-English speaking

countries, there is quite a diversity of

cultural meanings of sexuality and responses to

sexual health and illness. This is accentuated

by the fact that there are more than 130

different cultures and languages spoken in

Australia (Camit, 1997).

6

However, it is extremely difficult to

determine the number of NESB MSM in Australia,

or even specific cultural, linguistic and other

data in relation to HIV-positive NESB MSM.

Who and how many are there, may seem to an

outsider to be the question on which an

evaluation of monies spent, not to say services

delivered, is essentially dependent. Yet, over

a decade of HIV/AIDS, we have somehow managed

to proceed without formally answering it

(Eisenberg et al, 1993).

National surveillance for AIDS is coordinated

by the National Centre in HIV Epidemiology and

Clinical Research (NCHECR). Data on country of

birth and languages spoken at home are

nationally collected but not necessarily

publicised (see Eisenberg et all, 1993; Yueming

et al, 1996). Different state and territory

health departments have their own varying data

collection systems, such as the breakdown into

7

Caucasian, Asian and Other used in South

Australia (see Temple-Smith & Gifford, 1996).

Yet, as many health agencies and services point

out later in this report, no-one collates data

that provide a detailed insight into the

specificities of NESB MSM populations. In

particular, country of birth and languages

spoken at home as cultural indicators omit the

intricacies of second- and third-generation

NESB MSM. These latter groups become subsumed

into broader demographic categories and thus

are useless to health services and agencies

catering for NESB communities. Temple-Smith and

Gifford (1996) recommend data also be collected

on length of residence in Australia and

religious affiliation. They propose that a

‘national register of ethnicity-specific

information on STDs’ be kept and made available

to health services and researchers. However,

they are aware that ‘consideration must be

8

given to the potential unanticipated harmful

consequences of more thorough collection of

ethnicity data’ such as being used to

stigmatise specific communities and support

discriminatory treatment in employment and

health care (1996: 242).

Data of clients tested between 1985 and 1991 at

the Albion Street Clinic in Sydney indicated

that NESB people made up 11.4% of the sample

whose country of birth was known, and 18.9% of

people from NESB were diagnosed HIV positive.

HIV/AIDS data from New South Wales hospitals

between 1988 and 1991 indicate that NESB

admissions, based on country of birth,

accounted for around 11% of all admissions

(Eisenberg et al, 1993). Pullen(1993) reports

that a large number of men presenting with

HIV/AIDS to health care services were NESB.

They often presented with AIDS, ‘denying any

risk factor to the disease’ and had wives or

9

female partners ‘who had also been placed at

risk of infection’ (Alpak, 1995: 3; see also

Trotter, 1993). Hence, the total percentage of

people from NESB living with HIV/AIDS in New

South Wales is believed to be 10-15% of all

HIV-positive persons. Statistical evidence from

AIDS services such as the Illawarra Branch of

the AIDS Council of New South Wales suggests

that NESB accounted for at least 10% of MSM

contacted at beats, 15% of persons using the

ACON Illawarra Community Support Network (CSN)

caring for those living with HIV/AIDS, and 30%

of MSM using the Port Kembla Sexual Health

Clinic (Alpak, 1995).

The increasing recognition and acknowledgment

of NESB MSM and their needs is framed by

government policy. In 1985, the Commonwealth

Government adopted the Access and Equity

Strategy which aims to ensure that all

Australians can access health programs and

10

services easily and equitably. It acknowledges

the cultural, linguistic and religious

diversity of Australians and puts the

responsibility on agencies and services “to

deal with all clients equitably” by addressing

and catering for diversity in “their clients

and potential clients”(Voukelatos & Boswell,

1997: 14).

More recently and following on from the Access

and Equity Strategy, the National Non-English

Speaking Backgrounds Sexual Health Action Plan

(Draft) (1996) identifies the establishment of

competencies for working with cultural

diversity in training and service delivery.

National Audit

The National HIV/AIDS Strategy Partnerships in

Practice, although not giving equal attention to

issues of cultural diversity, acknowledges that

11

‘people of diverse cultural and linguistic

backgrounds and overseas travellers are also

priority groups requiring specific education

and prevention programs which meet their

educational and cultural needs’(1996: 45). In

response to this recognition and

acknowledgment, as well as to a need to

nationally document and publicise local and

specific projects, strategies and resources, a

national audit was conducted in the second half

of 1997 by the National Centre in HIV Social

Research, Macquarie University, Sydney. Funded

by the Commonwealth Department of Health and

Family Services, the audit was the first phase

of a two-part project. The second part is a

research component. This will be reported in a

separate publication.

In relation to NESB MSM, the audit reviewed:

· the range of existing sexual health, HIV/AIDS

and other STD services;

12

· knowledge of NESB MSM related to HIV/AIDS and

STDs;

· sexual relationships and practices, with

particular reference to risk practices for

the transmission of HIV and other STDs, of

NESB MSM.

Existing reports and data on the significance

and impact of the following issues were

collected:

· cultural constructions of sexuality

· the divergence/convergence between sexual

behaviours and sexual identifications

languages spoken

· religious regulation of sexuality

· levels of education

· rural/urban locations in both Australia and

pre-migrational abodes

· migrant, refugee, transient or second-

generation status

· family, marital and community relationships

13

· constructions of masculinity and femininity

· links with/participation in/alienation from gay

community both in Australia and pre-

migrational abode

· attitudes/responses to sex and sexual health

education

· socio-economic factors

The key areas for data gathering were:

AIDS councils

migrant health services

gay/bisexual organisations

ethnic community

organisations

university student and

health officers and centres

area health services

state health departments

NCHSR library and files

14

These centres/organisations, groups and

individuals were asked:

1. to provide documentation: any published

papers, brochures, research, etc from the

service

2. to discuss issues of concern for NESB MSM

accessing their services

3. to explain effective strategies: whom were

they reaching? how? why?

4. to comment upon less effective strategies:

whom were they not reaching? why?

5. to outline any future

directions/strategies/programs.

Based on the findings of the audit, this

report is divided into three main sections:

issues, strategies and resources. The

annotated bibliography at the end of this

report, while not complete, provides a broad

picture of books, articles, reports and other

15

resources that have been produced in

Australia.

16

2. NESB MSM: Issues

NESB MSM is a term that incorporates a

multitude of diverse and intricate

permutations. Overall, it defines a socio-

cultural position involving the negotiation

of identities and codes of belonging to at

least three socio-cultural groups: the ethnic

family and community; the gay community; and

the wider Australian society. NESB MSM may

experience regulation, exclusion and

omission in ethnic families, in the wider

society, in the various communities to which

they belong such as the gay community, and

in various environments as in the workplace.

NESB MSM may also experience acceptance,

mediation and active support in these

communities.

Two other major factors are also interwoven

with the above identity formation and

17

community location negotiations: the specific

socio-cultural constructions of masculinity

within each social group; and the value-

systems and structural boundaries operating

within health services and organisations.

Here is a framework based on five strategic

tools which assist in the understanding and

analysis of the multiple social and community

positionings of NESB MSM:

1. intra-category heterogeneity: identifying

and acknowledging intragroup differences and

individual experiences of NESB MSM rather

than homogenising lives and situations

through stereotypes and essentialism

2. interweaving of categories: drawing

attention to the relationships between

various conditions and constructs such as

ethnicity, class, gender, sexuality,

18

religion, age, length of residence in

Australia, marital status, geographical

location and education

3. connecting marginalities: making links

between many forms of prejudice and

oppression experienced by NESB MSM from

various social sites such as classism,

racism, sexism and heterosexism/homophobia

4. contextualisation: understanding that

definitions, identities and socio-cultural

values and attitudes in relation to

ethnicity, gender and sexuality are dynamic

rather than static;

5. self-ascription and personal agency:

acknowledging the subjective perceptions,

definitions and agency of NESB MSM, and their

efforts at negotiating the labels and

categories they have been slotted into.

19

These five strategic tools can be applied to

the following examples of NESB MSM:

Mohamed, 34, a fork-lift driver from the

inner west of Sydney lives with his family

(his wife and children) who are not aware

that he has sex with men. He was interviewed

in an inner city gay sauna but he identifies

as “straight”. In his opinion, “women are

life partners ... they look after you”. He

does not know why, but he is sometimes

attracted to touch other men’s bodies. When

asked to participate in a further, more in-

depth interview, he declined as he “didn’t

want to be involved” because he “only take an

hour or so away from my family to go to beats

or saunas to touch men and get off with

them”. It was his interviewer’s perception

that Mohamed did not understand that there

was something called homosexuality.

20

(Hood et al, 1994:

50).

Matteo: It’s harder for gay men and lesbians

from Italian backgrounds to come out. I love

my parents and don’t want to hurt them. I say

things like “Of course I’ll get married one

day, I’m just waiting for the

right girl”. How can two old people who’d

need to have the word ‘homosexual’ explained

to them ever come to terms with their gay

child? They’d think it was something we’d

picked up from Australian friends.

They’ve lived through poverty, war, hunger.

They come to a country where they have to

start again in everything. They make a

thousand sacrifices for the kids they

cherish. After all that, I haven’t got it in

me to break their hearts.

(Pallotta-

Chiarolli, 1991: 23).

21

I am an overseas student and have been

having some difficulties. Since arriving in

Perth, I have realised that I am gay. This is

something I think I’ve always known, but

recently I’ve been having some strong

feelings about it. I don’t know what to do

about these feelings. I have become very

homesick for my country and I miss my family

greatly. I am not sure how to deal with all

these feelings and to make the best of my

time here in Australia. I feel very alone.

(Speculations, June-July 1996:

5)

The son must carry the name of the family,

he must keep the blood of the family living.

But if they knew he was gay, the family name

would be disgraced. And his blood...

John is a tightrope walker, taking calculated

risks in his determination to live out his

22

realities, his truths as gay, as ‘ethnic’, as

HIV positive. He deals with daily bouts of

anger, silence, denial, paranoia with his

Muslim-Lebanese family, his Anglo-Australian

lover, his job, his church, his ‘ethnic’

straight friends, his Anglo-Australian gay

friends. How can ‘non-ethnics’ understand

what he cannot understand: ‘My family is so

loving and supportive that I can’t ask them

to support me’; ‘My family is so united that

nothing must break this unity’; ‘I want to

belong to my community even if it means not

being all that I am to them’.

(Pallotta-Chiarolli, 1994: 2).

Gloria and I are sitting on her back veranda

eating her home-made tiramisu. Her husband,

Sam, is swinging their kids on the

clothesline inbetween cooking the meat on the

barbecue. Both sets of grandparents are in

the garden discussing tomatoes, wine-making

23

and basking in the satisfaction of sitting

in the backyard of married children, knowing

they have fulfilled their parental duties in

getting their children to this stage of

‘sistemazione’. Gloria shrugs. “Sam and I are

bisexual, we occasionally have other lovers

in ongoing relationships, we are very happily

married, and we love being Italian and hope

our children cherish their cultural heritage

the way we do. But all these contradictions

are not meant to exist. …From when Sam and I

were teenagers, we knew we were different.

Not only different but supposedly non-

existent. It’s as if we were the only kids on

the whole planet who were not gay and not

straight, who wanted to have the good old-

fashioned Italian wedding and raise an

Italian family but not accept what would’ve

been traps for us like needing to be

monogamous and heterosexual. Well, we still

feel like we’re the only Italian-Australians

24

that have ever been through this and it’s so

isolating sometimes. There’s no one else to

talk to, no one else to tell you your lives

and mixed identities are realities, your

sort of marriage exists, your adolescent

feelings have matured into complex but

enriching adult roles. … These days it’s all

about multicultural identity and gay identity

and every now and again there’s stuff about a

multicultural gay identity, but neither the

multiculturalists nor the gay activists are

prepared to publicly discuss our

complexities…I love being married, I love

being bisexual, I love being Italian-

Australian. They can co-exist and they do

right here in this suburban [Adelaide]

backyard.’

(Pallotta-Chiarolli, 1995: 140-

141).

25

In each situation, class, migration, place of

residence, constructions of gender, familial

and marital expectations, intergenerational

relations, the convergence and divergences of

sexual identification and sexual practices,

the exclusionary and inclusionary codes and

practices of various communities, are all

interwoven and acted upon by NESB MSM.

Let’s take a more specific look at some of

the issues that were presented and discussed

by persons and groups participating in the

audit.

Ethnic identity and community

In order to provide effective services for

NESB MSM, it is necessary to ask:

26

· What is the range of knowledges, assumptions

and expectations within a particular ethnic

culture in relation to sexuality?

· What is the range of assumptions and

expectations among diverse ethnic cultures

uncomfortably lumped together as non-English

speaking background, and often presented as

in total opposition to the other

uncomfortable classification of Anglo-

Australian?

· How do children born into these cultures live

out their realities and make their decisions

about sexuality? How and why do they comply,

negotiate, resist and create positions for

themselves in relation to the messages and

lack of messages from their ethnic backgrounds

and from the wider society?

Family relationships and expectations

27

For many NESB MSM, family relationships and

expectations are very significant in personal

identity formation.

The confluence of filial piety, obedience and

age facilitates behaviour patterns which are

more directed to family than personal well-

being, where the advice of older relatives is

sought and respected and where older male

relatives are obeyed. ...concepts of self

stress social obligations and a socially

constrained presentation of self and these take

precedence over the individual (McMahon, 1996:

15).

The model of family is often defined in

Anglocentric sociology as “extended” from the

normative nuclear definition of family, as it

includes grandparents and other relatives. In

Australia, importance is placed on men getting

married and continuing the family and community

in this new land. Notions of collectivism

rather than individuality are dominant as

28

members of a family and community rely on each

other in negotiating external alien official

and unofficial socio-economic structures and

realities. Moreover, immigrant communities tend

to be more socially and religiously

conservative than the countries they have left

as maintaining the traditions and values of

their home country at the time of their

departure becomes a signifier of the cohesion

of their families and community. Linked to

ethnicity and family expectations is religion.

The breaking of religious regulations may mean

that NESB MSM may experience years of guilt,

intimidation and excommunication from the

family and community if their sexual behaviours

are disclosed (Poetschka et al, 1995; Tribes

Research Project, 1996).

It is important to remember that some of the

social stigma against gay men in ethnic

communities is not based on notions of

29

sinfulness or sickness but on anxiety about gay

men’s existence outside the family structure

and its support mechanisms. Parents fear they

and their gay sons will be left alone and

unprovided for in their old age, therefore

encouraging gay men to have children and/or

foster intergenerational interdependence (The

Last Coming Out, 1992; Sabri, 1994; Marg

Sutherland, interview). Minority groups

concerned with increasing the population of the

community in Australia and sustaining

intergenerationally supportive families can

sometimes have their fears allayed if gay sons

become parents (Chris Daniel, interview). It is

also important to put issues of sexuality

ostracism into context alongside other “social

disgraces” which may include poverty,

unemployment, divorce and adultery. These are

all signifiers of issues which work against

family and community strength, cohesion and

30

honour (Camit, interview; Farquharson,

interview).

‘Coming out’

Coming from traditional cultures where family

honour and shame are major signifiers of social

positioning, and having this accentuated by the

need to have status in a smaller migrant

community as well as status within the wider

Australian society, there is great pressure on

NESB MSM not to disclose their sexual

practices. This also prevents some NESB MSM

from seeking an alternative community of

support within the gay community. For example,

older men having sex with men are more likely

to have values that reflect a very traditional

and conservative community and a deeply

religious one (Trotter, 1993; Pullen, 1993;

Hood et al, 1994; Poetschka et al, 1995;

Mahat, 1997).

31

However, the individual process of ‘coming out’

or acknowledging one’s sexual preferences is

not only influenced by the centrality of ethnic

and family identity. Being seen to be

culturally different from the Anglo-Australian

norm of personal identity is also significant.

Moreover, there are strong negative attitudes

towards homosexuality in the community and

wider society, particularly as it is seen to

deflect men from their roles as sons, fathers

and husbands (McMahon, 1997).

Indeed, the model of ‘coming out’ is only

pertinent in a society where homosexuality is

constructed as an identity alongside a sexual

behaviour. The loss of ties that would result

in identifying as or ‘being homosexual’ would

be too difficult given the centrality and

personal need for belonging to a family and

community. Perhaps, in relation to NESB MSM, it

32

may be useful to reconsider the application of

the ‘coming out’ model with its linear

assumption of moving from one fixed point of

negativity, the ethnic family and community, to

its polarity, a fixed point of positivity, the

gay family and community. Moreover, for many

NESB MSM, ‘coming out’ is also about ‘coming

in’ to various communities and their cultural

and structural boundaries and regulations

(Pallotta-Chiarolli, 1994c; McMahon, 1996;

Gilbert, 1997). Both these processes are

occuring simultaneously and in multiple ways.

For example, NESB MSM may ‘come out’ from their

ethnic community in order to ‘come out/come in’

to the gay community. On the other hand, they

may also ‘come in/come out’ to informal and

underground networks of MSM within the ethnic

community as well as within the gay community.

Membership of these underground and informal

networks may not be perceived by NESB MSM as

problematic or necessitating some sort of

33

‘coming out’ process as they are not separating

from or attaching to either the ethnic or gay

community. They are participating in a sort of

sexual underground that exists separately from

the gay community (Hood et al, 1994; Prestage

et al (undated a); McMahon, 1995).

As a consequence of not ‘coming out’ to their

ethnic community, or of being less able to

openly discuss their sexual practices with men

even if not identifying as gay, many NESB MSM

are unable to seek assistance and support from

either their ethnic families or their ethnic

communities. Some NESB MSM who do identify as

gay may face forms of violence such as physical

assault or being thrown out of home.

My parents have discovered that I am gay

through a friend of theirs who saw me kissing a

man outside of the Mars Bar. They demanded that

I stop doing this and reluctantly I agreed.

There was a big rave about how I had brought

34

shame to the family and that I’d have to go and

see the priest and confess and do the

appropriate penance. They started restricting

my ability to go out and gave me the third

degree about all my friends. What really pissed

me off was that one of my uncles had made me

suck him off since I was thirteen, that stopped

about three years ago. Things had got so bad at

home that I just blurted it out, my father

struck me across the face and called me a

filthy liar attempting to cover up my own

faults. My father locked me in my room and went

to call the priest. I climbed out and haven’t

been home since.

(Waterford, 1997).

Hence, ‘coming out’ to families may be a time

of negative self-perceptions, alienation and

suicidal thoughts:

I feel like I’ve thrown away my whole future,

my study plans, my job plans, my part in the

35

family to be part of the gay community which so

far I’ve found is unable to even begin to

replace what I’ve lost.

There are implications for safer sexual

practice related to these feelings:

During the time after telling my parents, I

went out and had a lot of sex and did not care

about getting AIDS because I did not feel like

life was worth living anyway.

I just wanted someone to love me and I thought

if I asked him to have safe sex they would

think I had AIDS and I couldn’t stand the

rejection at that time.

Families may also undertake therapies and other

actions to save their sons from a ‘fate worse

than death’ (Waterford, 1997).

Whether they ‘come out’ or not, many NESB MSM

may move away from home and detach themselves

to a significant degree from their ethnic

36

communities. This causes levels of guilt and a

sense of loss for NESB MSM who may genuinely

want to remain part of families and

communities which provide much nurturance,

identity and love. The large family unit may

provide financial and emotional security as

well as a supportive structure from which to

face the world. Also, for many migrants and

refugees, other concerns such as employment,

housing, and schooling become more important

than dealing with sexual preference and sexual

identity. There appears to be an overlap of

NESB attitudes to homosexuality and masculinity

and working-class ESB views. Sexual

identification may be peripheral and perceived

by lower socio-economic NESB MSM and ESB MSM to

be linked to socio-economic positions of

affluence. Support and acceptance are not

always found in other groups, causing further

stress. Gay friends and networks may demand as

much commitment and conformity as ethnic

37

communities and not allow for difference due to

one's cultural backgrounds, values and

attitudes (Sabri, 1994; Pallotta-Chiarolli,

1994b; 1995; Prestage, undated a; Lackman,

1997; Peatfield, 1997).

‘Coming out’ is also dependent on the ethnic

community’s level of openness and understanding

about homosexuality. Attitudes tend to be more

open and tolerant in communities whose members

are relatively wealthy and well-educated, and

have come from more urbanised, industrialised

countries. The greater the level of

urbanisation and industrialisation in their

‘home’ countries, the more likely is exposure

to and incorporation of Western constructions

of homosexuality, and therefore less likely

is the construction of Western homosexuality as

alien. Of course, the types of Western material

made available on homosexuality may be framed

within medical and Christian discourses where

38

homosexuality is pathologised as a disease or

constructed as sinful (Yamine & Elias-

Schneider, 1995).

It is also interesting that while many in non-

Western cultures see homosexuality as a result

of Westernisation and colonialism, the very

processes of colonialism and Westernisation,

particularly in Christian missionary forms,

have been a significant contributor to the lack

of knowledge of pre-colonial and other cross-

cultural meanings of sexuality within these

non-Western cultures. For example, in some

cultures, there is much positive religious

significance attributed to transgender beings,

special social positions for transgender and

homosexual persons, and important roles for

homosexual practices in rituals and traditions

(Alley, 1996). Likewise, some members of non-

Western cultures consider ‘coming out’ to be a

Western construction based on Western notions

39

of homosexual behaviour as identity, and thus

not relevant to their own cultural

understandings of sexual practices and

diversity.

Significance of literacy

Literacy is also a significant issue in

accessing information in relation to sexual

health and sexuality in both community

languages and English. The migration process

itself is a significant factor linked to

literacy. Recently arrived migrants and

refugees are unfamiliar with English-speaking

service systems, and their lower levels of

English language competence prevent the

accessing of information and networks. In

relation to languages other than English, no

proper translations for words such as

homosexual may be available, apart from a

generic meaning of ‘pervert’(Farquharson,

40

interview; Safe Not Sorry: Cultural Applications, 1994;

Working With Diversity, 1995).

Transient NESB MSM

While some NESB MSM wish to negotiate the

worlds of their ethnic communities and sexual

desires, finding bridging points to straddle

the two, other NESB MSM, including overseas

students, come to Australia to escape their

families and often may feel isolated and

detached from their communities. They may also

have planned this deliberate escape to

Australia from their families in order to feel

free and be able to sexually experiment. These

feelings of isolation and escape may be felt

simultaneously in overseas students. Transient

NESB MSM face specific issues. Illegal

immigrants, tourists, businessmen, diplomats

and overseas students face isolation, and often

do not tell partners, families or friends of

41

unsafe sexual practices (Nathan W, 1997). Some

come to Australia deliberately to ‘come out’

while others ‘come out’ after experiencing

Australian constructions of gay culture and

community (Pallotta-Chiarolli, 1997).

Thus, in considering the above issues of

belonging to ethnic families and NESB

communities that are generally structurally and

culturally homophobic, the major concerns that

many HIV/AIDS services need to deal with in

relation to sexual health can be summarised as:

* how to build up a sense of gay identity for

NESB men if they so desire;

or

* how to assist NESB men in negotiating and

constructing a lifestyle with family and

community, based on having sex with men while

not identifying as gay.

42

I am not implying that the Anglo-Australian

society generally structurally and culturally

homophobic. Rather, it is more pluralistic and

urbanised, with values in regard to adult

independence and nuclear couple-based families

that make it easier, especially in the middle

classes and some upper classes, to negotiate

their sexualities with less constraints.

Socio-cultural constructions of masculinity

Because he is straight, I must be the girl... I

do the cooking like a girl...he is the first

one to fuck me there [anal sex]...without a

condom because we did not know...In Vietnam if

you are gay you must be the girl...wearing the

girl thing (McMahon, 1997: 16).

As this example illustrates, constructions of

masculinity, and their interconnectedness with

sexual behaviour, identity and expression, vary

according to socio-cultural and other factors.

43

The negotiation of gender and sexuality occurs

not only within the expectations and

assumptions of an ethnic group. The patriarchal

and heterosexist norms of the wider Anglo-

Australian host society also elicit responses

of compliance and resistance from both non-

English speaking and English speaking

backgrounds. Gender codes and regulations of

sexuality in both groups are constructed within

the overarching framework of patriarchal and

heterosexist socio-cultural, political and

economic structures and perspectives

(Pallotta-Chiarolli and Skrbis, 1994:

260).

Dominant English-speaking background (ESB) and

NESB heterosexual constructions of male

sexuality include emphasis on its

uncontrollability and its need for constant

expression. Therefore, situational

homosexuality may be tolerated as a form of

44

release when sex with women is not available.

Situational homosexuality for new migrants may

occur until they come into contact with the

wider NESB community and decide to get married

and have a family. In some cultures,

situational homosexuality is accepted as a

phase and/or reality in men’s lives such as in

a pre-marital context (Camit, interview).

Insertive partner/receptive partner differentiation

In some cultures the insertive

partner/receptive partner differentiation in

anal intercourse is considered an indicator of

heterosexual and homosexual masculinities. For

example, in some Arabic cultures, only the

receptive partner in a homosexual relationship

is considered “effeminate” or gay. The stigma

of homosexuality is attached to the act of

being penetrated because it is “having sex like

a woman”, rather than to the sex act itself.

45

Hence, this is based on gendered relations of

power and status (Elizabeth, interview;

McMahon, 1996). Confusion between gender

identity and preferred sexual practice may be

apparent. NESB MSM may lack assertiveness or

consider it taboo to request that their female

partners penetrate them anally with dildos and

other objects, or their female partners may not

want to engage in this form of insertive anal

sex. This may lead unsafe practices with men

and confusion over gender. There is a need to

counsel and educate these NESB MSM in relation

to sexuality about “claiming and reclaiming”

their sexuality, not necessarily coming out as

gay, and not necessarily having to go through

medical processes to change gender. Very few of

the NESB men seen at Foley House for gender

medical interventions and the Gender Centre,

for example, want to identify as homosexual or

want to belong to a gay culture. Most are

basically interested in broadening their sexual

46

practices (Elizabeth, interview; Bill Robinson,

interview).

In relation to sexual health, insertive

partners may miss and even deliberately avoid

safe-sex messages targeted at gay men as they

do not perceive themselves as gay (George,

1992). Married men with children, for example,

who have casual sex at beats may not consider

themselves as gay. They may not think much

about the sexual contact and are unlikely to

see themselves as presenting any danger (Hauff,

1993; Hood et al, 1994; Voukelatos, 1996).

Thus, heteronormative constructions of

masculinity impact upon sexual identity, sexual

practice and sexual health of NESB MSM in

various ways. Men may be seen as the providers

and protectors in families and leaders in the

community. Sons are inheritors, expected to

provide life-long support to the family, to

47

marry and carry on the family name, and worship

family ancestors. The responsibility of the son

on the death or absence of father may be to

head the family. These are examples of socio-

cultural constructions of heteronormative

masculinity that may need to be negotiated by

NESB MSM (Working With Diversity, 1995; Peatfield,

1997).

Female partners

Female partners of NESB MSM may be frightened

to raise sexual health issues with husbands,

and the raising of issues has sometimes

resulted in domestic violence. Yet, it is often

women who request information from health

services on how men have sex with men and

sexual health for themselves and their male

partners. In keeping with the constructions of

power and invincibility, men may be reluctant

to address AIDS for themselves but they will be

48

more receptive if it is presented in the light

of family protection. In other words, HIV/AIDS

could affect their families (parents,

relatives, friends, children) and as protectors

they need to make this their responsibility

((Lubowitz, interview; Men Who Have Sex with Men,

1992; Surgey, 1992; Alley, 1995; Lubowitz,

1995; Educational Resource for Women Partners of Bisexual

And/Or Gay Men, 1997).

Sara Lubowitz, from the Women of Bisexual

Partners Project at the AIDS Council of New

South Wales (ACON), reports that approximately

16 out of 100 women on her mailing list are of

NESB background and mostly married to NESB men.

She says that these women may have difficulty

accessing support services such as the Women of

Bisexual partners Project as they may have

children and other family responsibilities as

well as possibly being employed outside the

home, may lack mobility, and will not come to

49

organisations such as ACON. NESB women tend to

stay with their partners because they have no

family or other support, or in order to

maintain the family’s honour within the

community. They have children and see them as

the prime responsibility. Hence, there may be a

range of cultural and religious pressures for

women to stay together with NESB MSM. Men may

use the women as a front in their own

community. However, where women know

beforehand, are able to articulate how they

feel about the sexual practices of their

husbands, and equitably negotiate boundaries

and expectations, the relationships may be very

successful and relatively unproblematic

(Lubowitz, interview).

Gay identity and community

‘Men who have sex with men’ is a broad category

that can be split into groups (George, 1992):

50

1. men who identify as homosexual or gay

2. men whose main sexual practice is with other

men but who do not see themselves as

homosexual or gay

3. bisexual and heterosexual identifying men

whose main sexual practice is with women, but

who occasionally have sex with men.

Terms of sexual identification like

heterosexual, homosexual and bisexual arise

from a Western medico-historical context. As

already discussed, other cultures may not

categorise sexualities in this way. Some may

construct homosexuality along two related pairs

of roles: active/passive; masculine/feminine.

These structure the organisation of

homosexuality at the sexual and social level

(McMahon, 1997).

For ethnic communities, the gay community is

seen as being distinctive and outwardly

51

identifiable as Aboriginals are from Vietnamese

people (McMahon, 1996: 69). NESB MSM may

decide upon various levels of attachment to and

detachment from the gay community according to

how close to or different from the visual and

cultural representatives/representations of gay

communities and cultures they believe

themselves to be. Using the gay community

recreationally and attaching no other

importance to it is quite common among NESB MSM

as it is among some ESB MSM (Poetschka, 1995;

Prestage et al, undated a; Prestage et al,

undated b) . Attending gay venues and beats,

and having access to gay papers, does not

necessarily mean that NESB MSM feel part of a

gay culture . They often wish to seek out other

members of their own ethnicities in the wider

gay community. ‘While all were glad to have

found Oxford Street, gay is what these men do

rather than who they are’ (McMahon, 1997: 16).

Friendship networks seem to be constructed

52

along ethnic and racial lines as much as along

sexual identity lines. ‘Going to an Asian gay

nightclub is a gay thing they do, eating out in

Chinatown is one of the Asian things that they

do’ (McMahon, 1997: 16). However, some NESB MSM

may deliberately avoid associating with men

from their own communities. This may be because

of internalised racism whereby men from their

own cultural background are considered socially

inferior and less sexually attractive than ESB

men. Deliberate avoidance may also occur

because of the fear of being disclosed to

members of their own ethnic communities via

their sexual partners from these communities

(Ken Wong, interview).

Many NESB MSM want to keep a low profile within

the gay scene so as not to attract attention to

themselves and in so doing ‘out’ themselves.

This reluctance to be part of the wider gay

community often means that individuals are

53

reluctant to use support services or attend

educational workshops, thereby limiting their

access to support in dealing with their

sexuality and to the latest HIV/AIDS

information (Camit, 1994; 1996b).

Inner city gay culture

That most activity in the gay community occurs

around the venue scene is problematic to some

NESB individuals. Going to venues may incur

not only breaking taboos against homosexuality

but also against the use of alcohol and other

drugs. Many men want to meet other gay men in

non-scene related activities such as support

groups or social outings. The fact that most

gay activities occur late at night may also be

difficult for many younger men, as well as for

men who need to get to work the next morning.

Many are tied to the home because of family

responsibilities and the activities of their

54

ethnic communities may also occur at these

times (Waterford, 1997).

One of the major factors that may alienate NESB

MSM from situating themselves within a gay

community and culture is not always about

cultural alienation but also about the

construction and perception of inner city gay

culture as middle class, affluent and well-

educated. As Gifford et al. state,

“socioeconomic status (SES) is frequently

confounded with ethnicity” (1994: 29). The

schism may be not so much between traditional

Anglo and non-Anglo understandings of MSM but

between post-Stonewall Americanised gay

identity and traditional MSM identities (Camit,

interview; McGee, interview; Todaro and Savdie,

interview).

Cultural ignorance, racism and Anglocentrism

55

NESB MSM who have made decisions other than

coming out have faced blackmail and

heterophobia within the gay community. This

appears contradictory as sexual fluidity is

increasingly considered appropriate for Anglo-

Australians but not for NESB persons. Not

identifying as gay is immediately considered to

be a result of familial and social coercion in

their situation rather than a self-deliberated

choice (Hood et al, 1994; Pallotta-Chiarolli,

1996b).

Within the gay community, stereotypical

thinking can be quite problematic such as the

common belief that Asian men are passive and

feminine. Cultural ignorance and Anglocentrism

are problematic. Australian gay men may show

little understanding or appreciation of the

diversity of political systems, geography,

cultural systems, religion and family systems.

Ethnocentrism, cultural avoidance or a

56

reluctance to engage with or become part of

NESB men’s ethnic cultures are seen to be

denigrating the valued culture of NESB men and

mean that any form of relationship is to be

conditional upon the acceptance of white

cultural norms (Gilbert, 1997).

When I actually get to talk to gay men they try

to impress me with their knowledge of what they

presume to be my culture. One man went on about

Eva Peron and how wonderful he thought she was

and how bad it was that the death squads killed

homeless children and got away with it. Trouble

was that she was Argentinian not Chilean and

they were most probably referring to the street

kids of Brazil. Most Westerners don’t know much

about Chile but they sure like to pretend

they’re worldly wise.

Because of my interest and participation in the

Greek community I’ve found it hard to find a

long term partner who wanted to share that

57

aspect of my life...I am still deeply attached

to my community and most of the men I’ve met

are afraid of being part of it and that limits

their ability to relate to and understand me.

(Waterford, 1997:

pages unnumbered).

Many NESB MSM also experience racism within the

gay community:

This man cornered me in the toilet and demanded

I suck his dick, when I said no he punched me

in the face and told me to fuck off and go back

to my commie homeland where all you nips

belonged

(Waterford, 1997: pages unnumbered).

On occasion, the racism may become overt with

some men, particularly Asians, being the

subject of minor physical assaults and threats

of physical intimidation (Gilbert, 1997; Camit,

interview).

58

Objectification and exoticisation are also

concerns. Certainly, they can be flattering and

acceptable to some NESB MSM , while others may

find this sexual interest exploitative and

dismissive of other aspects of their lives

(Gilbert, 1997; Waterford, 1997).

Communication difficulties may also surface.

Sometimes, Anglo-Australian gay men may not

approach NESB men because of perceived language

difficulties and the stigma attached to mixing

with ‘foreigners’ (Gilbert, 1997; Waterford,

1997). However, Anglo-Australian gay men may

deliberately approach NESB men because the

lower level of English literacy among the

latter may give ESB men a sense of power and

superiority. Thus, while some NESB men may

deliberately select ESB men as they provide

access into and connections to social networks,

ESB men may take advantage of the low literacy

of a NESB sexual partner. Low literacy men may

59

mean being less able to articulate concerns in

regard to sexual practices and being less able

to negotiate sexual safety, thus meaning the

ESB sexual partner may have power and control

over the sexual encounter or relationship (Ken

Wong, interview).

In concluding this section, I will quote from

the Gay Education Strategies Project which

summarises the concerns that have been raised

above, particularly in relation to Asian men:

. . .

3. A power dynamic exists between Caucasian and

non-Caucasian men in the Australian gay

community, which is detrimental to the social

and sexual situations many Asian gay men are

in.

4. This leaves many Asian gay men with fewer

options regarding sexual partners and

behaviours and/or less able to be assertive

than many Caucasian men.

60

5. Many Asian gay men may not have the language

and other communication skills to enable them

to negotiate sex, sexuality, and safe sex with

non-Asian men.

6. ‘Asian’ and/or ‘gay’ are labels which many

members of the target group may not necessarily

use to describe themselves. The label ‘Asian’

emerged in a Western cultural situation. ‘Gay’

originated in and has greater history and

resonance in Western cultures.

(Gilbert, 1997: 7).

Location and position within the wider

Australian society

Being marginal to a NESB community that may

itself be outcast and misunderstood in the

wider Australian society is problematic in

constructing feelings of divided loyalties and

betrayal. The NESB community’s denial of the

existence of homosexuality may also be a denial

61

of Western constructions of this sexuality, or

a need to maintain the NESB community’s public

unity and image in the wider Australian

society. The public acknowledgment of one’s

sexual identity may be the problem, rather than

private behaviours that do not become publicly

known. Denial and silence are therefore forms

of internal community control and also group

cohesion, the construction of a united front,

against the real and/or imagined pressures from

the wider Australian society.

Living in a new country where there is little

that is familiar, ethnic identity and beliefs

may be the only strategy available for

psychological and emotional comfort. ...Tight

cultures, intolerant of ‘deviant’ behaviour,

attitudes and values, combined with an emphasis

on collectivism, produce a conservative culture

that is reluctant to change

(Voukelatos, 1996: 36).

62

Change is equated with assimilating to the host

culture’s norms and losing one’s own cultural

self, of losing the remnants of the ‘home’ that

was left behind in the migration or refugee

process. Suspicion of external authorities and

groups are also factors that increase the

insulation of the ethnic community (Axell &

Perkons, 1994; Farquharson, interview). The

need to protect offspring from the negative

impacts of the wider society can be seen in

other issues such as concerns over the links to

drug use and drug-using groups in the wider

community (Tribes Research Project, 1996).

Combinations of heterosexism, racism and ethnocentrism

Silence in the wider community in relation to

NESB MSM is also problematic. The combination

of heterosexism, racism and ethnocentrism

results in media distortions and the lack of

NESB role models, writings, visibility and

63

other cultural representations with which a

NESB MSM can identify. This is particularly so

as any portrayals and most visible gay men and

MSM continue to be from ESB, and thus there are

no available visual models for the wider NESB

families and communities with which to become

familiar. Isolation ensues whereby NESB MSM

cannot network with other men of similar NESB

to seek solace in shared cultural

understandings and concerns, and devise

strategies to deal with their specific cultural

dilemmas (Pallotta-Chiarolli, 1994c; 1995;

1996d).

Homophobic intimidation from not only the

ethnic community but the wider community is

also prevalent: ridicule, jokes, harassment,

threats, humiliation. Physical violence such as

attacks in the home and in the street, the

denial of life’s necessities such as employment

and housing, are also threatening realities.

64

Health services and organisations

Apart from the factors discussed in the above

sections, the inability to negotiate safe sex

can be based on low self-esteem related to body

image, depression, fear, wanting a partner,

fear of disclosure, blackmail and flawed

personal risk-reduction strategies. These

factors need to be taken into account in

relation to NESB MSM by health services

(Waterford, 1997; McKay, interview).

Cultural understandings and traditions related to illness

Voukelatos (1996) presents reasons based on

specific cultural constructions for why NESB

MSM may not be accessing health services. In

the Greek community, for example, illness is a

time to seek advice from friends and family and

the doctor is called in the last resort.

65

Usually, the doctor is also seen as a member of

the family. Confidentiality has little meaning

where ‘illness is a means of social interaction

rather than a professional relationship’

(Voukelatos, 1996: 14). Hence, disclosing

one’s sexual health concerns to a doctor is

often disclosing to the family and community

and running the risk of losing that support.

From the Greek community’s cultural

understandings and traditions related to

illness:

the personalised nature of many sexual health

clinics, intended to make use of their services

less alienating, may be actually keeping some

Greek background clients away. STDs are a set

of illnesses that most Greek background clients

do not want their kin to know about. The ‘home-

like’ ambience of some clinics may be

undermining the security clients feel in being

anonymous

66

(Voukelatos, 1996: 14).

There may be very few gay-friendly doctors

within NESB communities. Some clients may want

to see doctors in inner city areas or wherever

else there is a large gay clientele. They may

have found that suburban doctors have

insufficient information or are prejudiced.

Health services need to have a list of NESB

community doctors to whom MSM can go as some

NESB MSM are not seeking medical attention from

either their local sexual health services or

general practitioners (Samaha, interview).

Women’s health centres are also useful in the

dissemination of information as women are

generally less homophobic, may be the prime

teachers within their community, and as

cultural teachers may be creating attitudinal

shifts (O’Shea, interview).

67

There is also a need for support groups that

are not necessarily gay identifying or

associated with AIDS councils (Clews, 1993;

Hauff, 1993; Matsumoto et al, 1996; Yew,

1997) .

Successsful HIV/AIDS interventions for gay men

in Sydney have drawn on Anglo-American gay

culture. So, too, will interventions for gay

men from other cultures be successful if they

draw on and are relevant to a diversity of

cultural backgrounds

(McMahon, 1997: 18).

Building a constructive relationship with the

target group means understanding the beliefs of

the group, involving representatives from the

target group and being sensitive to the target

group (Sutherland, 1997).

I have encountered a stereotype of people of

Vietnamese background which views them as close

knit, secretive and unwilling to speak about

68

issues such as sexuality. It has been my

experience that if data collection methods are

culturally sensitive, they may succeed in

gathering information about issues such as

sexuality from Vietnamese background men

(McMahon, 1996: 37).

Language barriers

The use of interpreters is very important but

may also present issues that need to be

addressed such as the need for colloquial,

accessible languages and dialects rather than a

level of ‘home’ language that reflects a more

educated or particular class use of language.

Direct translations from English to other

languages do not work in health pamphlets and

other material as they can be culturally

inappropriate and offensive. For example, in

relation to Arabic, there is a need to use

69

‘broken Arabic’, ‘street-Arabic’ instead of

classical Arabic, or possibly a mixture of

Arabic and English. That was the problem with

the ACON brochure- classical Arabic which many

could not read (plus there were mistakes in it

like misplacing the accent marks). However,

whose street-Arabic is to be used? Egyptian,

Algerian, Yemenian, Jordanian, Moroccan,

Lebanese, Turkish, Tunisian, Sudanese, Saudi

Arabian, Kuwaitian, etc? (Tribes Research

project, 1996; Samaha, interview) There is also

a need to have more bilingual psychologists,

therapists and counsellors who speak particular

dialects. On the other hand, for second and

third generation NESB MSM, it must not be

overlooked that English may be their first

language (George, 1992; Eisenberg and Lee,

1994; Camit, 1996a; Prestage et al, undated b).

However, as Marg Sutherland writes, ‘it’s

possible to play a key role in the development

70

of health promotion programs without being

bilingual, trilingual, etc...providing you are

able to use a process that ensures linguistic

and cultural relevance’ (1997, unnumbered).

Thus, while it may not be financially viable to

translate resources for very small NESB

communities, there is a responsibility to adopt

a process and explore other strategies that

incorporate Access and Equity principles.

Barriers to applying Access and Equity in health services

Another major concern is the problem with

short-term ad hoc health and community

projects. There is little continuity and ad hoc

projects do not build up levels of trust and

confidence between client and service

(Farquharson, interview; Migrant Health

Service, interview).

71

Many workers believe that a major problem is

that NESB MSM issues are low priority in NESB

communities, AIDS Councils, Commonwealth, and

other health services (Gifford et al, 1994;

Mitchell et al, 1997). The lack of

collaborative work, the silences and lack of

organisational responses are major obstacles.

There is a lack of data with which to develop

projects and gain funding. Rather than

dismissing this lack of data as saying there is

no need, there is a need to ask why aren’t the

data there? As discussed in the introduction to

this document, data collection methods require

further breakdown into specific cultures as at

present the general homogenised discussions

means specific groups are not targeted

effectively and money is being wasted (Temple-

Smith & Gifford, 1996).

Access and Equity itself is still framed by a

cultural deficit model, defining NESB as the

72

problem only ameliorated by assimilating to ESB

norms. This leads to defensive and

justificatory responses from NESB communities.

There is still a lack of NESB representatives

on councils, and the use of the word

‘disadvantaged’ itself leads to alienation.

Thus, there is a need to apply Access and

Equity to AIDS Councils and other health

services in more useful ways that address

cultural diversity rather than position NESB

cultures as inferior ( Eisenberg et al, 1993;

Pallotta-Chiarolli, 1994a; National AIDS

Bulletin, 1997a, 1997b; McGee, 1997). The lack

of appropriate Access and Equity is reflected

in difficult client/worker relations, the lack

of organisational responses to NESB MSM

specificities, and the process of

marginalisation of certain issues and groups.

The split between community-based services and

health department (area services), the former

defined as gay and the latter defined as non-

73

gay, often means that NESB MSM fall into a gap

between them. Funding requirements also prevent

branching out and forming relationships with

other groups (Clews, 1993; Eisenberg et al,

1993; McGee, 1997; McMahon, 1997; McGee,

interview).

Mandatory cross-cultural workshops are required

in health services as well as training for

managers such as how to set program objectives

and indicators for NESB accessibility. At the

time of preparing this report, Patrick McGee of

AFAO is producing such a report and training

manual based on the cross-cultural training

program being conducted at the Victorian AIDS

Council. VAC’s program will then be used as a

national model (see also McGee, 1997).

Some agencies working with NESB MSM also

perceive a dilemma whereby government services

want statistical and quantitative approaches in

74

health services but this may not be the way to

work with ethnic communities where NESB MSM

request very local, confidential, one-to-one

personal approaches. Public health work is

considered by many health workers and their

clients to be too quantitative, alienating and

official (Migrant Health Service, interview;

Multicultural HIV/AIDS Education and Support

Centre, interview). These government services

will often say that working with NESB MSM

issues is a difficult area rather than examine

their own policies, practices and assumptions,

including the belief that one strategy will

work for all NESB MSM groups rather than

explore the need for different strategies for

various groups. Qualitative work,

autobiographical narratives and in depth

evidence of the lives of NESB MSM are required.

For example, the Ethnic Youth Issues Network of

Victoria, the Victorian AIDs Council

multicultural groups and the Migrant Health

75

Service in South Australia have put out calls

for submissions regarding anthologies of NESB

MSM and lesbians to be used by health services

as a means of peer support and NESB community

education.

It is very important to determine appropriate

levels of cultural sensitivity that avoid

cultural inappropriateness which may alienate

NESB communities. However, oversensitivity that

results in less useful service provision also

needs to be avoided. Hence, the issue of

cultural sensitivity needs to be

contextualised. Is the rhetoric about being

culturally sensitive being used to prevent

useful work being done? Is it an excuse for not

dealing with an issue by an organisation?

According to whose measure of what is

culturally sensitive? According to which

statistics and research? Health services must

be wary of not being dictated to by community

76

gatekeepers and must seek out broader community

opinions and perceptions (Pugh, 1993; Sturgess,

1993; Sutherland, 1997; Grant Farquharson,

interview; Marg Sutherland, interview). Some

health workers and health services may be

overly culturally ‘sensitive’, more so than

their clients warrant or want. For example,

this concern has been raised by overseas

students who believe their international

student advisers and university health services

may use ‘cultural sensitivity’ and ‘cultural

appropriateness’ in a patronising manner and to

cover their own homophobia and other

discomforts (Pallotta-Chiarolli, 1997).

Materials do need to avoid cultural and sexual

stereotypes, however.

Just as it is important not to homogenise NESB

MSM but focus on cultural specificity, there is

also a concern with the response to AIDS being

incorporated into a broader homogenised

77

strategy. This mainstreaming is meant to

normalise HIV and treat it like anything else

but it could also exclude it and alienate NESB

clients. AIDS still carries enormous stigma and

so there is a need for health services to be

specific about it rather than mainstream it

when it is not regarded as such. Normalising

sexual health services is difficult for NESB

persons who will not go into general health

clinics requesting HIV/AIDS information and

medical attention (Multicultural HIV/AIDS

Education and Support Centre, interview; McGee,

interview).

3. Strategies

Although many of the following strategies have

already been addressed , I wish to highlight

and detail those that are proving effective in

many services and organisatiosn across

Australia.

78

Access and Equity strategies

Services need to have Outreach, Access and

Equity, Cross-Cultural training, and Cross-

Cultural Awareness programs. They need to

question the degree to which unsuccessful

service provision is due to the culture of the

ethnic group and/or due to the culture of the

health/gay organisation. Services and

strategies may still be working within an

assimilative ESB linear model that says we need

to understand NESB MSM in order to move them

from an inferior polar NESB position to the

opposite superior ESB position. There is a

subtle distinction between this model and a

culturally pluralist model that empowers and

franchises its members by making the teaching

of English available in appropriate ways.

79

The development of appropriate safe sex

educational resources is a prime area of need.

Resources need to go beyond the translation

model to take into consideration cultural

understandings, cultural appropriateness, and

intracultural differences such as levels of

education and the types of dialects spoken

(Eisenberg, Painter, Todaro, 1993). It is

unreasonable to expect ethnic communities to

develop an understanding of HIV and sexuality

by simply providing them with a few pamphlets

in their languages.

Strategies for the dissemination of information within NESB

communities

The use of autobiographies and personal

narratives is a very useful strategy in

educating NESB MSM. The use of ethnic radio,

press, television as vehicles for these stories

is important: interviews, talkback, dramatic

80

sketches; regular features in mainstream ethnic

and mainstream press are ways of reaching MSM

who may then not feel as stigmatised and who

may have been raised within a culture where

storytelling and personal anecodotes are used

as teaching and learning strategies

(Sutherland, 1997; Sutherland, interview;

McGee, interview).

Encouraging cultural leaders/community

leaders/religious leaders to make public

statements is also very effective. However, as

mentioned in the previous section, it cannot be

assumed that community gatekeepers speak for

all members of their communities. The

homophobia expressed by often middle class

heterosexual male and religious leaders

claiming to be representative of the whole

community may not be representative at all

(Sutherland, 1997; Sutherland, interview).

Community members may not be able to publicly

81

challenge these views because of the need to

maintain group cohesion and honour in the wider

society as well as among themselves, but they

may have developed informal networks and

smaller groups that are actively challenging

and resisting such public homogenous

representation. For example, Tadgh McMahon, in

the process of his research, came across an

informal network of South East Asian young men

(late teens to early twenties) that operated

outside any formal organisation or structure

but the members would get together to socialise

and support each other (McMahon, 1996). Making

personal contact with community members,

recognising the diverse groups and factions

within each community, and not necessarily

working with gatekeepers but seeking other

existing networks are all effective strategies

(Sutherland, 1997).

82

One strategy that helps counteract the

construction of HIV/AIDS as Western,

particularly by gatekeepers, is the use of data

from countries of origin, using international

statistics, maps and charts (Camit, interview;

McCorriston, interview).

Peer-based informal networks, clients telling

each other about the service, building up the

local community’s trust, community networks and

understandings of confidentiality are all

important factors (Migrant Health Service,

interview; Multicultural HIV/AIDs Education and

Support Centre, interview). According to

Priscilla McCorriston (1997, interview),

setting up confidentiality contracts such as

not having to disclose one’s real name to the

worker, not needing to know everything, only

what the client wants workers to know, are also

strategies encouraging NESB MSM to access the

services. She found that being a woman, being

83

gay-friendly and culturally-friendly, were also

considered to be significant factors. This is

because researchers and service providers as

outsiders are often considered less likely to

invade personal and community spaces NESB MSM

inhabit and where their acquaintanceship would

have to be explained. In other words, they are

less anxious that the worker is someone he will

meet in other NESB community circumstances and

events.

Indeed, the mainstream ESB construction of

counselling which involves meeting in an office

or clinic, attending group sessions, and

following interview procedures, may be alien to

NESB and need to be reconsidered. Many NESB MSM

prefer a one-to-one conversational approach

either by face or by telephone, and in a public

space such as a coffee shop or a private space

such as in the home. Word-of-mouth networking

in the community is also an effective strategy

84

when official channels are resisted due to

risking disclosure (Migrant Health Service,

interview). The dissemination of information to

NESB MSM can also occur via community

businesses such as bakeries and shops to

distribute information to all NESB community

members. Therefore, there is less taboo than is

associated with information only being

available from doctors and at sex venues

(Farquharson, interview). However, some NESB

health services question how effective these

strategies may actually be. Information on

sexual practices and sexual health on display

in general public shops and other places may be

considered offensive and unacceptable, and it

may be unlikely that NESB MSM would pick up

such material due to the stigma and

implications.

The impact of new technologies such as

chatlines, websites and email may also be

85

utilised for information dissemination and

networking, particularly for younger and

overseas student NESB MSM (Pallotta-Chiarolli,

1997).

Images used in HIV/AIDS material are often not

representative of the group. For example,

people with low self-esteem, poor English,

geographic isolation and who are HIV positive

are not being visually represented. Images may

still be of inner city, affluent, ‘trendy’ club

scene young men. This lack of diverse visual

representation is linked to the lack of

ownership of labelling and identity by NESB MSM

in campaigns and organisations (Gilbert, 1997;

Camit, interview). There is a need to find

strategies that allow the people affected to

get involved. The development of a brochure for

Arabic MSM from the Cabramatta Community

Centre, co-ordinated by John Samaha, required

devising group meetings with health workers and

86

other interested parties at the Centre, and

separate one-to-one meetings with Arabic MSM in

their own homes as they did not wish to be

publicly identified. The suggestions and

recommendations from the Arabic MSM were

reported to the meetings by a mediator.

Likewise, doctors and key informants from

communities need to be consulted in ways that

do not compromise or harm their community

positions.

There is a need for more training for workers

in these fields, particularly in finding

alternative ways to structure and undertake

projects that do not create risks of disclosure

and community ostracism for NESB MSM. Just

because workers may be from NESB does not mean

they understand the dynamics of the interwoven

factors.

For example, the use of interpreters is itself

a good strategy but there needs to be an

87

awareness that interpreters may have their own

value judgments; may not want their communities

to look bad; and indeed may have a sense of

superiority to NESB MSM due to higher education

and a ‘better’ use of their own language

(Sutherland, interview; McGee, interview).

Peter Todaro and Wa’el Sabri from the

Multicultural HIV /AIDS Education and Support

Centre, and Marg Sutherland from Centre for

Social Health in Victoria stress the need to

train workers to hold one-to-one meetings with

community leaders to build respect, bonding,

and a sense of knowing each other; and the need

to walk the fine line with cultural sensitivity

issues- who is sensitive to whom? It cannot be

just ESB sensitive to NESB but both ways.

Shared meanings means the use of euphemisms may

be better than specific/explicit words and

labels, and workers need to be aware of these

and be able to use them. AIDS education is a

88

cultural construct. There are numerous ways of

getting the message across and the many

successsful projects working with and targeting

various sectors of NESB communities (including

both HIV positive and negative NESB MSM)

undertaken by the Multicultural HIV/AIDS

Education and Support Centre staff of

researchers, health workers, community workers,

designers, writers and artists, testify to this

multi-sited and multi-strategic approach

(Multicultural HIV/AIDS Education and Support

Centre Biannual Reports).

4. Conclusion:

Beyond Problematising Cultures and

Culturalising Problems

Is the focus too much on cultural differences

at the expense of similarities and other

differences? In doing this audit, there was

the constant two-pronged dilemma: that of

89

‘Problematising the Culture’ and ‘Culturalising

the Problem’; the fine line between presenting

problems in a NESB group without problematising

the NESB group or ethnicity or cultural

diversity itself; and the need to be

constantly aware of other factors than culture.

Significant factors in NESB MSM successfully

negotiating their various identities and

communities appear to be one or more of the

following: strong support networks and

friendships with other NESB MSM of same and/or

similar cultural backgrounds; drawing from both

the gay and ethnic communities while

transcending both to live with a code of their

own; making strategic and shifting choices in

relation to “coming out” to families and

receiving acceptance and support for those

choices from gay friends and ethnic friends;

and uncovering role models and historical facts

about NESB MSM from their own cultures.

90

In any work with NESB MSM, it is important

that it does not become an exercise in blaming

the culture but that workers are aware of the

factors that contribute to the cultural

situation of the NESB MSM and that many of the

issues apply to other men- such as ESB working

class men- who are not considered to adhere to

dominant constructions of masculinity. The aim

is not to assimilate a culture to Western

constructions but to deal with the realities of

sexual health and emotional health. Likewise,

it is important to remember that NESB codes are

framed by wider ESB codes that may often

support and reflect the same prejudices. For

example, with the second generation:

sexual behaviours and marital choices may be

monitored by parents and ethnic community in

order to maintain ethnic purity, family

cohesion and the continuation of community

91

strength. We also found that this is framed by

the wider society’s need to monitor sexual

behaviours and choices in order to maintain the

established patriarchal heterosexist

structures

(Pallotta-Chiarolli and

Skrbis, 1994: 270).

As McMahon succinctly summarises,

The notion of “access and equity” provides the

policy framework for interventions targeting

gay men from culturally diverse backgrounds.

There is also more than a decade of experience

to draw upon for guidance and advice. All that

is now required is the commitment to work with

this diversity of men who have sex with men

(1997:

18).

92

Appendix A: Existing Projects and

Strategies

I will now outline some existing projects and

strategies that exemplify various ways of

meeting the concerns outlined in the two

sections above.

1. Multicultural HIV/AIDS Education and Support Service

As stated above, the Multicultural HIV/AIDS

Education and Support Centre in Sydney leads

the way in Australia in regard to implementing

Access and Equity in relation to NESB

communities. Since its inception in 1991,

numerous education sessions, community

development intitiatives, training programmes,

media campaigns, research projects and

publications, collaborative ventures with other

organisations have been undertaken that

specifically address NESB MSM as well as

93

incorporating their issues into broader NESB

community initiatives. The annotated

bibliography at the end of this report will

illustrate the role the Centre has played in

many research and publication projects, and the

need for continuity and longevity in order to

gain the respect, trust and confidence of NESB

community gatekeepers and MSM in order to

undertake productive and useful projects.

2. ACON Spanish-speaking Project

In relation to the need for project and program

continuity, Grant Farquharson has been in the

ACON Spanish-speaking Project for 7 years. He

sees this continuity as very important for

clients in issues of trust, confidentiality,

shared history, and the building up of informal

networks. Most HIV positive Spanish-speaking

persons are migrants who come to Australia with

HIV, and have arrived in the last 15 years. As

migrants, they do not know how medical and

94

health systems work, may bring with them

baggage about the social superiority of

doctors, the importance of staying with one

doctor despite poor treatment due to not

wanting to betray him, and the need to be

obedient and passive in health care. It is

essential to have a person available over a

lengthy amount of time that the client can turn

to for advice and mediation.

3. Spectrum: AIDS Council of Western Australia

Several health organisations have created

structures that deal with the

multipositionings of NESB MSM. The AIDS

Council of Western Australia has a group for

NESB men called Spectrum, a social support

group which also has a regular publication. It

is co-ordinated by Bruce Maguire who is also

from the Ethnic Affairs Council. Spectrum has

over 130 members in a multicultural support

group which accentuates commonalities rather

95

than differences between ethnic groups. It

began as the ‘Asian & Friends’ group but the

term Asian was not acceptable to many members

as it was not seen as respecting the cultural

diversity of the Asian region of 57-60% of the

members. Many members are Southern European and

African, and identifying specifically as Indian

and Sri Lankan rather than Asian. Anglo

membership is low, not consciously, but this is

considered a good thing by the members. The

group includes men with permanent residency and

identifying as Australian, men who are second

generation or more, and overseas students

(Maguire, interview).

According to the flier, Spectrum seeks ‘to

increase the visibility and the voice of gay

multicultural men, while promoting integration

into the general community.’ It provides

advocacy, education and support in a safe

environment. Back copies of Speculations, produced

96

on behalf of Spectrum, reveal an array of

issues discussed on the problem pages,

articles that establish education and advocacy

as main goals, celebrations of culturally-

specific events such as the Chinese New Year,

fun articles, international news, prose and

poetry, and Spectrum events. Here is a run-down

of the content of some of the issues:

June-July 1997: Hong Kong politics and

homosexuality, international drinks,

depression, Tas gay law reform and WA

responses, gay myths and facts, interview with

drag diva, sauna etiquette, deaf and gay.

April-May 1997: older gay men, aphrodisiacs,

religions and homosexuality, Hep C, weight and

gay culture, attractions to Western men.

Jan-Feb 1997: transgenderism in Indian movies,

Hanson and Multiculturalism, useful internet

97

sites, French condom use advice, legal

situation in WA, homosexuality in Chinese

culture, permanent residence in Australia and

HIV.

Nov-Dec. 1996: cross-cultural relationships,

deaf sign language, internet, Indonesia and

AIDS, immigration news.

Aug-Sept 1996: relationships with Western men

and power dynamics.

June-July 1996: Immigration news, gays in Asian

families in Australia, male rape, body-

piercing.

In 1998, Spectrum hopes to develop cross-

cultural awareness training packages for

delivery to WA AIDS Council staff and volunteer

workers plus gay community organisations;

98

provide lectures to TAFE; and establish a Web

page.

4.Multicultural Men’s Group: AIDS Council of South Australia

A similar group is run by Stephen House from

the AIDS Council of South Australia, the

Multicultural Men’s Group. The group aims for

confidentiality, discretion and trust in its

sharing of stories. It also discusses

Australian behaviours, values and attitudes and

how they affect NESB gay-identifying men. The

group is also developing displays and hoping to

conduct workshops for specific organisations.

The group has stated that it does not want ESB

men involved including partners who may be ESB

unless it is an open social occasion (Stephen

House, interview).

The South Australian AIDS Council acknowledges

that very few NESB MSM use its services (Peter

McKay, interview). Some NESB MSM say that the

99

concept of coming to an AIDS Council is

‘horrific’. Those who do come in specifically

request working with ESB persons. The AIDS

Council is not really geared up to work with

NESB MSM issues as it encourages men to be

upfront about being gay which clashes with

cultural issues of discretion. Generally, the

material produced is explicit, targeting white

middle class men and thus is not necessarily

appropriate for other men. However, according

to the Chief Executive Peter Kay, there is

anecdotal evidence in South Australia that

sero-conversion used to be a middle class white

gay men phenomenon but now it is related to MSM

under extreme stress occasioned by

unemployment, being NESB and juggling

identities, and married men coming to terms

with their preferred sexual practices. It is no

longer about the lack of information but about

engaging in behaviours that are known to be

100

unsafe. Factors such as those outlined above

over-ride knowledge of unsafe practices.

5. Culturally specific groups: Victorian AIDS Council

Attached to the Victorian AIDS Council and co-

ordinated by Vic Perri are a number of

culturally specific groups such as:

Greek and Gay- launched a poster

Italian and Gay- about to launch an

anthology project of personal stories

Aleph- Jewish gay men’s group

Circulo Latino- gay and lesbian of Latin

background

Multicultural Gay Group

Silk- Asian men’s group

Positive Asian Men.

a/ The poster for ‘Greek and Gay’ is an

interesting and successful example of taking

into consideration culturally sensitive ways of

getting HIV and homosexuality information

across to a wider ethnic community. It has a

101

photograph of an old woman embroidering a

phrase, ‘Love and Understanding’ in Greek,

while the main title says in Greek and English,

‘It's all part of the tapestry of life’.

b/ The SILK(Support, Information, Laughter and

Kinship) pamphlet discusses socio-cultural

issues - religious, political, ethnic, gender,

sexuality. An overview of topics include:

family values and expectations; coming out; gay

culture and love, sex, relationships; stress

management; safe sex information; gay white

culture; gender; legal and moral rights

regarding racial and sexual discrimination;

definitions of ‘otherness’; self-esteem; cross-

cultural relationships; immigration issues.

c/ The Italian Gay Network pamphlet explores

cultural and sexual identity and gay lifestyle

issues; raises awareness about gay lifestyle

issues within the Italian community; raises

102

awareness of Italian cultural issues within the

broader gay community. The Greek and Gay

pamphlet is very similar.

d/ The Aleph (Jewish Gay and Bisexual Men)

pamphlet stresses the group’s role in providing

guidance, support and companionship;

alternatives to gay venues; dealing with social

and ethnic differences that may pose

difficulties.

e/ Asianline is a VAC referral phone service on

HIV and sexuality also open to non-gay

identifying Asian Australians. The line is

multilingual, providing culturally sensitive

and appropriate information when it operates

each Monday night.

f/ Positive Asian Men is a peer support group,

providing information on therapies,

counselling, and family support.

103

6. Jim Sotiropoulos co-ordinates the Youth

Project in which a large number of participants

are second-generation with at least one parent

born overseas and often speaking the parents’

language. Many are Italian, Greek, German,

Slavic and a smaller number are Vietnamese and

Chinese. The second most significant group is

young men from overseas as students. Mainly

from Singapore, Hong Kong, Malaysia and

Thailand, they will often go through a ‘coming

out’ process while in Australia, yet know they

usually will not be able to be openly gay when

they return home. They will often make initial

contact with Jim’s project to find out more

about the gay scene in Melbourne and how they

can meet other young gay men. The most under-

represented are recent young male migrants to

Australia. The majority are from Latin America

followed by those born in Australia but who

left at an early age to live in another country

104

and have now returned. The main issue for young

NESB MSM is how their sexual identity can fit

in with their culture, how their families deal

with their gayness. Often they perceive it as a

struggle between ethnic background and being

gay. They feel like they need to choose one or

the other. Often, either they really want to

meet other young gay men from the same

background or they are against this idea,

especially overseas students.

7. Gay Education Strategies Project: Australian Federation of

AIDs organisations

Keith Gilbert, Project officer, Gay Education

Strategies Project for AFAO has set up

committees of Asian gay men to develop

campaigns specific for those populations.

8. Migrant Health Service

The Migrant Health Service, Adelaide also co-

ordinates several group such as:

105

GAIM (Greek and Italian men)

Unidos (multicultural group),

Mariposas (Latin-American gays and

lesbians),

Shangri-la (Asian Support).

The group co-ordinators believe it is essential

to work with specific communities according to

particular factors such as place of residence.

For example, the Greek community in Adelaide is

quite different from the Greek community in

Melbourne. The Adelaide community is more rural

and poorer in origin and this impacts on

attitudes to STDs and sexuality. They have also

found that public advertising or too much of it

can be too confronting. More discreet and one-

to-one approaches are often better. It is also

important to have people of the same

ethnicity/community group, speaking the same

language and knowing the secret networks and

informants, co-ordinating the NESB MSM

organisations and support groups. The Migrant

106

Health Service does not do ‘classroom

education’ but believes in establishing small

groups over a long-term and working one-on-one

with NESB MSM. This ensures confidentiality,

and reassures men they are respected. For

example,workers go out to meet men wherever

they are such as at home, in coffee shops, in a

park, etc. The worker is seen as a person

demonstrating care and support and dealing with

the same issues. This initial relationship then

usually leads to men feeling more comfortable

in joining a group.

The group co-ordinators state that writing

submissions for grants is proving problematic:

the communities’ needs and strategies do not

fit the submission contexts. Communities need

to have more control over projects, more

community-ownership. They need greater

flexibility to shift project perspectives and

strategies as required. Funding organisations

107

need to be more aware of the complex processes

involved in such projects.

The personal lives of workers is another issue

for the Migrant Health Service: workers have to

conceal their own sexualities or they will lose

respect of the communities and not be able to

do their work. They are juggling roles

themselves, leading double lives pertaining to

their own families, Church participation,

geographical location within the community, and

their personal and professional roles as

workers and members of NESB MSM groups.

9. Second Storey: the Adelaide Youth Health Centre

Second Storey, the Adelaide Youth Health Centre

makes links with schools who contact Second

Storey for workshops, materials, etc.,

particularly schools with high NESB populations

and/or high homophobia. Student counsellors’

understanding of issues varies from non-

108

supportive to fully supportive. It has also

received calls from rural areas in relation to

Asian youth. Its workers liaise mainly with

Health and PE teachers and University student

associations (Ben David and Oliver, interview).

The Second Storey workers face the big issue of

how to get NESB youth to ‘walk through the

door’. Usually one-off conversations are the

only contact because of the NESB youth wanting

to remain anonymous and definitely not wanting

to meet someone from their own community. They

also ask questions about the type of men who

work there: do they ‘look gay’ as they will not

want to be seen with anyone who ‘looks gay’.

10. Prostitutes Collective of Victoria

The Prostitutes Collective of Victoria (PCV)

has implemented a series of staff development

workshops which modified and adapted a model

supplied by the Ethnic Communities Inc. of

109

Victoria. It addresses many of the issues

presented in this report. The membership,

management committee, staff and service users

were consulted and participated in order to

arrive at a final version which was adopted by

the Collective (Julie Futol and Trang,

interview).

The Policy outlines the following:

1. the right to equal access to the

organisation, resources, processes and

services;

2. the responsibility of the organisation to

make its services accessible

3. that affirmative action is necessary to

ensure accessibility and to meet additional

needs.

This strategy aimed at increasing access and

involvement of NESB sex workers in PCV was then

implemented with various outcomes:

110

1. creating a welcoming environment offering

culturally relevant, multilingual signage,

posters and literature;

2. staff becoming aware of cultural

differences, sensitive to the needs of

individuals and approaching them in a non-

intrusive manner;

3. employing staff from a variety of cultural

and ethnic backgrounds- staff education,

resources in the workplace which analyse needs

and suggest best practices, skills training;

4. networking amongst NESB community and ethnic

services, such as advertising in the ethnic

media; attending multicultural festivals with

an information stall also led to many calls.

111

Appendix B. List of Persons and

Organisations

Participating in the Audit

Tasmanian AIDS Council

Todd Harper: Executive Director

Brendon Nelson

AIDS Council of Central Australia

Mary O’Shea: NESB Women and Sexual Health

Project

AIDS Action Council of the ACT

Steve Towers: Education Officer

Ian Rankin: President

Queensland AIDS Council

Jackie Hauff, from Ethnic Communities Council

Northern Territory AIDs Council

112

Barry Horwood: President

AIDS Council of NSW

Bernie Coates: Executive Director

Di Furness of ACON Northern Rivers Branch

Grant Farquharson: Spanish Counsellor

Ed Moreno: HIV/AIDS Legal Centre

Sara Lubowitz: Women Partners of Bisexual Men

Sara Bergen: Librarian

AIDS Council of Western Australia

Chris Carter: General Manager

Bruce Maguire: Spectrum

AIDS Council of South Australia

Gay and Lesbian Counselling Service and Trainee

group meeting

Peter Kay: Executive Director.

Stephen House: Multicultural Men’s Group,

Between Men project, Outreach at beats and

saunas

113

Beth Tinning: Manager of SA Sex Industry

Network. (SASIN)

Adelaide Diocesan AIDS Centre

David Waterford: Levi-Strauss Young NESB MSM

project

Victorian AIDS Council

Susan Harben: Chief Executive

Jim Sotiropoulos: Youth Project

Vic Perri: Coordinator of multicultural groups

Sue Kimberley: doing a needs analysis/resource

inventory in Victoria re AIDS services

Bev Brain: cross-cultural worker

Australian Federation of AIDS Organisations

Keith Gilbert: Project Officer, Gay Education

Strategies Project

Patrick McGee:at VAC doing a NESB HIV Services

Access Project

114

Multicultural HIV/AIDS Education and Support

Service, Sydney

Peter Todaro: Coordinator

Wa’el Sabri

Tony Savdie

Tadgh McMahon

Matthew Hua

Cross-cultural staff meeting

Ethnic Communities Council, NSW

Barry Gamba: Arts Co-ordinator

Multicultural Health Communication Service,

Sydney

Michael Camit

Migrant Health Service, Adelaide

Group meeting with Deb Thiele and coordinators

of GAIM (Greek and Italian men) and Unidos

(multicultural group), Mariposas (Latin-

115

American gays and lesbians), Shangri-la (Asian

Support)

SBS Radio

Ozen Ozuiner : Turkish Program.

Olya Booyar: Program Manager, Sydney

Aynur Cagli: Program manager, Melbourne

Centre for Culture, Ethnicity and Health,

Melbourne

Mirta Gonzalez: Director

Tonina Gucciardo-Masci

Ethnic Youth Issues Network, Melbourne

Soo Lin Quek

Macquarie University, NSW

Nassim Arage: Sexuality Officer

Griffith University, Qld

Steve: Pride organiser

116

Flinders University, SA

Gerard Meek: President of OUT

Cross Campus Sexuality Network (CCSN)

Melissa de Silva: Coordinator

University of Sydney Nursing Society

Roger Levi

University of Melbourne Student Welfare

Morag Logan: Chaplain

Carol Hogan: Chaplain to International Students

Margaret Bollen: Head of Student Services

University of Sydney

Christine Inglis: Faculty of Education

Dr Phillip Brown: Head of University Health

Services

University of New South Wales

117

Mary-Louise McLaws.

Chris McCauley: HIV Project

Mary Woolhead: EO

Brian Burke: Director of International Students

University of Newcastle

Bethne Hart: Sociology Department

Northern Sydney Institute of Technology

Peter Dwyer: Educational Support Consortium,

Course Development and Development of Student-

Based Programs

International Students Association

Patrick Willix: International Studies Co-

ordinator, University of Notre Dame

Dr Ross J Lehman: Southern Cross University

Queensland Ethnic Communities Council

Mo Mahat

118

Centre for the Study of Sexually Transmissible

Diseases, La Trobe University

Christine Bakopanos

Meredith Temple-Smith

St George Hospital, Sexual Health Clinic

Priscilla McCorriston

Family Planning, NSW

Dermott Ryan

Family Planning, NT

Bill Parlitt

Self-Health for Queensland Workers in Sex

Industry (SQWISI)

Bradley: Male Project Officer

Second Storey Health Centre, Adelaide

David Ben David and Dean Oliver: Project

Officers

119

Commonwealth Department of Health and Family

Services

Eamonn Murphy: Assistant Director, Public

Health Education Unit, National Centre

for Disease Control

Heidi Stefanoff: Public Health Education Unit,

HIV/AIDS, Hep C, Sexual Health Unit

Alan Thorpe

Liverpool Community Health Centre

Ken Wong

Cabramatta Community Centre

John Samaha: Arabic-speaking MSM project

coordinator

Arabic-speaking MSM Project group

Mary Enkababian: Fairfield/Liverpool Health

Team

Faiza Anwar: Acting Manager, Nurse

Practitioner, Family Planning at Fairfield

120

AIDS Society for Asia and the Pacific (ASAP)

Steve Lovell-Jones

Maria O’Connor (per John Dwyer)

Foley House

Bill Robinson

Elizabeth

Stephanie Taylor

Gender Centre

Craig George

Albion Street Centre, Counselling Unit

Kim Begley

Staff meeting

Asian Harm Reduction Network: McFarlane Burnett

Paul Deany: Director

Peter Deutschman

Kim Benton

121

Shanton Chang: Convenor of International

Students Association

Australasian Society for HIV Medicine (ASHM)

Beatie Pearlman

HIV and Sexual Health Social Work Service

Anthony Schembri

Social Workers in AIDS (SWAIDS)

Andrew Harvey

Sex Workers Outreach Project (SWOP)

Maggie Moylan

Maria McMahon

Polly Purser

NSW Health Department

122

Gray Sattler: Policy Analyst, AIDS and

Infectious Diseases.

Northern Territory Health Services

Sue Dubow

Tasmanian Health Department

David Coleman: Surveillance Branch

David Gardner: Migrant Health Policy

Queensland Health Department

Tania Bain

Hugo Ray

Western Australian Health Department

South Australian Health Commission

Westmead Hospital, NSW

Marianne Wyder: sexuality and suicide

researcher

123

National Centre in HIV Epidemiology and

Clinical Research

John Kaldor

Garrett Prestage

Prostitutes Collective of Victoria

Julie Futol

Trang: NESB worker

Centre for Social Research, VIC

Marg Sutherland

Australian Centre for Lesbian and Gay Research,

University of Sydney

Maude Frances

Gerard Sullivan

Peter Jackson

AusAID

Heather McDonald: Health re overseas students

124

Ann Malcolm: private consultant

Scarlet Alliance

Sue Metzenrath

Victorian Education Department

Peter Roberts and Debbie Ollis: STD/AIDS

Prevention Education Project

Ten trial schools of the project

Cultural Perspectives Consultancy, Sydney

Christine Dwyer: Principal Researcher/

Consultant

National Centre in HIV Social Research,

Macquarie University

Hedimo Santana

Edward Reis

Paul Van de Ven

Juliet Richters

125

Women in Industry and Community Health (WICH),

Melbourne

Maybe Baby Gay and Lesbian Parenting

Chris Daniel

Macquarie Sexual Health Clinic, Dubbo

Chris Bourne

South Eastern Sydney Area Health Service

Colin Clews

Irena Brozek

126

Annotated Bibliography of

Australian Material

Articles

Alley, Jo (1996). Tranys, Dicks and

Fannys: men who have sex with both men

and transgenders. Unpublished Paper.

Women’s Health Service, South Eastern

Sydney Area Health Service.

This article includes information on cross-

cultural-cultural studies of MSM which may

challenge Anglo definitions of ‘transgender’.

Refers to (1) study in Northern Thailand that

outlined 29 terms/concepts used to describe MSM

according to varying masculine/feminine traits,

desire to change gender, sexual practices and

127

roles; (2) study in Vietnam of restricting sex

with men to fellating ‘masculine’ men.

Antonakis, Steven (1994). Greek, Gay and

Positive. National AIDS Bulletin 7 (11):

26.

The writer discusses the difficulties and

concerns he had in telling his family he was

HIV positive, despite knowing they would care

for and support him. Issues of culture,

migration, family and intergenerational

relationships are explored.

Camit, Michael (1994). Positive Asians:

a hidden Minority, National AIDS

Bulletin 8 (8): 26-27.

This article addresses some of the reasons why

it is difficult to reach out to positive Asian

128

men and what makes them ‘invisible’. Issues

such as Asian heterogeneity, language barriers,

issues regarding trusting authority and

government figures, immigration rejections due

to status, internalised racism, and cultural

meanings of illness and death, are presented.

Camit, Michael (1997). Working With

Diversity, National AIDS Bulletin 11

(2), 11-13.

This article argues that improving access and

equity in HIV/AIDS services requires strategic

commitment and planning on the part of

community-based organisations. Some definitions

of ‘access and equity’ and ‘working with

diversity’ are offered, and a guide to how the

principles behind each can be put into effect.

129

Clews, Colin (1993). Multicultural

Education in Sydney, National AIDS

Bulletin 7 (2): 22-25.

This article outlines three HIV/AIDS education

projects amongst cultural and linguistic

minorities in Sydney: Vietnamese Youth Project;

Arabic Community Education Program; and the

Vietnamese Community Education Program. It

identifies the strengths and weaknesses of each

project according to a checklist of major

issues that a successful health promotions

program covers. Adequate resourcing, culturally

and linguistically specific needs assessment,

and community involvement are three key factors

in a successful HIV/AIDS prevention program.

Eisenberg, Masha; Painter, Lesley; and

Todaro, Peter (1993). The Challenge of

130

HIV/AIDS in a Multicultural Society,

National AIDS Bulletin 7 (2): 17-21.

This article presents several HIV/AIDS

challenges in a multicultural society such as:

moving beyond the translation model,

collecting NESB data reliably and publicly,

allocating funds equitably, reflecting the data

and providing sufficient long term NESB

specific service structures, NESB

representation at planning levels of AFAO,

NAPWA, etc.

Farquharson, Grant (1992). Migration,

Homosexuality, HIV and AIDS: the NESB

challenge, National AIDS Bulletin, 6

(5): 29-31.

This article explores the effect of the

socially constructed AIDS= homosexuality

131

equation on NESB persons who have HIV/AIDS.

However, the heterosexualization of AIDS by

service providers is not the solution. There

is a need to analyse the equation within

dominant Western culture, and analyse the

interaction that exists between the equation

and the cultural norms of individual cultural

groups within multicultural Australia; and work

toward modifying specific cultural attitudes

about homosexuality so that it is seen as a

reality to be understood rather than an evil to

be feared and rejected. The article also

discusses the impact of migration in relation

to migrants having to learn the workings of a

new bureaucratic system and how to fight for

their rights.

Farquharson, Grant (1993). HIV and

Multiculturalism, National AIDS Bulletin

7 (2): 14-16.

132

The author interviews two HIV positive

migrants, an Argentinian and a Brazilian. Issue

ssuch as family, migration, HIV treatments,

emotional support, are discussed.

Hauff, Jacqueline (1993). Multicultural

HIV/AIDS Awareness for Queensland.

National AIDS Bulletin 7 (2): 34-36.

The article outlines a research project

conducted with eight different ethnic

communities in Brisbane and Townsville. Four

target groups were identified for specific

education programs: the general community;

young NESB people; those engaging in ‘high risk

activities’ such as MSM, injecting drug users,

and sex workers; and recently-arrived NESB

migrants and refugees.

133

Lackmann, Annegret (1997). The Continuum

of Developmental Casework in Working

With Positive Women of NESB, Noah’s Arc:

Newsletter of the Australasian Society

For HIV Medicine, 9 (2): 20-21.

Although this article is about NESB positive

women, the issues it raises are pertinent to

the situations of NESB positive men such as:

invisibility within their own NESB communities,

issues of shame and family honour, moving away

from family and community.

McGee, Patrick (1997). Productive

Diversity?, National AIDS Bulletin 11

(2): 8-9

134

The author uses Cope and Kalantzis’ model of

productive diversity to discuss the cultural

diversity of the HIV community and how the

potential for conflict needs to be understood

and subverted by focusing on the paradox

“cohesion through diversity”. Diversity is a

strength in the HIV community that binds people

together into a cohesive group with a common

purpose.

McMahon, Tadgh (1997). Cultural

Difference and Gay Identity:

implications for HIV interventions,

National AIDS Bulletin 11 (3): 16-18.

McMahon argues that a policy framework for

meeting cultural diversity within the gay

community exists in Access and Equity, and that

there is a wealth of HIV/AIDs experiences to

draw upon to make HIV/AIDS interventions more

culturally appropriate. He uses life stories of

135

three Vietnamese men who came to Sydney from

Vietnam as teenagers to explore issues of

cultural, gender and sexual identity and

belonging.

Nathan W. (1997). Rice Queens- The Asian

Hunters, SILK Newsletter, August, pages

unnumbered.

This article uses the experiences of an Asian

student from overseas to explore exploitative

experiences involving White older men, and the

implications for HIV infections.

National Aids Bulletin (1997a). What

Access? Whose Equity?, National AIDS

Bulletin 11 (2): 19-23.

Six people working in AIDS across Australia are

asked the above question including: Sue

136

Metzenrath, Co-convenor Scarlet Alliance; Keith

Gilbert, Project Officer, Gay Education

Strategies Project, AFAO (refers to setting up

committees of Asian gay men to develop

campaigns specific to those particular target

groups); Di Furness, Manager, AIDS Council of

NSW (Northern Rivers Branch); Brendon Nelson,

Services Manager, Tasmanian AIDS Council

(speaks of problems with establishing peer

support groups with one out gay Asian man; how

to access communities with no regular venues;

the need to prioritise issues and programs);

Michael Camit, Cross-Cultural HIV/AIDS Worker,

South Eastern Sydney Area Health Service (good

section on strategies for multilingual

information and services, issues of access and

equity; need for a consistent approach to data

collection on ethnicity to reflect the

diversity of cultures within the target group).

137

National AIDS Bulletin (1997b). Case

Studies in Access and Equity, National

AIDS Bulletin 11 (2): 24-27.

Community-based HIV/AIDS organisations talk

about their efforts at improving access and

equity including: Sex Workers Outreach Project

(SWOP) (significant number of NESB female sex-

workers are not accessing SWOP and other

relevant services; about one third of sex

establishments that SWOP maintains contact

within NSW employ NESB sex workers; SWOP has

two part-time bilingual staff for resource

development; education and liaison with other

services; outreach; ‘reaching in’: staff talk

about their own cultural barriers and training

needs); Prostitutes Collective of Victoria

(PCV) (includes Thai transgender workers or

Mandarin-speaking Australian women working in

massage and other NESB sex-workers; Project

SIREN for NESB sex-workers, produced booklets

138

and tapes for Thai and Filipino workers; higher

proportions of NESB men who are clients of sex

industry; the need to access ethnic media;

attending ethnic festivals).

Pallotta-Chiarolli, Maria (1994a).

Access and Equity: multiculturalism and

HIV/AIDS, AIDS Awareness Week Bulletin

1: 4.

Written in conjunction with the Multicultural

HIV/AIDS Education and Support Centre, this is

a summary of the concerns and failures of

addressing NESB issues as part of the Access

and Equity policy. Suggestions for more

inclusive, incorporative processes of mediation

and negotiation are discussed.

139

Pallotta-Chiarolli, Maria (1994b). It’s

Not My Death I’m Worried About, AIDS

Awareness Week Bulletin 2: 2

A narrative biographical reconstruction of an

interview with John, an HIV-positive Muslim-

Lebanese man who is a client of the

Multicultural HIV/AIDS Education and Support

Centre. Issues of family, ethnic and gay

community belonging, and their impact on living

with HIV, are presented.

Pallotta-Chiarolli, Maria (1996a).

Multiculturalism meets Multisexualities:

forging our own relationship patterns,

National Biways: Australian Bisexual

Network Newsletter 5: 23.

140

This paper presents a diversity of lifestyles

and sexual identifications being lived as NESB

sexualities.

Pallotta-Chiarolli, Maria (1996b). Only

Your Labels Split The Confusion: of

impurity and unclassifiability, Critical

InQueeries 1 (2): 97-118.

This paper presents a diversity of lifestyles

and sexual identifications being lived as NESB

sexualities.

Pallotta-Chiarolli, Maria (1996c).

Landscapes of Conflict and Negotiation:

health services, ethnicities and

141

sexualities, Social Alternatives 15 (4):

20-24.

This article explores the specific issues in

relation to family, ethnic community, peer

groups and networks and the wider society non-

heterosexual persons of NESB need to negotiate

and how these factors impact upon mental and

emotional health. The limitations inherent

within national health policies and medical

services in relation to NESB sexualities are

also examined.

Pallotta-Chiarolli, Maria and Skrbis,

Zlatko(1994). Authority, Compliance and

Rebellion in Second-Generation

Individuals From Cultural Minorities,

Australia New Zealand Journal Of

Sociology 30 (3): 259-272.

142

This paper explores the multi-positionings of

second-generation individuals in relation to

ethnic, gender and sexual identifications.

Sabri, Wa’el (1994). Astride Two

Cultures, Between Two Families,

National AIDS Bulletin 7 (12): 17-18.

This piece is based on an interview between a

worker from the Multicultural HIV/AIDS

Education and Support Centre with ‘John’, a

client, who is HIV positive and from NESB

culture. Talks about cultural and other issues,

his relationships within gay community,

position of the son in his family and NESB

community, and how Sabri meets his client in

coffee shops along Oxford Street away from

where John lives with his family.

Temple-Smith, Meredith & Gifford, Sandra

(1996). Should Sexually Transmissible

143

Disease Surveillance Include Ethnicity

Data? Communicable Diseases

International 20 (10): 240-243.

This article discusses the inconsistent

collection of indicators of ethnicity in

Australian data relating to HIV and sexually

transmissible diseases. It argues that such

information is essential for effective planning

in prevention and treatment. Current ethnicity

data is examined. Suggestions are made for a

staged framework for collecting such

information and for uses of these data. The

authors also address the concerns that prevent

more specific ethnicity data from being

collected and publicised, such as

discrimination and marginalisation.

144

Trotter, Gary (1993). No Identified

Risk. National AIDS Bulletin 7 (2): 31-

33.

The author outlines the issues encountered by

ten per cent of patients in the AIDS unit of

the Royal Prince Alfred Hospital who are NESB ,

usually MSM and married with children. Issues

include denial of risk behaviours, family

relationships and disclosure, isolation from

the community, lack of culturally specific

support, death customs and rituals.

Voukelatos, Alex and Boswell,

Deborah(1997). Calling All Cultures:

where policy and practice converge,

National AIDS Bulletin 11 (2): 14-15.

This paper looks at the work of the

Multicultural HIV/AIDS Education and Support

145

Centre in NSW, its projects and use of ethnic

media.

Yueming, Li, Gold, Julian and McDonald,

Ann and Kaldor, John (1996). Demographic

Pattern of AIDS in Australia, 1991-1993,

Australian And New Zealand Journal Of

Public Health 20 (4): 421-425.

This paper shows how information is broken down

by sex, age group, country of birth and

geographic area of residence, and addresses its

findings and its limitations.

The study may have documented the ‘geographic

heterogeneity’ but it certainly has homogenised

NESB issues.

Audio-visual and Other Resources

Heart Of A Tiger

146

Cassette and Training Kit

Ethnic Youth Issues, Vic, of Youth

Affairs Council of Vic, 1995

Beng Lim speaks about being HIV positive and

Malaysian, and significant family and cultural

issues, in an interview and two public forum

presentations.

The Last Coming Out

1992, VHS 89 mins

Producer/Director/Writer: Con

Anemogiannis

Fortian Productions PTY LTD.

Looks at the multicultural communities of

Australia, showing how they have been affected

by HIV/AIDS. Examines Australia’s gay community

through the eyes of its multicultural members.

Australians from NESB reflect on living with

147

the knowledge of HIV, of having to tell their

closed communities and families. It is the last

coming out, double isolation. Also interviews

councillors and other service providers.

Ethnicity and Sexuality Segment,

Life Matters

Producer: Lorenza Bacino

Geraldine Doogue’s ABC Radio National,

February 3rd, 1997.

Interviews with ‘John’ who is NESB gay-

identifying second-generation, Happy Ho lesbian

of Chinese background and her mother, and Maria

Pallotta-Chiarolli.

Men Who Have Sex With Men

148

SBS Television and National AIDS

Campaign as part of the English at Work

series.

1992

Explores issues of HIV and STD prevention for

men who have sex with men and women. Culturally

diverse representations of doctors, clients,

etc. Centres around young married man who has

sex with football team mate.

National HIV/AIDS and Sexual Health

Video Project for NESB

Senior Project Officer: Tony Savdie

Multicultural HIV/AIDS Education and

Support Centre, Sydney

In process, 1997-1998.

A video, facilitator’s handbook, workshop

materials and board game are being developed in

149

seven languages: Chinese, Vietnamese, Tetum,

Arabic, Spanish, English and Bosnian. The video

will present jargon-free information on HIV and

STDs, and use story-telling and case studies as

additional material.

Peatfield, David (1997). Heterosexual

Men Who Have Sex With Men: an

information manual for health service

providers. Sydney: Western Sydney AIDS

Unit: HIV Education.

Has a section on heterosexual MSM of different

cultural backgrounds. Deals with different

understandings of sexual identity, marriage and

family, and gives hints about cross-cultural

undertandings such as assessing English

speaking skills.

150

Play It Safe: HIV/AIDS Awareness Project

And Report

Multicultural HIV/AIDS Education and

Support Service and Central Sydney Area

Health Service, 1996.

Video is part of a campaign using soccer as a

means of educating people about HIV/AIDS.

Soccer celebrities and other celebrities are

interviewed. It targets soccer spectators and

players, multicultural men and women usually

around 13 to 25.

Safe Not Sorry: Cultural Applications

Community Programs, Personal & Community

Services Industry Training Division,

TAFE, NSW, 1994.

151

A kit of multilingual resource sheets that

provides teachers and educators with basic

knowledge of issues which may assist them when

implementing HIV/AIDS education with people

from the following language/cultural groups:

Arabic, Italian, Greek, Macedonian, Khmer,

Loation, Thai, Vietnamese, Polish, Chinese,

Cantonese, Croatian.

Each language has a section on MSM.

Sex, Living And Dying: Cross-Cultural

Meanings and HIV/AIDS.

Audio-cassette and package by Amos Hee

for the Ethnic Youth Issues Network of

Victoria. Uses ‘Heart of a Tiger’ by

Beng Lim. 1997.

The story of Beng Lim, a young HIV positive man

from Malaysia, showing how migration, culture,

homosexuality, being young and HIV Positive

152

interact in a powerful way. Provides some

definitions of ethnicity, culture, values and

social justice; offers guidelines on how to

make organisations more accessible to young

NESB people. Also shows how shame can act as a

cultural barrier where young NESB MSM may not

disclose to workers their frequenting of beats,

for example. The issue of coming out is also

addressed. Also presents other case studies

such as ‘Mike’, young NESB MSM.

Three In A Marriage: educational

resource for women partners of bisexual

and/or gay men.

Sara Lubowitz, Women of Bisexual

Partners Project, ACON, 1997.

Several women are interviewed about their

relationships, sexual infections, and includes

153

footage from GP episode. Women are culturally

diverse.

Working With Diversity

Training Film for Health Workers

South Eastern Sydney Area Health

Service: Michael Camit and Colin Clews

NSW Health Department, 1995

Pegasus Video,

NSW Film and TV Office

Addresses some of the issues surrounding NESB

MSM using short scenarios. Includes an

accompanying training package with workshop

activities, discussion starters, essays.

154

Books/Monographs

Jackson, Peter and Sullivan, Gerard (ed)

(forthcoming, 1998). Multicultural

Queer: Australian narratives. New York:

Haworth Press.

This is a collection of theoretical essays,

autobiographical narratives, and research

papers that explore being of NESB and of

diverse sexualities in Australia. There are

some sections exploring sexual health and HIV.

Lubowitz, Sara (1995). The Wife, Her

Husband, His Boyfriend...Her Story.

Canberra: AIDS/Communicable Diseases

Branch, Commonwealth Dept of Human

Services.

155

One of the interviewed women, Zoe, is of NESB

with a bisexual husband. Talks about not being

able to tell her NESB family. Both their

families have placed much pressure on them. Has

remained friends with her husband, still loves

him.

Pallotta-Chiarolli, Maria (1991).

Someone You Know: a friend’s farewell.

Adelaide: Wakefield Press.

An autobiographical/biographical book with

AIDS, death and dying, and friendship as

primary themes. Issues of ethnicity, sexuality

and gender are also major focuses.

Pallotta-Chiarolli, Maria (1994c).

Negotiating Ethnicity, Gender and

Sexuality: the personal identity

formation of lesbians of Non-English

156

Speaking Backgrounds. M.A. in Women’s

Studies Thesis published as a monograph

in Multicultural Australia Papers (No.

73, 1994), Ecumenical Migration Centre,

Collingwood, Victoria.

Textual and empirical research on issues of

cultural conflict, cultural synthesis and the

negotiation of family, ethnic and lesbian

communities and society that is of relevance to

NESB MSM.

Surgey, Di (1992). Women Talk...About

AIDS, Sex And Sexual Health.

Melbourne: Women in Industry and

Community Health (WICH).

A bilingual book for women from Arabic speaking

communities that raises issue of husbands

157

having sex outside the marriage ‘with anyone

else’ so gender remains unspecified.

Book Chapters

Pallotta-Chiarolli, Maria (1992). What

About Me? Lesbians of Italian Background

in K. Herne, J. Travaglia and E.

Weiss(ed) Who Do You Think You Are?

Writings By Second Generation Immigrant

Women. Sydney: Women’s Redress

Press/Melbourne: Artemis Press from

1996.

158

Drawing upon interviews with four lesbians of

Italian background, the chapter explores their

negotiations, conflicts and points of synthesis

with their families, ethnic communities, wider

society, feminist and lesbian networks that are

also pertinent to NESB MSM.

Pallotta-Chiarolli, Maria (1995). ‘A

Rainbow in My Heart’: Negotiating

Sexuality and Ethnicity in C. Guerra

and R. White(eds) Ethnic Minority Youth

In Australia: challenges and myths.

Hobart: National Clearinghouse on Youth

Studies.

Explores the specific issues in relation to

family, ethnic community, peer groups and

networks and the wider society non-heterosexual

persons of NESB need to negotiate.

159

Pallotta-Chiarolli, Maria (1996d).

Landscapes of Conflict and Integration:

Negotiating Ethnicity, Gender and

Sexuality in Relation to Mental and

Emotional Health in J. Larbalestier, M.

Spongberg, M. Winn (eds) Women.

Sexuality. Culture. Sydney University

Women’s Studies Centre and United

Nations Development Fund.

Explores the specific issues in relation to

family, ethnic community, peer groups and

networks, and the wider society non-

heterosexual persons of NESB need to negotiate

and how these factors impact upon mental and

emotional health. The limitations inherent

within national health policies and services in

relation to NESB sexualities are also examined.

160

Pallotta-Chiarolli, Maria and Skrbis,

Zlatko (1995). Ethnicity, Sexuality and

Gender: Authority, Compliance and

Rebellion in J. McNamee and L. Rowan

(ed) Voices Of A Margin: speaking for

yourself. Rockhampton: University of

Central Queensland Press.

Explores the multi-positionings of second-

generation individuals in relation to ethnic,

gender and sexual identifications.

Conference Publications

161

Camit, Michael (1996a). Working With

Diversity, Out There Too: social

research and practice forum on health,

sexuality and HIV/AIDS. Adelaide, March

14-15, 1996. HIV/AIDS Progress Unit, SA

Health Commission.

Introduces the package ‘Working With Diversity’

that unpacks assumptions, generalisations, by

presenting a training video that uses dramatic

sequences to illustrate issues around

assumptions HIV/AIDS workers make about

clients. It outlines possible impacts language

and culture have on HIV/AIDS related knowledge

and behaviours; the impact of language and

culture on access to HIV/AIDS services, outline

possible strategies for linguistically and

culturally sensitive HIV/AIDS programs. Also

provides suggestions on how to incorporate

issues of diversity into the organisations.

162

Camit, Michael (1996b). An Invitation to

Yum Cha: HIV Positive Asians,

Out There Too: social research and

practice forum on health, sexuality and

HIV/AIDS. Adelaide, March 14-15, 1996.

HIV/AIDS Progress Unit, SA Health

Commission.

Discusses Asian Project of ACON: its

exploration of issues of class, geographic

isolation, culture in Western Suburbs of

Sydney; and its aim to minimise adverse impact

of HIV infection on Positive Asian gay men, and

foster and promote principles of self-

determination, empowerment and personal

responsibility. Explores strategies of indirect

recruitment to access Asian HIV positive men

and their carers, and avoid them having to

163

disclose before being reassured of ACON’s

confidentiality, trust issues.

Discusses why it’s difficult to reach out to

Positive Asians: Asians are not one homogenous

group eg. religious differences, language

barriers, internal class structures,

traditional role of family, confidentiality eg.

refusing interpreter from same culture, wary of

anyone in authority or linked to government,

immigration issues and fear of deportation,

unaware that testing and treatment is free,

seeing HIV as result of becoming Westernised,

issue of arranged marriages, sickness as

punishment for past sins or karma.

Calls for essential multilingual treatments

information being placed on the agenda of

education for HIV positive people;

acknowledgment of traditional medicine as an

option; national campaign needed to raise

164

visibility of HIV positive Asians; partnership

between HIV organisations and ethnic community

organisation to create supportive environments

and sharing of resources; quality social

research on NESB living with HIV that

recognises impact of language and culture.

Farquharson, Grant (1996). The ‘Por La

Vida’ Project: A Short History and

Recommendations, First National

Conference For Spanish-Speaking

Organisations, March.

Presents history and objectives of “Por La

Vida”, organisation for HIV awareness and

support in Spanish speaking communities. HIV+

165

clients are 98% male (55) and 1 female. 70%

identified as homosexual, 9% as bisexual, while

7% did not specify. 48% had contracted HIV

through sexual transmission.

Matsumoto, Kirsten Axell, Thiele, Deb

and Kunst, Jens-Peter (1996). Migrant

Health Service: Crossing Barriers with a

Multicultural Community Support Program,

Out There Too: social research and

practice forum on health, sexuality and

HIV/AIDS. Adelaide, March 14-15, 1996.

HIV/AIDS Progress Unit, SA Health

Commission.

Discusses HIV/AIDS Community Support Program to

work with clients from diverse cultures not

accessing mainstream HIV/AIDS information and

services. Discusses the use of peer education

model and multicultural community support model

166

as peer education model is not feasible due to

different languages, cultures and other social

complexities.

Community Support Workers are called upon to

work in community education, client support,

program advocacy and representation at

meetings, workshops, etc. They are given

Community Support training, paid for attending

meetings.

Found that successful ethnic community access

depends on liaisons with ethnic community

organisations and that informal education

processes through family and friends are

valuable and need to be documented.

Discusses ongoing development of the program

and its use by and connections to other

organisations.

167

Pallotta-Chiarolli, Maria (1993).

Landscapes of Conflict and Integration:

Emotional and Mental Health Issues for

Women of Non-English Speaking

Backgrounds in Relation to Gender and

Sexuality, Health For Multicultural

Australia (Computer Disk of National

Conference Papers, Sydney University and

Southern Sydney Area Health Services,

November, 1993)

Explores the specific issues in relation to

family, ethnic community, peer groups and

networks and the wider society non-heterosexual

persons of NESB need to negotiate and how these

factors impact upon mental and emotional

health. The limitations inherent within

national health policies and medical services

in relation to NESB sexualities are also

examined.

168

Pallotta-Chiarolli, Maria (1996e).

Landscapes of Conflict, Negotiation and

Integration: Health Services and the

Intersections of Ethnicities and

Sexualities, Out There Too: social

research and practice forum on health,

sexuality and HIV/AIDS. Adelaide, March

14-15, 1996. HIV/AIDS Progress Unit, SA

Health Commission.

Explores the specific issues in relation to

family, ethnic community, peer groups and

networks and the wider society non-heterosexual

persons of NESB need to negotiate and how these

factors impact upon mental and emotional

health. The limitations inherent within

national health policies and medical services

in relation to NESB sexualities are also

examined.

169

Pallotta-Chiarolli, Maria (1997). HIV,

Sexual Health and International Students

at Australian Universities,

International Education- In It Together:

8th International Student Advisers’

Network of Australia Conference.

Melbourne, 3rd -5th December, 1997.

This paper provides an overview on homosexually

active male International Students in relation

to HIV/AIDS and STD knowledge; and sexual

relationships and practices with particular

reference to risk practices for the

transmission of HIV and other STDs.

It outlines the types of issues that will be

explored in a research project curreently

underway in 1998 from the National Centre in

HIV Social Research, Macquarie University.

Interwoven factors of culture, gender and

170

sexuality are explored in this paper, and will

be explored in the research. It is envisaged

that the information gained from the research

will assist universities in planning and

implementing programs and other initiatives for

International Students.

Pugh, Lynette (1993). Ambiguities in

Defining Sexual Health: The Impact on

Service Delivery, Health For

Multicultural Australia Conference, 10-

12 December, 1993.

In addressing issues and strategies for NESB

women’s sexual health, this article presents

useful ideas for addressing NESB MSM:

confidentiality, low costs, personal and

unhurried services, active participation of

client groups in the service, exchange of

social and personal information (education) as

171

well as health information, need to incorporate

sexual health into broader health care and

occasionally address sexual issues indirectly,

testing our own homogenising assumptions and

stereotypes, ‘the need to balance the

culturally appropriate advice that is essential

in designing programs for cultural communities

and the traditional taboos about sexual health

topics which may never change without

challenges being made to them’, which cultural

beliefs are more correct and who decides which

beliefs should be challenged?

Project Reports

172

Alley, Jo (1995). The Missing Half:

women partners of bisexual men (WPBM),

Women’s Health Service, South Eastern

Sydney Area Health Service.

Acknowledges there is no documented information

about WPBM from NESB. Research conducted

suggests that education and support for WPBM

from lower socio-economic backgrounds and some

NESB should be a priority.

Recommends culturally specific research

conducted with women and men from NESB should

include issues related to fidelity, adultery,

power relations, help-seeking patterns,

attitudes to homosexuality, attitudes towards

husbands having sex with men, impact of

religion, etc.

Recommends development of education strategies

to reach WPBM from NESB

Little documentation available on attitudes of

NESB women towards MSM and the implications for

173

marriage and relationships. Religious beliefs

and gender relations both in Australian NESB

communities as well as in the countries of

origin have a considerable impact. Culturally

appropriate material about WPBM is required in

languages other than English. To be made

available at early childhood and other health

and communty centres.

Alpak, David I. (1995). A Report on Men

From Non-English Speaking Background Who

Have Sex With Men in the Illawarra

Region. Port kembla Sexual health

Clinic; Illawarra Area Health Service;

Multicultural HIV/AIDS Education and

Support Service.

Questionnaires, unstructured interviews with

NESB MSM and structured interviews with migrant

health workers and HIV/AIDs professionals in

174

the Illawarra region were conducted . The

research found that concealment of sexuality

was a top priority and this fear of disclosure

was a major reason for NESB MSM not accessing

HIv/AIDs services. Most migrant health workers

were not equipped to provide adequate HIV/AIDS

intervention to MSM in their communities. It

was concluded that outreach work is crucial due

to the need for concealment and that existing

migrant health services and the Multilingual

Information Line be restructured to direct

their provision to MSM.

Axell, Kirsten and Perkons, Rita (1994).

The Multicultural HIV/AIDS State

Strategy Project. Adelaide: Migrant

Health Service and Ethnic Communities

Council, HIV/AIDS Programs Unit, South

Australian Health Commission.

175

Distinguishes between explicit culture that

represents overt cultural behaviour such as

attending church or dressing in a certain way.

Implicit culture is covert behaviour learned

subtly through art, folk stories or behavioural

cues from parents and other role models. Raises

issue whether incorporation of NESB issues into

service planning leads to stereotyping cultures

or as raising awareness of diverse community

needs. Need for an individualistic response.

NESB MSM presenting late at hospitals with

infections. Ten year lag in information about

HIV in some NESB communities.

Asks if culturalist explanations of behaviour

are sometimes used to legitimise non-

intervention in the case of potentially

difficult NESB clients, and if services place

NESB issues in the ‘too hard basket’.

Need to assist and link NESB communities and

mainstream organisations in their

misunderstandings and ignorances of each other.

176

Lists the physical resources needed: eg

interpreters, funding, central points to meet,

etc.

Addresses issue that ‘workshop’ model is too

Western for some NESB people; informal contact

often better.

Eisenberg, Masha and Lee, Ilona (1994).

Eastern Sydney Multicultural HIV/AIDS

Access Project. Eastern Sydney Area

Health Service and Multicultural

HIV/AIDS Education and Support Service.

Surveyed knowledge and practice of HIV/AIDS

service providers in the area and a survey of

bilingual practitioners. Found that HIV/AIDS

staff do not always use appropriate resources

in their interactions with NESB clients.

Substantial gaps in info/training regarding

NESB issues and resources. Biggest issues were

177

language barriers and lack of understanding

cultural attitudes and beliefs such as in

relation to homosexuality.

Eisenberg, Masha, and Sabri, Wa’el

(1994). Arabic Men Social Research

Project. Sydney: Multicultural HIV/AIDS

Education and Support Service.

Study ‘measures’ the effectiveness of a half-

day workshop program in Arabic in increasing

HIV/AIDS awareness among a select group of

Arabic Christian and Moslem speaking men.

Results show it is possible to raise level of

HIV/AIDS information and change some beliefs

about its transmission and this was monitored

six weeks after the workshop. Also, men’s

attitudes and beliefs changed such as the

recognition that homosexuality was practised in

their culture. No evidence in this study that

178

either age or religion make accessing Arabic

men for HIV education difficult.

George, John (1992). A Report On A Needs

Assessment For An HIV/AIDS Education

Program For The Arabic Speaking

Community. Southern and South Western

Sydney Area Health Services and

Fraternal Society of Tripoli and Mena.

A series of interviews with individuals and

organisations in Arabic-speaking community

and/or providing HIV/AIDS services; survey of

Arabic speaking doctors; survey of Arabic

speaking high school students; confidential

phone line.

179

Gifford, Sandy; Mitchell, Anne;

Rosenthal, Doreen; and Temple-Smith,

Meredith (1994). STD And HIV/AIDS

Education For People Of Non-English

Speaking Backgrounds. La Trobe

University Centre for the Study of

Sexually Transmissible Diseases,

Melbourne and Australian Government

Publishing Service: Canberra.

This report reviews the existing research and

programs relating to the educational needs of

people of NESB in relation to STDs and

HIV/AIDS. It documents knowledge in three

areas: epidemiology, social and behavioural

research, and education strategies and

programs. Several of its recommendations

address the need to prioritise men who have sex

with men as requiring ethnographic and

qualitative studies which examine the social

180

and cultural context of sexuality and safe

behaviours; the need for AIDS councils to

develop specific strategies for targeting NESB

MSM who do not identify with the gay

community, particularly those who use beats,

and that funding be directed to specific NESB

MSM groups such as NESB sex workers, illegal

immigrants, overseas students.

Hauff, Jacqui (1993). Report On HIV/AIDS

Education For The Non-English Speaking

Background Communities Of Queensland.

Brisbane: Ethnic Communities Council.

Provides overview of initiatives in other

states and the underlying principles adopted by

Queensland: community involvement/consultation,

personalised information, provision of a non-

threatening, secure environment, ownership of

message by target group, opportunity for

diversity and adaptation of style of message to

181

target population, participation of audience at

all stages of program, need for verbal and

visual representation of information for less

literate and poor people.

In regard to Queensland NESB MSM, the report

found that none of mainstream AIDS/health

organisations had conducted any research or

employed any project officers to educate/inform

NESB MSM; and none of services are being

accessed by NESB men, often alienated by ‘gay

network/culture’, more closeted in Brisbane

than Sydney. Significance of talking in terms

of ‘risky activities’ rather than ‘risky

people’ as ethnic men may not identify with

‘gay’ labels and so believe they are not at

risk. Need to identify social/communication

networks of NESB MSM in Queensland.

182

Hauff, Jacqueline (1994). Multicultural

HIV/AIDS Awareness Evaluation Report.

Brisbane: Ethnic Communities Council.

A valuable report of the implementation of the

‘Multicultural HIV/AIDS Awareness Training and

Workshop Program’. Provides insights into

issues that arise, strategies, practicalities

that need to be considered regarding NESB

communities.

Hauff, Jacqueline (1996). Project Gemini

And Gemini Phase II. Brisbane: Ethnic

Communities Council.

Outlines overview and background of Stage I of

Project Gemini and how the recommendations have

183

been addressed, and the establishment of Phase

II.

Hood, Daryl; Prestage, Garrett;

Crawford, June; Sorrell, Tania; and

O’Reilly, Chris (1994). Report On The

Bisexual Activity/Non Gay Attachment

Research (BANGAR) Project. National

Centre in HIV Social Research, Macquarie

University: Sydney.

The project included NESB MSM; accessed by

using community-based media and strategies to

determine culture-specific aspects of

sexuality, language of sexuality and sexual

practices, and relevance of migration.

Ethnic Chinese men and Arabic/Middle Eastern

men were recruited and they generally did not

live a gay lifestyle and did not necessarily

184

participate in gay community. Found sex

partners among friends or at beats.

Found that NESB MSM do not easily relate to

messages directed at men who have sex with men,

in general.

Mahat, Mohamad (1995). Social Needs

Assessment: NESB MSM. Brisbane:

Queensland AIDS Council and Ethnic

Communities Council.

Overview of issues and existing data and

research.

Issues include: myths of Asian immunity to

HIV, arising from low incidence of reported

AIDS cases in most Asian communities provide

convenient denial escape mechanisms for some

Asian men; cultural taboos and attitudes toward

sexuality, illness, disease, death and dying;

other pressing issues are seen as more in need

of immediate attention eg. isolation and

185

loneliness, cultural differences, relationships

including family, discrimination and violence,

etc.

Project targeted 3 NESB MSM sub-groups: NESB

members of gay community, NESB persons living

with HIV/AIDS, NESB homosexually active men who

do not identify as gay.

Methodology: Face to face interviews, survey

questionnaires, telephone info line, interviews

with key individuals/agencies, Asian group

discussion.

Mahat, Mohamad (1997). Gemini Phase II-

NESB Men Who Have Sex With Men: Project

Evaluation.

Discusses need for a wholistic approach to

HIV/AIDS education and prevention in relation

to family, community, culture, religion.

Highlights how repressive social environment

where sex and homosexuality are taboo or seen

186

as perversion could only result in NESB MSM

negative attitudes or shying away from

information or services in relation to

HIV/AIDS.

5 target groups: homosexually active NESB MSM

(including rural and non-identified gay NESB

MSM); HIV positive NESB MSM, NESB youth,

general ethnic communities including health

care workers and service providers, newly

arrived overseas students.

Report provides Program Description:

objectives, strategies and context for the 5

target groups, Program Evaluation, Conclusion.

Outcomes were: increase of knowledge of

HIV/AIDS and subsequent practice of safe sex;

development of social and support networks and

formation of self-help groups for identified

NESB MSM target groups; provision of supportive

and safe environment where NESB MSM can discuss

issues pertinent to their lifestyle and where

they can be themselves; increased understanding

187

by Health Care Workers and ethnic communities

of needs and issues pertaining to NESB MSM;

increase in understanding by NESB Youth on

issues pertaining to Homosexuality and safe

sex; increase in the understanding of issues

pertaining to safe sex by the newly arrived

overseas students.

Limited success in accessing non-Asian NESB MSM

target groups, especially those with European

backgrounds.

McMahon, Tadgh (1995). Report On Non-

English Speaking Background Isolated Gay

Men. Sydney: Multicultural HIV/AIDS

Education and Support Service.

A study was conducted with MSM from Vietnamese,

Indonesian, Polish and Italian backgrounds (2

new communities and 2 established communities)

to identify gaps in services, increasing access

to services and information, and establishing

188

models to contact and survey target groups. A

phone-in strategy was selected with bilingual

gay male interviewers recruiting interviewees

through advertisements in local newspapers,

ethnic media, gay press, stickers in beats,

fliers to sex-on-premises venues.

Found that only a minority in all groups was

attached to gay community. Most went to their

doctors for information on health issues but

unclear if they do so about HIV, some from

newspapers, few used free health services.

Found that health service providers need to be

further aware of issues relating to NESB MSM,

that further research be done into health

behaviour of isolation from gay community and

effects of cultural hegemony of mainstream gay

community.

McMahon, Tadgh (1996). Issues Around

Sexuality For Men Of Vietnamese

Background Living In Sydney Who Have Sex

189

With Men. Faculty of Nursing and Health

Studies, UWS Nepean.

Comprises three life stories of Vietnamese MSM,

conducted in English.

Research indicated importance of family

identity in participants’ lives, particulalrly

responsibility sons, especially eldest sons,

have in the family structure. Oxford Street is

seen by many as culturally alien.

Importance of face-to-face meetings and

possibly one or two before people feel

comfortable being interviewed.

Importance of active/masculine and

passive/feminine roles in their experiences of

homosexuality. Bound up in gender issues and

may impact upon adoption or negotiation of safe

sex between men. Premium attached to ‘love’ and

desire to form long-term ‘marriage-like’

relationships with men may influence structure

of such relationships. Gay identity is not

190

central to their personal identity and derive

few cultural values from the gay community,

therefore materials/services designed for gay

men may not be appropriate for Vietnamese MSM,

particularly newly arrived immigrants. ‘Coming

out’ may be culturally proscribed. Issues of

racial or ethnic differences seem to have

prominence in choice of male sexual partner and

the emotive issue of “older” Caucasian men

requires further investigation.

Migrant Health Service and the Ethnic

Communities Council of South Australia

(1994). The Multicultural HIV/AIDS State

Strategy Final Report. Adelaide:

HIV/AIDS Programs Unit, South Australian

Health Commission.

Sets out four distinct sub-groups to be

targeted: long-term residents, recent arrivals,

191

children of NESB migrants, overseas students.

Addresses denial of HIV and homosexuality in

NESB communities, and issues of confidentiality

and distance as barriers to access.

Mitchell, Anne; Rosenthal, Doreen;

Walsh, Jenny (1997). Second National

Sexual Health Education Forum For People

Of Diverse Cultural And Linguistic

Backgrounds. Melbourne: La Trobe

University Centre for the Study of STDs.

Describes gay men and non-gay identifying men

as a priority group requiring issues of

identity, gay or ethnic, be addressed.

Multicultural HIV/AIDS Education and

Support Project . Biannual Reports.

Central Sydney Area Health Service: NSW

Health Department.

192

Present a series of reports on projects and

other work of the Centre.

Multicultural HIV/AIDS Education and

Support Service (1996). Chinese-Speaking

Background Beats Outreach Report.

Sydney: Multicultural HIV/AIDS Education

and Support Service.

Anecdotal evidence suggests that at some beats

up to 50% of users are of Asian background.

These beats were identified and one was chosen

in which to conduct beats outreach and have

informal talks with men of Chinese background.

50 men were chosen at random from the Chinese

background men using a particular BEAT. Aged

18-43 and most had been in Australia for 5

years or more.

193

34% engaged in anal sex; 34% never used a

condom while only 20% used a condom every time.

56% were not gay-identified. 56% had ‘good’

level of English; 46% had limited knowledge of

HIV while only 28% had good knowledge. Most men

had had only one HIV test, and 30% had never

had an HIV test. Not all of men identified as

gay actively participate in the gay community,

so a large number of Chinese background men may

not be getting HIV information. Of the men, 5

had a student visa.

Pallotta-Chiarolli, Maria (1994d).

Mediation and Negotiation: the work of

the Multicultural HIV/AIDS Education and

Support Service in New South Wales.

Sydney: Multicultural HIV/AIDS Education

and Support Service.Unpublished report.

194

Based on interviews with clients and workers,

the report details the concerns and needs of

HIV positive NESB clients and workers, and how

the Centre addresses these.

Poetschka, Neil; Costa, Robert;

Brotherton, Allan; Clews, Colin;

Prestage, Garrett (1995). The Impact Of

Language And Culture On The Knowledge

And Practice Of Safe Sex Among Men Who

Use Beats. Sydney: South-Eastern Sydney

Area Health Service.

Large numbers of non-Anglo men attend beats who

are reluctant to talk to Anglo-Australian

outreach workers; select sex partners who are

not obviously from their own immediate ethnic

community for fear of exposure and judgement;

prefer men from other cultures but not Anglo-

Australian due to alienation, language

195

difficulties, perceptions of Anglo men as

potential sources of infection. Older NESB men

more likely to be involved in ethnic

communities and dependent on them for

information, language and services as well as

cultural fulfilment, therefore fear of

ostracism heightened.

Likely to have no social or political

involvement with the gay community and more

likely to have poor knowledge of HIV issues.

Cultural and religious experience of non-Anglo

men seems to outweigh the importance or

benefits of identifying with gay community.

Less likely to identify as homosexual.

Prestage, Garrett; Crawford, June;

Sayed, Jamal; Hood, Daryl; Sorrell,

Tania (undated a) Arabic-Speaking Men

Who Have Sex With Men. (draft only)

196

45 men recruited through advertisements in

Arabic press and local newspapers and outreach

at sex venues. Tended to engage in fewer sexual

practices and more affectionate practices.

Used venues simply as means of meeting male

partners and for sexual enjoyment and did not

have any closer association with gay community.

Less homosexually-oriented than non-Arabic-

speakers. Intended to maintain and develop

family-based heterosexual lifestyle within

their respective Arabic communities. Not

interested in commitment to gay community; see

this commitment as irrelevant to their

lives.Compartmentalise their lives. Did not

want venue in their local area as concerned

about disclosure in their communities. More

comfortable with the term bisexual.

Translations of words like homosexual are a

problem as no Arabic word for an identity,

just receptive anal intercourse practice.

Homosexuality as a product of Western culture.

197

Prestage, Garrett; Crawford, June; Wong,

Ken; Hood, Daryl; Sorrell, Tania

(undated b) Chinese-Speaking Men Who

Have Sex With Men. (draft only)

Semi-structured telephone questionnaire.

Recruitment of some through Chinese press.

Tended to classify themselves as homosexual

although not identifying with or attached to

organised gay community. However, the way the

question was asked about sexual identity, had

to make a choice between labels which, in the

manner of translation, were actually more

descriptive of sexual behaviour than sexual

types. Very few had female partners.

Language appeared to be most important factor

in not participating in organised gay

community. Increases difficulty in discussing

homosexuality as issue has never really been

acknowledged, and words like ‘gay’ have no

198

proper translation. Homosexuality as a product

of ‘Western culture’.

Difficulties in interviews due to translations,

and cultural interpretations of words and

labels. Therefore dependence on English words

and labels means those with little access to

English words and labels would find

participation in gay community as irrelevant or

difficult, minimal use of personal advertising.

Greater dependence on personal networks and

friendships for finding male sex partners. Also

issues of discrimination both from within gay

community and from within NESB communities.

Often felt that Anglo men were only interested

in ‘sex’ rather than affectionate intimacy.

Pullen, Stuart (1993) The Use Of Beats

By Men Of Non-English Speaking

Background. Multicultural HIV/AIDS

Education and Support Project: Sydney.

199

Found that beat users had poorer English

skills, older men were an obvious risk for

HIV/STD infections; high education needs of

these men; ability to access redress to police

intervention in beat use or to homophobic

violence seems poor. Would not attempt to seek

medical or legal protection; difficult to

negotiate safer sex in a beat situation,

isolated from gay community; have barriers

against forming long relationships with men and

more likely to have higher numbers of partners.

Suggest local police should be made aware of

NESB issues; more information like stickers in

beats and toilets in different languages.

Schneider, Anne-Marie Elias (1994).

Korean Community HIV/AIDS Needs

Assessment In The Southern Sydney Area

Health Service. Sydney: Multicultural

HIV/AIDS Education and Support Service.

200

Identifies Korean businessmen as ‘high risk

group’ because they are travelling to countries

where there is little or no information about

HIV and they engage in unsafe practices.

Also identifies overseas students who arrive in

Australia with little information on HIV.

Very negative community attitudes toward people

with multiple partners and homosexuals (45 -

50%) with 25% males and 15% females saying

they deserved to get infected.

65% females and 70% males think homosexuality

is uncommon in Korea. 65% males and 60% females

do not feel comfortable talking to homosexual

persons.

Saw related factors such as unemployment rate,

lack of educational qualifications, low

incomes, conservative Confucian beliefs,

cultural values in relation to sexual

relationships as being very important.

For businessmen, thought the dissemination of

pamphlets through travel agents, airlines and

201

overseas embassies, and Karaoke bars; also

dissemination of literature through overseas

students’ unions.

Sturgess, Stuart (1993). AIDS Related

Knowledge, Attitudes And Behaviour

Amongst Adelaide’s Latin-American

Population. Adelaide: Second Story Youth

Health Centre.

Discusses lack of adequate data collection re

AIDS diagnosis which results in inadequate

planning and funding strategies. 1989 national

HIV awareness campaign for NESB persons by

Commonwealth government used multi-media

approach but had little impact due to low

levels of English literacy; AIDS seen by NESB

as an Anglo issue; lack of targeting for

particular ethnic groups. Differences between

groups regarding the practice of anal

202

intercourse, visiting sex workers, use of

condoms.

Found that sometimes the view that NESB groups

find questions of sexual nature too confronting

was more a reflection of Anglo-Australian

concepts/perceptions of conservatism and their

own discomfort with such topics, and even

somewhat patronising towards the culture

concerned.

No data collected on locality of respondents’

residence or socio-economic status.

Sutherland, Marg (1997). HIV/AIDS

Awareness for NESB Communities: ethnic

media project report. Melbourne: Centre

for Social Health

Documents the process used to provide

information and to raise awareness about

HIV/AIDS and related issues in five community

203

languages through the use of ethnic media. Key

strategy was the recruitment and involvement of

community working groups, and key people in

communities. Identified NESB MSM as special

needs group.

Prestage, Garrett; Campbell, Danielle;

Van de Ven, Paul; Kippax, Susan; Knox,

Stephanie; Kinder, Paul; Crawford, June;

French, Judy; Cooper, David (1996).

Ethno-Cultural Differences In Three

Samples Of Homosexually-Active Men In

Sydney, Melbourne And Brisbane,

Australia. National Centre in HIV Social

Research, Macquarie University, Sydney:

HIV AIDS & Society Publications.

Examines ethno-cultural backgrounds of men is

SMASH, MMASH, BRASH. Most men were gay

identified, had strong gay community

204

involvement and had widely disclosed their

homosexuality to relatives, friends and

acquaintances. Middle Eastern men less likely

to identify as gay, while Southern European,

South Asian and Middle Eastern men were more

likely to express some discomfort with their

sexual identity. Southern European men were

less likely to see themselves as part of the

gay community and East Asian men were less

likely to have disclosed their homosexuality to

others, while South Asian men spent less free

time with gay friends.

South and East Asian men had fewer male

partners while Middle Eastern men had a greater

number of casual partners. All engaged in

similar types and range of sexual practices

with both their casual and regular partners.

East Asian men less likely to consider anal

intercourse important.

Used a broad range of health services. South

Asian and East Asian men were less likely to

205

have been tested for HIV and less likely to

have tested HIV positive. Most men had some

knowledge of HIV transmission but less likely

to use gay press. Fewer Middle Eastern men were

able to name education campaigns or services

aimed at gay men. Condom use was high.

Unprotected anal intercourse with regular

partners was more common but mainly with

seroconcordant couples.

Tribes Research Project (1996). Drug

Users Of Arabic Background. Cabramatta:

Cabramatta Community Centre.

Generally the Arabic community does not

acknowledge a drug problem and same sex

activities do not exist. AIDS is associated

with Western community, gay community and

homosexual activities. Believe that culture and

religion will protect them. Important to

include Arabic workers and leaders in the

206

research work and also to break down

stereotypes among mainstream workers.

Voukelatos, Alexander (1996). The Greek

Men HIV/STD Research Project Report.

Central Sydney Area Health Service:

Multicultural HIV/AIDS Education and

Support Service.

81 men were interviewed about HIV/STD and

related issues. The strategy of targeting

Greek-Australian MSM through the general male

community was successful. Results indicate that

as many as 10% of all respondents could be

beats users. Although no direct questions were

about sexual behaviour with other men, an

indication of knowledge of MSM activity is

suggested by the identification of ‘beats’ as a

palce to meet others for sex. Just over 10% of

men mentioned parks, beats, public toilets, or

207

saunas as places to meet others for sex,

possibly from personal use. It would have been

easier if the Greek MSM had a formal community,

or a communal meeting place. It is even

doubtful whether Greek MSM label their sexual

behaviour as ‘sex’, making it even harder to

identify these men.

Waterford, David (1997). NESB Young Men

Who Have Sex With Men (first draft).

Adelaide: Migrant Health Service,

Adelaide Diocesan AIDS Centre and Levi-

Strauss.

Investigates relationship between young NESB

MSM (15-25) and largely White gay community in

Adelaide. Examines the impact this disparity in

resources and differences in culture have on

the ability of these young men to adequately

protect themselves from contracting HIV. Survey

208

with 30 individuals investigates interviewees

demographic backgrounds, their general

knowledge of HIV/AIDS transmission, their

sexual practices and their perceptions of

Adelaide’s gay community and the impact of

culture on these items.

Yamine, Rick and Elias-Schneider, Anne-

Marie (1995). HIV/AIDS Needs Assessments

For The Chinese And Vietnamese

Communities Across Four Area Health

Services In Sydney. Sydney:

Multicultural HIV/AIDS Education and

Support Service.

Identified Vietnamese and Chinese young people

as a higher risk group, and that Chinese and

Vietnamese communities tend to see HIV as a

punishment for immorality only affecting

homosexuals, prostitutes, injecting drug users,

209

people with many sexual partners, and that it

is largely a Western or Caucasian disease.

Vietnamese are far more likely to perceive HIV

as a homosexual disease. Research did not ask

for gay affiliation or identification. Majority

of Vietnamese (66%) see homosexuality as

uncommon in their community, as a Western or

Caucasian problem.

Found that homeless young people’s behaviour

and culture are largely about taking risks,

including sexual practices. Eg: increased

number of young Vietnamese males having sex

with other young males although do not see

themselves as gay or at risk of contracting

HIV/AIDS.

Yew, Kong Tham (1997). Preliminary

Readings into the Perceptions of the

Asian Project, ACON. (Unpublished paper)

210

Discusses issues surrounding Asian gay men and

ACON based on his time as Asian Project

Officer.

Miscellaneous

Gilbert, Keith (1997). Asian Gay Proud

Campaign: briefing to AIDS Council

campaign workers, AFAO. Courtesy of

Keith Gilbert.

Describes development of three posters and

three business cards to challenge stereotype of

what it’s like to be an Asian gay man in

Australia (eg. passive, young, unsexy, white

man’s toy-boys, living outside gay community).

Also meant to encourage more Asian gay men to

get involved in AIDS Council services. The

campaign arose out of a need for a gay

community campaign about marginalisation and

211

racism. Also intended to engender a sense of

pride amongst Asian gay men with particular

regard to their sexuality, racial and cultural

difference and community attachment, and to

increase awareness of HIV/AIDS issues amongst

Asian gay men.

1.Design Brief for Working Party Developed for

the Pride Campaign.

Three posters to deal with: Pride in

negotiating safe sex and/or drug use; Asian gay

men in relationships; sensuality. Imagery to be

sexy, powerful, having choices about

relationships and sexual health.

2.‘WHY AND HOW’ and “WHAT AND WHO’ Detailed

Briefing Kit.

Racism in gay community through lack of

representations, culturally-unfriendly

services, outright discrimination in venues and

services, complex interpersonal relationships

212

which may place Asian men at risk of violence,

coercion, HIV/STD transmission. Absent from

national HIV/STD surveillance data integral to

identifying epidemiological trends and setting

up appropriate services.

Appropriateness of language use was an issue in

poster development: words like ‘gay’ and

‘Asian’, ‘family’. Intend to push the debate

around ‘Asianness’: does the label refer to

culture, family, geography, history, identity?

What is an appropriate representation of an

Asian gay man?

Provides a list of possible campaign

activities.

3. Design Brief For Poster Series For Gay Asian

Men Living With AIDS

To increase visibility of gay Asian men living

with HIV/AIDS amongst: Asian-Australian

families and communities; the gay, lesbian and

213

PLWHA communities in Australia; and amongst

HIVpositive Asian gay men themselves.

Sub-groups of Asian gay men for consideration:

those on periphery of gay community; newly

arrived, possibly without English skills, and

having new experience of being ‘different’ in a

predominantly white, English-speaking culture;

both single men and men in relationships

(either with other Asian men or non-Asian men).

For families: that they need not feel ashamed

or isolated; that there are confidential

support and information services available. The

aesthetic needs to be in the Asian tradition,

but avoiding stereotypes

For HIVpositive Asian gay men: confidential

support services, family of origin is major

consideration for Asian gay men.

For gay communities: the issues facing Asian

gay men in gay communities, that HIV is a

‘taboo’ subject for many Asian gay men.

214

Hauff, Jacqueline (1995; 1996) Three

Documents Relating To The Application

For Funding etc For Gemini Phase II.

Includes data on Asian and Friends support

group establishment.

McGee, Patrick (1998) Treatments Issues

for HIV Positive People From Diverse

Cultural and Linguistic Backgrounds:

Planning Document. Sydney: Multicultural

HIV/AIDS Service. (In process).

This document will set out a strategic response

to the treatments needs of HIV positive NESB

specifically and ‘positive living’ issues

generally. The document will incorporate an

action plan, short term strategies and possible

outcomes, as well as identifying long term

goals and how to achieve them. Issues covered

215

will include HIV?AIDS pathogenesis, HIV

testing, viral load testing, changes in HIV

treatments and what these changes mean for NESB

HIV positive people.

National Non-English Speaking

Backgrounds Sexual Health Action Plan

(Working Document Only) October, 1996;

Public Health Education Unit.

Refers to 4 specific groups: long-term

residents; recent arrivals; children of NESB

parents; overseas visitors (students or

workers).

Sees ethnic organisations as to various degrees

the gateway to accessing broader ethnic

communities.

Lists and explores strategies for

implementation.

216

Partnerships In Practice: National

HIV/AIDS Strategy 1996-7 to 1998-99.

Commonwealth Department of Health and

Family Services.

Very few references to NESB issues:

7.1: that in effort to place HIV/AIDs

inititatives in a broader public health context

we ensure programs do not become diluted or

irrelevant to their target populations.

7.1.1: education and prevention programs in

specific communities are best delivered by the

communities involved, in partnership with

governments, health professionals, researchers.

... must take account of diversities in

cultural and linguistic backgrounds, gender,

age, sexual orientation, disability,

geographical location.

7.2.3: needs of groups of HIV+ people who may

experience difficulty in gaining access to

appropriate services need to be met.

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7.3: priority has to be given to social and

behavioural research into the contexts of risk

behaviour and appropriate prevention

strategies. Results of this have been the

development of priorirties for education and

prevention.

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