The Seven Truths of Resilience: Understanding Wellness and Longevity Among Long-Term HIV-Positive Gay, Bisexual and Two-Spirit Males

Background and purpose.  Despite numerous obstacles, many two-spirit and/or gay/bisexual HIV-positive Aboriginal men (TS PHAs) who have been living with HIV for a long time report that they are doing well.  This community-based study was designed to bring together a team of researchers comprised of Aboriginal and non-Aboriginal community members and academics to examine the ways in which two-spirit men with HIV understand the skills, resources, knowledge and practices that contribute to their health and wellbeing.

Methods.  In conjunction with a community Aboriginal advisory board, the research team conducted focus groups that were developed using Indigenous knowledge and methods that modeled Aboriginal sharing circles. These circles were used to gather data in three locations (Hamilton, Toronto, and Ottawa, Ontario, Canada).  Participants were men (n=14) who identify as Aboriginal, gay, bisexual, and/or two-spirit, and who have been diagnosed with HIV for 10 years or more.  Through the use of the Medicine Wheel (MW), a North American Aboriginal symbol representing one’s healing journey, participants were invited to discuss historical, biomedical, social, spiritual, sexual, and behavioural factors affecting their health, wellness and resiliency.  Data analysis involved several stages: (1) Cross-cultural training on the teachings of the MW and in qualitative data analysis were provided; (2) once transcribed, all data expressing similar patterns were coded using NVivo 10; (3) using participatory analysis, selected key quotes were mapped to the MW in areas expressing similar meaning; (4) codes that expressed a relationship to one another were grouped and then labeled consistent with the teachings of the MW and their relationship to the study purpose; and (5) innovative data visualization was used to present findings using the MW.  Validity was established by independently verifying coding work and utilizing member-checking of the tentative findings with our community advisory committee.

Results.  Through the analysis of participants’ discussion, the Seven Truths of Resiliency arose as integral components of their health, wellness, and resiliency.  These Seven Truths of Resiliency represent a framework for understanding TS PHAs resiliency as specific systems of personal, cultural, community, and spiritual assets and resources.  The Seven Truths of Resiliency are:  (1) Worldview, (2) Finding One’s Strength, (3) Walking Towards Balance, (4) Recognizing True Power, (5) Mino-bimaadiziwin (living the way of a good life), (6) Self-care, and (7) Living Our Truth. 

Conclusions and implications.  Through an active community/academic partnership with meaningful engagement to address the resiliency of long-term HIV-positive TS PHAs, this project has focused on ways in which two-spirit PHAs understand their own resiliency. The project has helped to identify the ways in which HIV prevention campaigns can be better suited for two-spirit men, identified issues related to living with HIV, and advanced the development of knowledge necessary to address the needs and concerns of those who have been living with HIV longer term.