FES professor awarded a $300,000 CIHR research grant

When York Professor Sarah Flicker started holding focus groups with youth in Ontario and Quebec regarding HIV and AIDS, she didn’t expect to find Aboriginal youth standing apart in the research – but she did. That prompted her to study the phenomenon further. Now, with a Canadian Institute of Health Research (CIHR) grant awarded in April worth a total of $297,117 over three years, Flicker is about to explore an arts-based approach to developing Aboriginal youth leadership in HIV prevention.

"The experience of Aboriginal youth was distinct in ways that warranted a more in-depth examination," says Flicker, a professor in the Faculty of Environmental Studies. "We interviewed black youth, Asian youth, rural and urban youth, but the Aboriginal youth really stood out as different from the non-Aboriginal youth."

The focus groups were part of a larger research project – Gendering Adolescent AIDS Prevention, involving a team of researchers working on various research projects and studies with young people in relation to sexuality, HIV prevention and AIDS awareness.

It was already known that Aboriginal youth have a higher rate of HIV/AIDS in their community. While indigenous peoples in Canada represent three per cent of the population, they accounted for almost nine per cent of new HIV infections in 2005. In Canada and around the world, indigenous youth are one of the most vulnerable groups to HIV and AIDS.

So when the focus groups involving a variety of youth yielded stark differences for Aboriginal youth in their views on HIV and AIDS, Flicker decided to hold six focus groups with 61 Aboriginal youth in Ontario and Quebec. Her study, titled "It’s hard to change something when you don’t know where to start: Unpacking HIV Vulnerability with Aboriginal Youth in Canada", was recently published in Pimatisiwin: A Journal of Aboriginal and Indigenous Community Health.

Left: Sarah Flicker

What this research found was that not only were Aboriginal youth more aware than their counterparts of HIV/AIDS and the structural inequities that increased risk, they were the only group to filter the disease through a colonial lens. Most of the non-Aboriginal youth thought HIV/AIDS was an individual problem, that each person was responsible for making their own decisions about things like unprotected sex and unclean needles. Making a poor decision and becoming infected showed a weakness in character.

Not so for Aboriginal youth. They were more likely to view the disease as a community issue affected by colonialism. Under colonialism, the Aboriginal youth saw the residential school issue – which led to generational violence along with alcohol and drug abuse and a change in family norms and culture – the tainted water crisis in their communities and the issue of HIV/AIDS as linked. They saw the whole and all its pieces.

"The Aboriginal youth linked the disease to the whole like no other groups did in a way I thought was really sophisticated. To get a teenager to think like that is really challenging, but a lot of the Aboriginal youth did see that whole," says Flicker. "The youth would say, ‘If one person is not well, the whole community is not well’."

At the same time, these Aboriginal youth were upset with how stigmatized HIV/AIDS was in their home communities and how little the elders and their parents knew about the disease. Because the disease is highly stigmatized in the Aboriginal community, many youth did not feel safe discussing the issue or admitting they had been infected.

Unlike other youth, Aboriginal youth felt their elders should participate in disseminating information about HIV/AIDS, but they also stressed the importance of involving other youth in the prevention of the disease.

Flicker’s CIHR-funded project, titled "Taking Action: Using Arts-Based Approaches to Developing Aboriginal Youth Leadership in HIV Prevention", is based on her focus group research with Aboriginal youth. It is a three-year initiative that will work closely with six Aboriginal communities across the country to reach out to youth through dance, art, theatre, video and photography documentary mediums and music.

"It’s a way to get some dialogue started," says Flicker. "We wanted to be responsive to the issue of HIV/AIDS in a way that was respectful of their culture."

The idea is to find ways of tapping the creativity and optimism of youth as a means of engaging them in health promotion activism, which has proven effective locally and globally in the past. "We’re looking at a more strength-based approach," says Flicker.

The research is not only interdisciplinary, but collaborative – Randy Jackson, director of research at the Canadian Aboriginal AIDS Network, is the co-principal investigator, while co-investigators include Melanie Rivers, an educator for the past nine years for Chee Mamuk, an Aboriginal Program at the British Columbia Centre for Disease Control; and Jeanette Doucet, manager of Sexual Health and HIV Policy and Programming with Pauktuutit Inuit Women of Canada. Other university-based co-investigators include June Larkin, a professor in the University of Toronto’s Women and Gender Studies Institute and vice-principal of New College; Jean Paul Restoule, a professor at U of T’s Ontario Institute for Studies in Education; Tracey Prentice, a CIHR doctoral trainee at the University of Ottawa; and Claudia Mitchell, professor in the Faculty of Education, McGill University.

The study will explore how Aboriginal youth link structural inequalities with individual risk, HIV and Aboriginal culture; develop and disseminate community-specific HIV prevention and support materials by youth and for youth; and create a national digital repository of those materials. Flicker is hoping the arts-based approach will make a real difference in the lives of Aboriginal youth. She hopes it will lessen the stigma of the disease, open up dialogue and change how the communities deliver HIV/AIDS education. The first workshop will take place this fall in Toronto.

For more information, contact Sarah Flicker at flicker@yorku.ca.

By Sandra McLean, YFile writer