Indigenous men’s pathways to ‘living the right kind of life and walking the right path’: Understanding impacts of systemic oppression and guidance for healing and (w)holistic sexual health.

Citation:

Rand, J., Melro, C., Biderman, M., McMillian, J., Miller, A., Lekas, S., Numer, M (2022). Indigenous men’s pathways to ‘living the right kind of life and walking the right path: Understanding impacts of systemic oppression and guidance for healing and (w)holistic sexual health. Culture, Health, and Sexuality. Open Access: https://www.tandfonline.com/doi/full/10.1080/13691058.2022.2055149

Abstract:

Indigenous men around the world hold expertise over their own lives. Informed by this perspective, this study centres this experience to better understand what is needed to improve sexual health outcomes among a group of men with a history of incarceration. Semi-structured interviews were conducted with 10 Indigenous men with such a history. Through thematic analysis the study identified two major themes: 1) the impacts of systemic oppression; 2) the value of guidance in walking the right path. Men identified colonial trauma and the associated mental, physical, emotional and spiritual wounds stemming from systemic oppression as continuing to impact their wellbeing. Men also described the systems of support necessary to help guide them on their journeys through incarceration, rehabilitation and building strong and nurturing relationships. Findings from the study provide important guidance from Indigenous men for future more holistic sexual health intervention programming.

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Pathways for Sexual Health Promotion Among Indigenous Boys and Men: A Community Report

Citation

Gaspar, C. M., Rand, J., Biderman, M., Boussard, A., Bogner, E., Lekas, S., Miller, D., McMillian, J., & Numer, M. (2021). Pathways for Sexual Health Promotion Among Indigenous Boys and Men: A Community Report. Halifax, NS.

Executive Summary

The Pathways for Sexual Health Promotion among Indigenous Boys and Men was a research project designed to specifically understand Indigenous boys’ and men’s holistic sexual health in Canada, and more specifically in Atlantic Canada. It was co-developed by Dalhousie University, Healing Our Nation and Mi’kmaw Native Friendship Centre. The project was supported by the Canadian Institutes of Health

Research (CIHR) through a Catalyst Grant and aimed to meet the following objectives:

• Review the academic and grey literature on the current state of holistic sexual health among Indigenous boys and men provincially and nationally

• Organize community consultations in partnership with community organizations to explore the topic of Indigenous boys’ and men’s holistic sexual health

• Gain insight into the perspectives, experiences and contributions of key informants and stakeholders

• Investigate the role of post-colonial masculinities in the production of Indigenous boys’ and men’s holistic sexual health

  A key message driving the project was the need to provide Indigenous boys

  and men spaces of healing and mentorship to inform sexual health programing. The

  specific findings from this project include:

• The review of the literature emphasized that there is a scarcity of research exploring the sexual health of Indigenous boys and men in Canada, particularly in the Atlantic Canada region.

• Community consultation demonstrated the need for safer spaces for Indigenous boys and men to be able to talk about sexual health to promote healthy relationships and positive sexual health practices through role modeling.

• The findings from the stakeholder interviews revealed three pathways for sexual health promotion: 1) developing healthy relationships and highlighting role models, 2) providing access to comprehensive sexual health information, and 3) fostering open communication among Indigenous boys and men.

• Emerging from the 10 interviews with Indigenous men were two key themes: 1) the systems of oppression that effected their journeys; and 2) the systems of support that have and will enable them to recover.

  The findings from this project informed the proposal for a larger CIHR Operating grant project, Indigenous Masculinities and Sexual Health: Exploring community- driven interventions among boys and men through land-based methodologies, in collaboration with Dalhousie University, Healing Our Nation and the Mi’kmaw Native Friendship Centre. This Indigenous Masculinities and Sexual Health Project is now exploring holistic sexual health of Indigenous boys and men through Major Gatherings and Learning Lodges. These gatherings and lodges are being developed by Healing Our Nation and the Mi’kmaw Friendship Centre based on the findings from this catalyst project and the community-based sexual health findings are being explored by the Sexual Health and Gender Research Lab at Dalhousie University.

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Pathways for Sexual Health Promotion Among Indigenous Boys and Men: Stakeholder Perspectives

Citation

Biderman, M., Doria, N., Sinno, J., Rand, J., Hackett, L., Miller, D., McMillan, L.J., Lekas, S. & Numer, M. (2021). Pathways for Sexual Health Promotion Among Indigenous Boys and Men: Stakeholder Perspectives. AlterNative. 1(10). DOI 10.1177/11771801211023207 

Abstract

The sexual health of Indigenous Peoples in Canada has been identified as an important community and public health concern; however, there is a lack of research on the sexual health needs of Indigenous boys and men. This article shares results from interviews conducted with six stakeholders to explore pathways for sexual health promotion and considers the impacts of colonialism and other socio-political contextual factors on Indigenous boys’ and men’s sexual health. The study employed thematic analysis, and the findings indicate the following three pathways for sexual health promotion of Indigenous boys and men: (1) developing healthy relationships and highlighting role models, (2) providing access to comprehensive sexual health information, and (3) fostering open communication among Indigenous boys and men. Sexual health promotion with Indigenous boys and men in Atlantic Canada should include addressing the impacts of colonization and their unique socio-cultural contexts.

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A rapid review of Indigenous boys’ and men’s sexual health.

Citation

Hackett, L., Biderman, M., Doria, N., Courville, J., Bogner, E., Miller, A.D., Spencer, R., & Numer, M. (2020). A rapid review of Indigenous boys’ and men’s sexual health. Culture, Health and Sexuality. DOI: 10.1080/13691058.2020.1722856

Abstract

Indigenous boys and men in Canada face adverse social and structural circumstances that affect their ability to achieve and maintain sexual health. Research about Indigenous sexual health, however, is largely limited to matters relating to women and statistics on sexually transmitted infections. A rapid review of research was conducted to determine what is currently known about Indigenous boys’ and men’s sexual health in Canada. Given the prevalence of research documenting quantitative disparities, the current review included qualitative research only. Thirteen included studies explored a wide range of topics relating to sexual health and an overarching intersection between social conditions and individual health outcomes was observed. The results of this review reveal significant gaps in the literature relating to the holistic sexual health of Indigenous boys and men and highlight important domains of sexual health to consider in future research. Findings suggest that sexual health programmes that promote traditional Indigenous knowledge and intergenerational relationships may be effective for promoting sexual health among Indigenous boys and men. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

https://doi.org/10.1080/13691058.2020.1722856

Graphic facilitation as a tool to guide community-based research on Indigenous boys’ and men’s sexual health.

Citation

Doria, N., Biderman, M., Miller, D., Prosper, A., & Numer, M. (2019). Graphic facilitation as a tool to guide community-based research on Indigenous boys’ and men’s sexual health. Journal of Indigenous HIV Research, 10, 20-27. Retrieved from https://www.ahacentre.ca/uploads/9/6/4/2/96422574/
graphic_facilitation.pdf (Open Access)

Abstract

The sexual health of Indigenous1 boys and men is becoming increasingly recognized as an important area of research (Bingham et al., 2014; Grace 2003; Healey & Meadows, 2007). To date, however, much of the research exploring the sexual health of Indigenous Peoples has focused on women and girls. While further research is needed to explore the sexual health of Indigenous boys and men, future research must consider how interacting and dimensional factors such as colonization, racism, discrimination and prejudice contribute to poor sexual health outcomes (Bird et al., 2016; George et al., 2016; Hallett et al., 2017; Negin, Aspin, Gadsden, & Reading, 2015; Reading, Wien, & National Collaborating Centre for Aboriginal Health, 2009; Reading, Loppie, & O’Neil, 2016). It is important to recognize that generations of trauma and abuse have produced the poor social conditions in which Indigenous Peoples experience worse sexual health compared to the national average, such as higher rates of HIV and other STBBIs (Haddad et al., 2018). This paper describes our experience of conducting a community consultation to explore the current state of Indigenous boys and men’s sexual health and wellness. We also discuss our experience of using graphic facilitation as a culturally responsive tool to collect qualitative data on this subject matter. The community consultation is an outcome of a larger program of research that ultimately aims to decrease HIV rates within the Indigenous community across Atlantic Canada and beyond. Ethical approval for this project was obtained from both the Dalhousie Research Ethics Board and Mi’kmaw Ethics Watch

This paper is open source. Read it here.

Gay men’s sexual health promotion in virtual space: Exploring stakeholders’ attitudes and approaches to outreach on mobile apps in Nova Scotia.

Citation

Thompson, R., Joy, P., Numer, M., & Holmes, D. (2018). Gay men’s sexual health promotion in virtual space: Exploring stakeholders’ attitudes and approaches to outreach on mobile apps in Nova Scotia. The International Journal of Community Diversity, 18(3-4), 17-29.

Abstract

HIV infections are still are a concern for many gay men in Canada despite prevention efforts. Social networking applications (SNAs) have predominantly been where gay men meet for sexual encounters. Grindr is the most common app used, which is a GPS-enabled SNA that was released in 2009. In Nova Scotia, there is a culture of silence in the gay community surrounding HIV/AIDS discourses. It is suggested that the perspective of professional stakeholders in sexually transmitted and blood borne infections (STBBI) prevention is needed to enhance prevention efforts. The purpose of this qualitative study is to explore the perspectives of service providers regarding STBBI risk on one SNA for gay men. Key stakeholders in this current study were sexual health service providers working in Nova Scotia. Four stakeholders were interviewed as part of a larger study. Secondary thematic analysis was employed to examine this data for this research project. The interviewed stakeholders experienced outreach challenges because of the “changed landscape” of online partner finding. Stakeholders have an interest in accessing these spaces for prevention and suggest that online forums such as Grindr can be used for sexual health prevention aimed at gay men. Further, leaders in the gay men’s community may be able to help service providers understand the implications and potential contributions of sexual health promotion efforts.

http://hdl.handle.net/10222/75936

The development and validation of sexual health indicators of Canadians youth aged 16 to 24 years.

Citation

Smylie, L., Clarke, B., Doherty, M., Gahagan, J., McKay, A., Numer, M., Otis, J., Smith, G., & Soon, C. (2013). The development and validation of sexual health indicators of Canadians youth aged 16 to 24 years. Public Health Reports: Supplement on Sexual Health, 128(2), 53-61. DOI: 10.1177/00333549131282S106. (Open Access)

Abstract

Objectives
We developed and validated a set of self-administered, multidimensional indicators of sexual health among Canadians aged 16–24 years.

Methods
This study used a mixed-method qualitative and quantitative approach to develop and validate indicators of sexual health We used the four-stage Dillman method to identify, focus-test, pilot-test, and validate key metrics to measure sexual health We collected quantitative data to validate the measures through a computer-assisted self-interviewing program among a purposive sample of 1,158 people aged 16–24 years recruited from four Canadian provinces.

Results
The survey contained 75 items measuring five dimensions of sexual health: (1) physical, mental, emotional, and social well-being in relation to sexuality; (2) approach to sexuality; (3) sexual relationships; (4) sexual experiences; and (5) discrimination, coercion, and violence. Principal components analysis for composite measures found seven components with eigenvalues ≥1. The factor structure was stable across gender, age, size of area of residence, and language in which the survey was completed. Cronbach's alpha coefficients ranged from 0.79 to 0.90. Indicators of condom use at last vaginal sex, protection self-efficacy, sexually transmitted infection/HIV testing self-efficacy, and sexual orientation also showed good construct validity.

Conclusions
The indicators constituted a conceptually grounded survey that is easy for young adults to complete and contains valid, reliable, and psychometrically robust measures The survey instrument provides a tool for future research to collect population-level data to measure and monitor trends in the sexual health of young people in Canada.

https://doi.org/10.1177/00333549131282S106

The sexual health of gay men: Exploring the intersections of identity, masculinities and sexual health promotion.

Citation

Numer, M. (2008). The sexual health of gay men: Exploring the intersections of identity, masculinities and sexual health promotion. The International Journal of Diversity in Organisations, Communities and Nations Annual Review, 8(3), 249-254. DOI 10.18848/1447-9532/CGP/v08i03/39611

Abstract

This paper will explore the implications of traditional masculinity in relation to public health discourse aimed at the sexual health of gay men. The examination of gay men as gendered subjects who perform gender acts in relation to sexual health practices is critical to addressing issues of diversity in this sector of health care, particularly in relation to HIV/AIDS. Despite the growing attention given to the theory and practice associated with gay men’s sexual health behaviors, there remains a gap in the literature and a lack of understanding of dominant or hegemonic masculinity as it influences the sexual health practices of gay men. Traditionally, there is a paradoxical relationship between gay men and the notions of masculinity. While gay men theoretically hold a subordinate position in the hierarchy of heterosexual hegemonic masculinity, there exists a similar masculine hierarchy within the gay male community which in turn has an erotic association. That is, gay men are often ranked according to their ability to “measure up”, both in relation to other men and as sexual objects, to the standard of hegemonic masculinity which entail power, dominance, invulnerability and more. This situation, along with the recent theorizing of men’s practices of masculinity being associated with their poorer health, leads to the logical conclusion that gay men’s sexual health practices can be linked to a systemic hegemonic masculinity. If the full breadth and depth of sexual health among young gay men are to be considered in the development of health policy and health promotion, the intersections of gender, sex and sexuality must be explored. The aim of this argument is to present issues of diversity within the category “men”, and to illustrate the multiplicities and intersections of identity within the category “gay men”.

https://doi.org/10.18848/1447-9532/CGP/v08i03/39611