Promoting Aboriginal and Torres Strait Islander gay men and sistergirl sexual health in Queensland: The 2 Spirits program

HIV Australia | Vol. 11 No. 3 | October 2013

By Michael Scott

Program history and summary

The 2 Spirits program was originally established to provide health education and community development to Aboriginal and Torres Strait Islander communities and to establish networks for Aboriginal and Torres Strait Islander gay men and sistergirls across Queensland.

In addition, since its inception the 2 Spirits program has continued to provide direct one-on-one support advocacy and referral for Aboriginal and Torres Strait Islander people living with HIV.

The program was originally established in 1996 as the Queensland Aboriginal and Torres Strait Islander HIV/AIDS Project (QATSIHAP).

In 2009 the name of the program was changed to ‘2 Spirits’. The term ‘2 Spirits’ refers to a person whose body simultaneously houses masculine and feminine spirits.

The rebranding of the program promoted the importance of culture in health education to Aboriginal and Torres Strait Islander communities.

The 2 Spirits logo was also launched in 2009. Developed by Arone Meeks, the logo features male and female images, along with the symbol of infinity.

The colours of the logo reflect the colours of the rainbow, as well as colours featured in both the Aboriginal and Torres Strait Island flags.

Although a part of Queensland Association for Healthy Communities (‘Healthy Communities’), the 2 Spirits program is funded primarily by OATSIH (Office for Aboriginal and Torres Strait Islander Health).

This enabled the program to continue despite the defunding of Healthy Communities by the Queensland State Government in 2012.

Covering the entire state of Queensland, the program promotes the health of Aboriginal and Torres Strait Islander gay men and sistergirl communities through sexual health promotion, campaigns, community outreach, education workshops, support and referrals.

The Whole of Community approach

2 Spirits utilises a ‘whole of community approach’ (providing education to the entire community) to provide health education about HIV and other sexually transmissible infections (STIs) and blood borne viruses (BBVs), and to reduce stigma and discrimination experienced by Aboriginal and Torres Strait Islander gay men and sistergirls.

This approach has been highly effective, as it is culturally appropriate and allows the program to reach gay men and sistergirls in remote and regional community settings.

While our primary target groups are gay men and sistergirls, we always use a whole of community approach because it is extremely difficult to reach these groups using a more targeted approach – particularly in regional and remote communities.

We cannot simply turn up to a community and ask to speak with ‘gay men and sistergirls only’, as this would immediately ‘out’ these people.

Another advantage of using a whole of community approach is that it includes men who have sex with men – people who would not necessarily engage with education targeting gay men and sistergirls.

The whole of community approach normalises sexual health discussion, making it accessible to everyone.

Diversity of the program

2 Spirits is an extremely complex and multi-layered program, and faces challenges that many other programs do not have to overcome, including:

Geographical spread: the program covers the entire state of Queensland, reaching from the southern borders of NSW to the Torres Strait, and from the eastern coastline to the Northern Territory (NT) border. The program has two offices (Brisbane and Cairns).
Cultural diversity: Indigenous culture is not all the same across the state of Queensland. There are significant differences between Aboriginal culture and Torres Strait culture, and also between different communities across the state.
What may work well with one community may be completely ineffective in another, hence our cultural strategy must be specific to each community we visit. Similarly, there are major differences between urban, regional and remote communities.
Competing priorities: HIV and sexual health are just some of the many issues affecting Indigenous people across Queensland and Australia and are arguably not at the top of the list of everyone’s priorities.
Similarly, the needs of gay men and sistergirls are not at the top of the list of priorities for Indigenous people.
The program works hard to promote the importance of sexual health; however, this is always within a context of relatively poor health outcomes for Indigenous people.
HIV sector workforce: Within the HIV sector, Aboriginal and Torres Strait Islander needs are poorly understood. People within the sector promoting the importance of ‘peer education’ are often not peers of Indigenous community.

Community visits and Elders Forums

The program has developed a series of Elders Forums, which involves the program speaking with Elders of the community who guide the program on the needs of the community.

The program cannot only focus on Brisbane and Cairns; it must target a range of remote and regional communities to reach its target populations.

When preparing to visit a community, the program takes a series of steps to ensure this has the greatest opportunity for success as possible. These steps involve:

Identifying key health workers within a community, and working with them to determine what is best for the community
Identifying and speaking with Elders of the community to guide the program on community needs Making an initial visit to introduce the program to the community
Follow up with multiple visits to build rapport and trust with the community
Delivery of an Elders Forum involving community Elders, and a community stakeholder gathering of health workers and community members
Evaluation of community events to gather suggestions for the future.

It is important to be patient through each of these steps. Some communities will require several years of community visits before our education can be delivered.

Nothing can be forced on a community – at times we have been completely prepared for a community visit only to discover the community is dealing with sorry business (bereavement), and we are forced to cancel our visit.

Similarly, when working in regional Queensland, flooding may make some communities inaccessible at parts of the year and this is not always predictable.

Within our community visits, we often deliver ‘Creating Inclusive Services’ – a training package that targets service providers to make their workplace more inclusive to LGBT people (including Aboriginal and Torres Strait Islander clients).

Northern Peninsula Area (NPA)/ Torres Strait outreach

The 2 Spirits program has visited the Northern Peninsula Region a number of times in recent years, each time building on previous successes and building trust within the communities visited.

In 2011, the program conducted a ‘condom festival’ in conjunction with Bamaga Sexual Health involving a series of workshops targeting HIV, viral hepatitis transmission and sexual health education through the whole of community approach.

Community visits were conducted in the communities of: Injanoo, Umagico, New Mapoon, Siesia, and Thursday Island.

To assist with building trust within these communities, 2 Spirits worked with the Sexual Health Education Unit and Family Resource Centre in Bamaga, the Bamaga Hospital as well as the Torres Strait Island Sexual Health Services.

Subsequent to these visits, 2 Spirits have been involved in Kasa Por Yarn in the Torres Strait. The Kasa Por Yarn (Just for a Story) Project was developed by Queensland Health and 2 Spirits as part of a multi-pronged strategy to develop and promote positive health messages for Aboriginal and Torres Strait Islander communities in some parts of Queensland.

Kasa Por Yarn is a 12-part radio play now being broadcast throughout the Torres Strait. The program was involved in the Kasa Por Yarn launch of Kasa Por Yarn 2, in Umagico, Northern Peninsula Area in 2012.

Our involvement in this exciting project opened up avenues for further health promotion in this region which will involve upcoming visits to the Northern Peninsula Area to promote sexual health.

Further to Kasa Por Yarn, 2 Spirits has been involved in the ‘Qualitative Research Living History Project’. This project, based in the Northern Peninsula Region, seeks to better understand the sexual health risks experienced by gay men and sistergirls through a series of in depth interviews of community members from the Northern Peninsula Region.

The research will be invaluable in guiding future education in the region targeting gay men and sistergirls.

Working in urban settings

2 Spirits work is extremely different within the urban centres of Brisbane and Cairns. Within Brisbane we collaborate closely with other organisations that work with our target group – specifically Open Doors (who work with young lesbian gay, bisexual and transgender [LGBT] people), ACPA (Aboriginal Centre for Performing Arts) and BIMA (Brisbane Indigenous Media Association).

We also work closely with members of gar’ban’djee’lum, a social group for LGBT Indigenous people from Brisbane and surrounding areas (see the story on page 24).

An example of health promotion within Brisbane is Brown Sugar, which is an Indigenous LGBT dance party with an annual theme.

Organised by gar’ban’djee’lum and 2 Spirits, Brown Sugar attracts 150–300 people each year and allows the 2 Spirits program to tailor unique sexual health messages and conduct social research in an environment which is fun, safe and embracing of Indigenous and LGBT cultures.

Within Cairns we collaborate closely with other service providers; primarily, these are: CISHWN (Cairns Indigenous Sexual Health Workers Network), CHIVAS (Cairns HIV Services), RASHAC (Regional Area Sexual Health Advisory Committee) and Cairns Sexual Health.

Additionally, we also work with Apunipima, Wu Chopperin, Positive Directions and Queensland Positive People, as well as Yupla Mipla Ahfla, a social group for LGBT Indigenous people in Cairns. The program also provides one-to-one support for Indigenous people living with HIV.

This is strongly utilised in Cairns, where there are a shortage of services available for the community generally. This service is not a case management service, and is more focused on bridging a cultural gap between Indigenous community and the service provider.

Condoman and Lubelicious

The 2 Spirits program is probably best known for its development of the Condoman and subsequent Lubelicious and STI characters.

Condoman was originally developed in 1987 (Townsville) by Aunty Gracelyn Smallwood and a team of other Aboriginal Health Workers in response to the Grim Reaper campaign, which was being shown on TV at that time.

As a character, Condoman became synonymous with his sex positive safe sex message, ‘Don’t be Shame Be Game’. In 2009, the 2 Spirits program relaunched Condoman with a new look and the first Condoman Comic Book.

In 2013, 2 Spirits relaunched Condoman with a female sidekick Lubelicious and a range of STI characters representing the STIs HIV, syphilis, gonorrhoea, chlamydia, HPV, hepatitis B, herpes as well as another character called ‘Stigmalien’ representing the stigma attached to STIs and sexual health.

A series of resources have been developed: the second comic, ‘Condoman and Lubelicious’,¹ which introduces all characters, plus a range of character costumes to be worn by actors in community settings to bring the characters to life.

Additionally, the 2 Spirits program has collaborated with BIMA (Brisbane Indigenous Media Association) to develop a series of radio skits to give the characters a voice, to promote sexual health on radio, and to de-stigmatise sexual health within Indigenous communities.

For more information on the 2 Spirits program, you can view our Facebook page or call us in Brisbane (07) 3017 1777 or Cairns (07) 4041 5451.

Michael Scott is the Manager of the 2 Spirits program at Healthy Communities, in Brisbane, Queensland.

Reference

1 For further information, and to access the Condoman and Lubelicious comics online, see: www.qahc.org.au/condoman