Purpose of Study

To explore the impact of historic trauma (HT) on treatment in Aboriginal males living with HIV and AIDS in British Columbia

DiscussionKey ingredients in the beginning stages of study build-up:

• Recognition of “survivors” as those who attended residential school and, secondary and subsequent generations of Aboriginal people affected by the original trauma through various means (Bombay, Matherson, & Anisman, 2011).

• Explicit integration of social context analysis, including the relations of inequality - a shift away from conceptualization of “historical trauma” as static & “historical,” to emphasis that HT in Aboriginal people’s lives remains contemporary & current (Haskell, 2009).

• Drawing on literature on resilience (Ledogar & Fleming, 2008) & posttraumatic growth (Triplett et al., 2012).

• Engaging in informal conversations with males living with HIV/AIDS, other service users, and co-researchers at the VNHS.

• Building, drawing on and extending relationships of trust

Next Steps in the Research• Year 2: September 2014 - August 2015

• Development of interview questions

• Application for ethics approval

• Data collection – interviews and focus group

• Analysis and writing dissertation

• Reporting to participants and knowledge users

Meck Chongo1, Josée Lavoie1, Henry G. Harder1, Robert Hogg2,4, Eric A. Roth3

1-University of Northern BC, 2-Simon Fraser University, 3-University of Victoria, 4-BC-CfE

HIV/AIDS

Experience Talks, Resilience ShapesRevisiting Historic Trauma: Impact on Treatment in Aboriginal Males

living with HIV/AIDS in British Columbia

Year One: Starting the Process of Growth

Building with Community: Working from History

Building from a Relationship of Trust

• 2009 to date - Built a relationship with the VNHS • Conducted research for master’s thesis - brought the realization that

HT may have both positive and negative effects on one’s health and wellbeing. Current study builds on this.

Reflecting on Community and Tradition

• “We are still here. We are not just survivors; we are the architects of our survivance. We carry our Native philosophies into an ever-changing modern world. We work hard to remain Native in circumstances that challenge or threaten our survival. Our Lives is about our stories of survivance, but it belongs to anyone who has fought……..discrimination, or stereotypes” (Alivizatou, 2012, p120).

• “I grew up knowing my cultural traditional practices and to me I find that, if my spirit is low, I’ll not take my medication, any kind of medication or medicines didn’t work or they don’t work as well” (Aboriginal male living with HIV/AIDS) [Chongo et al., 2012].

Considering Daily Lived Experience

• “It happens quite a bit. Stigma down here. There’s a lot of things out here to make a person angry. A lack of recognition for me as a human being, okay, that’s one of the things that I sadly don’t like at all. I hate it that they just, I’m just a tool. I don’t have any connection in the community. I’m on the outside and so, I don’t take medication” (Aboriginal male living with HIV/AIDS) [Chongo et al., 2012].

Building on Strengths• “But there’s an upside to everything,….well we don’t have anything to

eat, ‘well I spent lots of time where I didn’t eat for five days when I’d run away’ - so that’s the upside - it makes you really tough. So it’s not just one way, plus am really smart at the street level, but tougher in a way, so” (Aboriginal male living with HIV/AIDS) [Chongo et al., 2012].

Research Questions• What role does the experience of HT play across generations,

and between direct and indirect survivors, in the treatment of HIV/AIDS?

• What role can resilience play in the treatment of HIV/AIDS with respect to HT?

• What information or services can support healing from HT and improve treatment-seeking behavior in a culturally safe way?

Methods

• Qualitative study over two years (2013 – 2015)

• Method of Interpretive Description (Thorne, 2008) and a Cultural Safety lens will be used (Smye et al., 2010)

• 1 community: Vancouver

• Tri-Council Policy Statement provisions on ethical conduct for research involving humans will be followed

• Ethics approval from Research Ethics Board at UNBC and letter of approval from the Vancouver Native Health Society (VNHS ) research committee

• Purposive and theoretical sampling (King & Horrocks, 2010) will be used to recruit Aboriginal males, 15-64 years of age, who are on HIV/AIDS treatment

• In-depth open-ended interviews with twenty-four participants and one focus group will be conducted

• Interviews will be analyzed and themes developed.

• Rigor and credibility will be attained through triangulation, the criteria of moral defensibility, disciplinary relevance, pragmatic obligation (Thorne, 2008), and through constant comparative & iterative analysis by knowledge experts (i. e., supervisors & peer-researchers)

• Results will be brought back to knowledge users at VNHS and the community for discussion and disseminated through various media for advocacy efforts, policy and decision-making. Funded by:

1) UNBC Graduate Entrance Research Award 2012-2015

2) Canadian Institutes of Health Research (CIHR) Doctoral Research Award 2012-2015

Vancouver Native Health Society

Conflict of Interest Disclosure: “I have no conflicts of interest”

Materials Cited• Alivizatou, M. (2012). Intangible Heritage and the Museum: New Perspectives on Cultural

Preservation. Walnut Crek, CA: Left Coast Press.• Bombay, A., Matheson, K., & Anisman, H. (2011). The impact of stressors on second generation

Indian Residential School survivors. Transcultural Psychiatry September, 48(4), 367-391• Chongo, M., Lavoie, J. G., Hoffman, R., & Shubair, M. (2012). Determinants of Adherence to

HAART in Aboriginal Men in the DTES of Vancouver. Canadian Journal of Aboriginal Community-based HIV/AIDS Research (CJACBR) (4).

• Haskell, L., & Randall, M. (2009). Disrupted attachments: A social context complex trauma framework and the lives of aboriginal peoples in Canada. Journal of Aboriginal Health, November, 48–99

• King, N., & Horrocks, C. (2010). Interviews in Qualitative Research. London: Sage.• Ledogar, R. J., & Fleming, J. (2008). Social Capital and Resilience: A Review of Concepts and

Selected Literature Relevant to Aboriginal Youth Resilience Research. Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health, 6(2), 25-46.

• Smye, V., Josewski, V., & Kendall, E. (2010). Cultural Safety: An Overview. First Nations, Inuit and Métis Advisory Committee, Mental Health Commission of Canada.

• Thorne, S. (2008). Interpretive Description. Walnut Creek, CA: Left Coast Press.• Triplett, K. N., Tedeschi, R. G., Cann, A., Calhoun, L. G., & Reeve, C. L. (2012). Posttraumatic

growth, meaning in life, and life satisfaction in response to trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 4, (4), 400-410