Purpose: Centering Two-Spirit (2S) and Indigenous experiences and ways is critical for more respectful, reciprocal, relevant, and responsible sexual health research with gay, bisexual, and other men who have sex with men (gbMSM). The Two-Spirit Dry Lab, a collaborative initiative of Indigenous and settler researchers, conducted a study to explore drivers of sexual health knowledge with 2S and other gbMSM community(ies).
Methods: We used data from the 2015 Canadian Sex Now online survey. Our models balanced Indigenous ways of knowing with western epidemiology: we applied mitakuye oyasin (i.e., everything is related)—a Sioux teaching—alongside linear regression (i.e., certain relationships enable certain outcomes), to examine drivers of sexual health knowledge (a 6-point scale), comparing 2S and other Indigenous gbMSM. We also examined differences between those living in urban settings versus those living in non-urban ones.
Results: Income and education were correlated, as were having a gay peer network, living in an urban setting, social support, and education. Income, education, gay peer network, and social support were associated with greater sexual health knowledge, as was younger age. In stratified analyses, living in an urban setting had a large and statistically significant association with sexual health knowledge for 2S men but not for other Indigenous men.
Conclusions: Our study emphasizes the need to work with 2S and other Indigenous gbMSM to improve sexual health knowledge, focusing in particular on those with lower levels of income or educational attainment –who are less connected to gay peer networks –and older men.
About the Authors
Harlan Pruden (nēhiyo/First Nations Cree Nation) (pronouns: anything said mindfully and respectfully) works with and for the Two-Spirit community locally, nationally and internationally. Harlan is an Educator at Chee Mamuk, an Indigenous public health program at BC Centre for Disease Control; the Managing Editor of the TwoSpiritJournal.com; and an Advisory Board Member for CIHR’s Institute of Gender and Health.
Travis Salway (pronouns: he/him/his) is a settler and researcher who has been working in queer health and community organizing for 20 years. He is the co-founder of the Two-Spirit Dry Lab and an Assistant Professor of Health Sciences at Simon Fraser University, where he works on unceded and traditional territories of Musqueam, Squamish, Tsleil-Waututh, and Kwikwetlem Nations.
Teddy Consolacion (pronouns: she/they used most regularly but I don’t correct anyone who uses “he/him”) is an epidemiologist at BCCDC in HIV. With a PhD in social psychology, they have worked in different public health agencies in US and Canada for over 10 years. Their interests include research on intersectionality of identities and downstream health outcomes.
Jannie Wing-Sea Leung (pronouns: she/her) grew up on the unceded territories of the Squamish, Tsleil-Waututh, Musqueam and Kwikwetlem peoples (Burnaby and Vancouver), and her ancestors are from China. She has an MSc in Community Health and Epidemiology and has worked as an epidemiologist in different public health organizations for the past 8 years, focusing on health equity, public health surveillance, and communicable diseases.
Aidan Ablona (pronouns: he/him) is a first-generation Canadian of Filipino ancestry, currently settled on unceded territories of the the xʷməθkʷəy̓əm (Musqueam), Sḵwx̱wú7mesh (Squamish), and səl̓ilw̓ətaʔɬ(Tsleil-Waututh) First Nations. He works as a data analyst with the Digital Sexual Health Initiative (DiSHI) team at the BC Centre for Disease Control and is an Affiliated Researcher with the Community-Based Research Centre. He is passionate about sexual health, community-based research, and health equity, particularly for racialized, Two-Spirit, queer and trans communities, and is committed to anti-racist public health practice.
Ryan Stillwagon (pronouns: he/they) is a Ph.D. Candidate in the Department of Sociology at the University of British Columbia. His current work focuses on sexual health, queer placemaking, and food insecurity.