HIV Endgame: What are the syndemics in Ontario?

Speaking at the HIV Endgame conference in November, 2016, Josephine Wong provides an overview of syndemics as a messy and interconnected set of factors that contribute to overall health. Her talk touches on racism, homophobia, colonization, intergenerational trauma, and masculinity.

Descriptive Transcript

The HIV Endgame conference logo appears on screen. A title card reads: Josephine Wong, What are the syndemics in Ontario? Josephine Wong stands alone on the Endgame stage. An on-screen graphic identifies her as an Associate Professor from Ryserson University.

Joesphine Wong: What I want to actually focus on in my four-and-a-half minutes, now, is social amnesia. I have been reflecting on — since I engage in HIV research for the last 15 years, I seldom have met a critical historian who was part of our research. And, I think that it’s time for us to think about it. And, as I was trying to think about, “How do I connect the presentations by Janet as well as the presentation by David?” And, as Janet had pointed out, colonialism and racism is actually — are the driving force behind the syndemics, to a large extent.

And, in some ways, very often, in Canada, especially now that Trump is making Americans look so bad, we deny that we actually have racism or colonialism or that type of historical legacy. And, I just want to give an example how colonialism and racism still impact on LGBTQ communities at this point.

So, in 1533, Henry VIII established the first legislation against homosexuals in England. And, it’s an Act that criminalized people but, at the time, it was done because they wanted to persecute the nuns and the monks. I’m not a historian — I won’t pretend to be. But, what the impact is is not only negative impact in England, but that, as the British went and colonized around the world, it actually had a lot of impacts because those laws become the laws in those lands. In the 1920s, England had actually colonized one-quarter of the entire globe, so, you just think about places — all these laws are in there. So, in 1967, the law in England and Wales was amended so homosexuality was decriminalized, but this type of removal of unjust laws and persecution was not removed from the countries that were colonized, and, in that way, nowadays in Asia, many countries in 2016 — 72 countries around world — still criminalize LGBTQ people, and it’s mostly in Asia and Africa. And I have heard and seen on the internet, amongst colleagues, the kind of comments that came out to say that, how “uncivilized” those countries are. “We need to put in human rights and, you know, eliminate that.” But, little do we think about that, before colonization, sexuality was actually very fluid.

In many of these countries, homosexuality did not exist, because people are — people were welcome to express their sexuality and intimacy in whatever way they want. And, you know, their desires, as long as it is actually not harming anybody in the community. So, that it’s just one way to kind of think about that. And, when I looked at — coming back to nowadays, I do work with African, Caribbean, and Black communities, the Latino communities, immigrants and refugees, and [unintelligable] people in the Greater Toronto Area. And racism continues to affect people. Homophobia continues to affect that. And, this is why stigma becomes an issue.

And other things that we also need to think about is, in recent years, we talk about trauma — I don’t know how many minutes I still have — I’ll talk fast — but trauma needs to be looked at as multi-generational. So, look at what happened to African, Caribbean, Black people. We cannot just say that slavery did not affect Canada. We cannot say that, right now, our system has kind of become equitable because we have human rights.

When I go and talk to young people, those who are living in the low-income marginalized community, majority of them are from the Black communities or they’re from the Indigenous community — racialized communities — when I went in March to talk to a group of young people, and I wanted to ask them, how do they define masculinity? How do they see they themselves as young Black men being vulnerable? They don’t want to talk to me about that. For 30 minutes, they were questioning me. Suddenly it turns, you know, the focus on me. And I welcome that. Because it was a humbling experience, and it makes me reflect on my privilege.

And they want to say, “Josephine, how come you wouldn’t come into my neighborhood in the evening?” And they talked about the issue that they’re concerned about is, why is it that they cannot go home feeling safe? That anytime on the way from school, that we take for granted, that our children take for granted, they’re actually stopped by the police because they are doing a neighborhood investigation. Why is it that every time when people — when they hear, when young people say that, you know, “Stay low,” they automatically lie down on the floor, because they know that there could be violence that’s happening, either within the community, or actually being imposed by the police? Why is it that the young man that I used to do research with, Desmond Cole, when I read his article, and we actually went and did research way back in 2007 — he was a university graduate then — a young person being stopped by police over 300 times is unacceptable.

Wong’s slides display an image in which many different types of stigma are layered on top of each other in messy, complicated ways. The image is overwhelming and the relationships are, intentionally, unclear.

So, those are the type of things that we need to think about if we are really going to stop syndemics — we need to address not only HIV stigma, but what about sexual stigma? What about stigma that is tied to addiction? What about stigma that is tied to mental health? Are we doing intervention that is addressing that? So, tied to the resilience — why are you not waving at me? I’m on five minutes — So, the one thing that I feel very proud of and very grateful to my team, is the work by the Committee for Accessible AIDS Treatment. We did an intervention to address HIV stigma, but the outcome is actually we have proven that we’re able to address stigma that’s tied to racism, tied to sexuality, tied to mental health and addiction.

And I was challenged one time by my colleague who said, “Who are you guys to go and ‘intervene’ in people’s behavior?” And, so I want to make it clear to all of you, when we do interventions, we’re not intervening in individual behaviors, we are intervening in unjust, and unfair, and discriminating systems. That’s what we are intervening. So, at the end, we are actually promoting collective empowerment.

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