2Spirits: providing a multi-generational, culturally competent approach to health promotion for Aboriginal and Torres Strait Islander communitiesadmin
2Spirits: providing a multi-generational, culturally competent approach to health promotion for Aboriginal and Torres Strait Islander communities
HIV Australia | Vol. 13 No. 3 | December 2015
By Brett Mooney and Phillip Sariago
A key outcome from the inaugural Anwernekenhe conference was the recommendation to establish an Aboriginal and Torres Strait Islander HIV and AIDS Project in each AIDS Council in Australia.
This resulted in the formation of the National Working Party of Aboriginal and Torres Strait Islander gay men, sistergirls and people living with HIV.
The job of the working party was to help forge a response to the HIV epidemic threatening Indigenous communities in Australia, which set the foundations for an ongoing community-driven program to address HIV among Aboriginal and Torres Strait Islander communities in Queensland.
The Queensland AIDS Council formed its 2Spirits program in 1996. 2Spirits currently consists of a small team of Health Promotion Officers – Nikki Hill and Arone Meeks based in Cairns, Phillip Sariago and Brett Mooney in Brisbane and Manager/Executive Director, Michael Scott.
Tony Coburn, Brett Mooney, Wilo Muwadda, Shannon Jackson, Earl Roses, Brendan Leishman at Condoman relaunch, Brisbane, 2009.
The program adopts a ‘whole of community’ approach for providing HIV, sexually transmissible infections (STI) and blood borne virus (BBV) health education.
Queensland is traditionally the home of many Aboriginal and Torres Strait Islander peoples. The state has the largest combined population of both cultures in Australia, uniquely setting us apart from all other states and territories.
2Spirits is seen by peers as specialists in our approach in developing and maintaining a cultural presence in health-based community engagement, to empower individuals to make informed choices about their sexual health.
Over 19 years of service delivery, 2Spirits’ specialist program has provided culturally appropriate sexual health promotion projects in Queensland, and national campaigns such as Condoman.
It is the only program in Australia providing a cultural workforce development project that focuses on the health and wellbeing of Indigenous gay men and sistergirls.
In addition, our program addresses stigma, discrimination and associated violence that is often aimed at Aboriginal and Torres Strait Islander gay men and sistergirls within communities.
Health promotion projects
Our program provides education across the life span. The 2Spirits team works closely with young people across Aboriginal and Torres Strait Islander communities in Queensland, delivering a six week sexual health program at the Aboriginal Centre for the Performing Arts (ACPA) in Brisbane to first year student cohort.
The program has had a positive impact with students, expanding their knowledge on how they view and make better choices around their sexual health.
Building on this relationship, 2Spirits have employed students from ACPA to raise community awareness focusing on sexual health and regular testing by portraying Condoman, Lubelicious and other STI characters at community events in NAIDOC Week and World AIDS Day.
At the opposite end of this age spectrum, 2Spirits works with Aboriginal and Torres Strait Islander Elders, through Elder’s Forums.
As custodians of Indigenous cultures, it is imperative that Elders are actively involved in the planning, promotion, implementation and evaluation of programs and not simply included. For this reason, 2Spirits has involved Elders as key stakeholders throughout its history of service delivery.
In 2013, 2Spirits conducted an Elder’s Project with community Elders drawn from communities as far apart as Yarrabah in Far North Queensland, down the East coast of Queensland to Stradbroke Island.
The aim of the project was to develop health promotion through the voices of our Indigenous Elders educating communities about sexual health, support, tolerance, acceptance and the importance of family regardless of sexuality.
Creative approaches are intrinsic to the work of 2Spirits. To increase community awareness in far north Queensland communities, art workshops provide individuals another form of learning and expression relating to identity, sexuality, acceptance, inclusion, diversity, respect and sexual health.
The artwork produced from these workshops is used to develop relatable individual and community oriented health promotion resources and campaigns.
A partnership with the Brisbane Indigenous Media Association (BIMA), developed a range of radio skits featuring super heroes Condoman and Lubelicious to educate and normalise sensitive topics about sexual health, people living with HIV (PLHIV) and treatments and removing stigma and shame, acknowledging men’s and women’s business.
Adopting radio to get into homes to educate communities on sexual health in ways never before utilised, the skits are promoted through airways in the south east, central and northern parts of Queensland as well as in Tasmania.
Cultural competence training
2Spirits have identified a significant need for cultural competence training across Queensland.
The program invests resources and time within each community, building workforce capacity with organisations that provide services for gay men and sistergirl and brotherboy communities within those communities, as well as providing specialised cultural awareness and workforce development for organisations to engage effectively with these populations.
2Spirits has developed partnerships with key community organisations through conducting service provider forums. One such forum, held in Rockhampton, promoted sexual health and awareness of an Aboriginal and Torres Strait Islander gay men and sistergirls target group in Central Queensland.
2Spirits partnered with Queensland Health in Rockhampton to assist in setting up the first Central Queensland Youth Interagency Sexual and Reproductive Health Forum in 2014 for service providers to create linkages and strategies to reduce rates of HIV and STIs.
The 2Spirits team works collaboratively with Indigenous and mainstream services to ensure that communities have a greater understanding of key areas of health promotion, delivered in an appropriate way.
2Spirits has collaborated with Hepatitis Queensland and the Torres Strait Islander community to produce a series of hepatitis brochures in the Creole language (the primary binding language spoken throughout the Torres Straits).
2Spirits revamped Condoman, the longest running sexual health campaign in Queensland to include the Torres Strait colours into his costume, making the super hero inclusive of two traditional cultures in Queensland.
Mental health and wellbeing
Many Aboriginal and Torres Strait Islander gay men and sistergirls routinely face a variety of challenges related to their sexuality.
This can lead to a range of mental health problems, many of which are related to the issue of acceptance and homophobia from the wider Indigenous and non-Indigenous communities.
Other issues of concern relate specifically to service provision – issues such as such as access, inclusiveness, confidentiality and cultural sensitivity by service providers.
Medical professionals require development of their ability to appropriately address the unique health needs of gay men, sistergirls, brotherboys and lesbians.
Widespread neglect from past governments has carried through to current generations, leading to poor health that has added additional strain on health services that are ill equipped in their service models for Aboriginal and Torres Strait Islander people.
The effects of past government policies that led to the removal of Aboriginal and Torres Strait Islander children from their families1continues to present severe consequences for social and emotional wellbeing; poor mental health leads to unconventional forms of coping mechanisms that place Indigenous people at risk of further negative health implications.
Intergenerational trauma and grief continues to cause Aboriginal and Torres Strait Islander people many health and social challenges, forcing 2Spirits to adopt strategic approaches in our holistic service delivery to ensure our clients receive appropriate health care to meet their needs.
Looking to the future: addressing gaps in funding, knowledge and awareness
Funding has been challenging for 2Spirits, particularly in an environment where there are increasing rates of STIs and HIV among Aboriginal and Torres Strait Islander gay men and other men who have sex with men (MSM), and sistergirls in Queensland.
Currently 2Spirits consists of three fulland one half-time health promotion officers that provide service to the whole mainland state of Queensland and support 17 Islands of the Torres Strait across urban, rural and remote settings.
To be more effective in our current workforce capacity, additional funding would be beneficial to develop more culturally appropriate HIV and STI prevention programs and health promotion in areas of high population density for our target group, the far north Queensland regions.
Uniquely, 2Spirits modifies its health promotion strategies to allow for growth and empowerment of communities to be a part of effective, culturally appropriate and sustainable sexual health outcomes.
2Spirits has identified gaps in knowledge and awareness with health professionals that provide services to gay men, MSM and sistergirls who are identified as most at risk target groups in several national and state Strategies including the Third National Sexually Transmissible Infections Strategy 2010–2013, Fourth National Aboriginal and Torres Strait Islander Blood Borne Viruses and Sexually Transmissible Infections Strategy 2014–2017, National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019, National Aboriginal and Torres Strait Islander suicide prevention strategy and the Queensland Mental Health, Drug and Alcohol Strategic Plan.
Homophobia and acceptance of homosexuality continues to be a problem in Australia for Aboriginal and Torres Strait Islander gay men, sistergirls, brotherboys, lesbians and the wider LGBT community.
The 2Spirits program will continue to work with health professionals and communities to enable Aboriginal and Torres Strait Islander gay men and sistergirls (in particular) to take control of their health and improve their quality of life.
Increased funding for more community education and promotion is vital to strengthen 2Spirits’ current workforce capacity for our Queensland wide brief, and to extend our service delivery to address mental health, drug and alcohol use, suicide and lesbian health for this at risk target group that continues to be presented with discrimination and inequities within service provision, legislation and society.
1 Lavarch, L. (1997). Bringing Them Home Report. Commonwealth of Australia, Canberra
Brett Mooney and Phillip Sariago are Health Promotion Officers, 2Spirits Program/Queensland AIDS Council.