What is a ‘Deliberative Dialogue’? It is a forum where many diverse stakeholders come together and discuss an issue – sharing perspectives and potential ways forward. Its strengths as a process include the fact it is collaborative in nature and engages diverse groups of people. It’s a great tool for thinking through how to move an issue forward in a multi-dimensional, responsive way.

Our research has given us an understanding of how stigma impacts the lives of people with HIV

By actively moving research findings into action The Pacific AIDS Network (PAN) used this method by facilitating the Stigma Reduction Initiative Deliberative Dialogue in November 2019. This work built of findings from the BC People Living with HIV Stigma Index(a community-based research study that examined the experiences of stigma among 176 participants living with HIV).

Our research has given us an understanding of how stigma impacts the lives of people with HIV in the province but the goal of this study is to do more than this. The goal is to build programs, projects and initiatives that positively impact the way people experience stigma and ultimately improve the quality of people’s lives. With this in mind, the conversations at the Deliberative Dialogue allowed us to determine where to focus our work in terms of stigma reduction in BC, while still ensuring our work is grounded in GIPA/MEPA and Nothing About Us, Without Us principles.

Collaborating with diverse voices

The Deliberative Dialogue was firmly grounded in community-based processes which puts people with lived and living experiences at the centre of planning and decision-making. The Study Team was able to ensure that the Deliberative Dialogue was inclusive of diverse backgrounds and experiences, as well as geographic location from across BC. Gathering together in Vancouver were attendees from all five health regions in British Columbia; the Deliberative Dialogue had 35 attendees and more than one third of them were people with lived and living experiences.Also included were service providers, staff of community-based organizations,and policymakers.

Grounding Conversations in Intersectionality

Our learnings from the StigmaIndex data and the consultation work the Study Team has done led us to adopt intersectionality as a crucial element to the Deliberative Dialogue.Moving us beyond looking at HIV stigma alone but as one piece of a person’s experience of stigma.

Intersectionality is… a metaphor for understanding ways that multiple forms of inequality ordis advantage sometimes compound themselves … intersectionality isn’t so much a grand theory, it is a prism for understanding certain types of problems

- Kimberlé Crenshaw, an American civil rights advocate and professor at UCLA School of Law and Columbia Law School (Crenshaw, What is Intersectionality?, 2018)

By engaging with intersectionality we were able to examine wherestigmas occur in people’s whole lives, in their overlapping identities (for example, stigmas that engage substance use, hepatitis C status, HIV status,ethnicity, sexual identity, etc.).

Deliberative Dialogue in action

This approach allowed us to hear from several community-based organizations about their diverse and intersectional stigma reduction work happening across the province. This built a foundation for moving the group into a mapping exercise to identify where stigma reduction work is already happening, but also where there may be gaps or potential opportunities to impact change.  

At the end of the meeting the attendees were asked to come up with “Big Ideas.” We asked teams to dream big, to think about the initiatives that would have the biggest impacts on stigma (figuring out how to implement them would come later). There were many interesting ideas including:  

·      Working with health authorities, nursing unions,physicians to educate staff and members about the concept of Undetectable =Untransmittable (U=U) and having them sign onto U=U and including this within their organization’s goals and missions

·      Using storytelling and education about stigma and the intersectional identities that are stigmatized from the ‘cradle to the grave’

·      ‘Indigenizing’ all organizations (engaging leadership to re-write their constitutions, embody decolonization, and to implement initiatives responding to the Calls to Action in the TRC

·      Supporting peer-led, peer-driven gatherings or conferences where people can network together and engage in capacity-building on how to address stigma

·      Developing an accountability measure for organizations and institutions (a stigma audit)

Engaging with the “Big Ideas”

PAN has immediately used the Deliberative Dialogue outcomes.Looking to our organization’s mission and mandate we decided to seek out resources to develop an organizational stigma assessment tool that can be used to unearth stigma embedded in organizations, intra-group stigma within organizations and structural barriers that need more of a collective approach.We are also continuing to partner with other organizations to find ways to move other ‘Big Ideas’ forward.

The Deliberative Dialogue was an excellent opportunity to bring people together, to network and brainstorm collaboratively and our evaluation reflects this sentiment. The Deliberative Dialogue has definitely built momentum for innovative work moving forward, and we are very excited to continue working to bring information into action that will reduce HIV stigmain a meaningful way.

For more information on the BC People Living with HIV Stigma Index project, please visit:

www.pacificaidsnetwork.org/training-leadership/stigma

For more information on the Deliberative Dialogue, please visit:

https://pacificaidsnetwork.org/training-leadership/stigma/deliberative-dialogue-2019/

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