'This is what's going to heal our kids': bringing the Sexy Health Carnival into Indigenous cultural gatherings.

The Sexy Health Carnival is a peer-developed Indigenous health initiative designed to provide culturally-relevant health information for Indigenous youth. The Carnival takes a strengths-based, holistic approach to address topics in fun and interactive ways. As part of the study described here, the Carnival was taken to 6 First Nations, 3 Métis, and 2 Inuit cultural gatherings in Canada. Due to complex histories of colonialism, bringing sexual health and harm reduction programming to cultural gatherings remains controversial. Interviews were conducted with 10 Carnival leaders. Transcripts were transcribed verbatim and inductively coded using NVivo. There was strong support for bringing the Carnival into cultural spaces because (a) teachings on health, sexuality, and reproduction are sacred and belong in cultural spaces, (b) doing so was requested by the communities themselves, (c) the Carnival holds potential to challenge harmful stigma, and (d) the Carnival supported a peer-led initiative. Facilitators also described several challenges encountered including (a) resistance to discussing stigmatised subjects, (b) issues of safety and (c) the intensive physical and emotional demands of the Carnival's implementation. The Carnival aids in re-imagining what culturally safe health promotion can look like when it is led by and for Indigenous youth. While the Carnival contributes to Indigenous cultural resilience and resurgence, further support is needed to enhance sustainably.

Quilted cellphilm method: A participatory visual health research method for working with marginalised and stigmatised communities.

The use of participatory visual methods and integration of cellphone technology is expanding in global public health research. Cellphilm method capitalises on these trends by inviting participants to use mobile devices to create short videos about health topics. This paper presents the quilted cellphilm method, which supports the participation of stigmatised populations to engage in research. We present the method with reference to the Celling Sex project, which worked with young women who have transactional sex experience. Four key steps in our unique model are discussed: (a) individual cellphilm-making; (b) participatory analysis; (c) creating a composite video; (d) publicly screening the work. We consider how working individually with participants in the cellphilm-making process built trust. We unpack how offering participants opportunities to engage in either group or one-on-one activities promoted participation in collaborative analysis. We outline how creating a composite video of the cellphilms and organising screenings facilitated knowledge translation and exchange. Overall, the quilted cellphilm method created a supportive community for vulnerable participants to generate products that challenged social stigma. Increased reliance on mobile media, especially during the COVID-19 pandemic, makes the quilted cellphilm method an opportune, exciting and accessible approach for participatory public health research.

Staying safe: how young women who trade sex in Toronto navigate risk and harm reduction.

Celling Sex was a community-based participatory research project that used a strengths-based approach to explore the agentic harm reduction practices employed by young women who trade sex and learn about their experience accessing health and social services. Fifteen racially diverse young women participated in interviews. They described how they tried to stay safe and advice for others. Each participant also individually made a brief digital video (cellphilm) to tell their story. Participants were invited to a private screening at which cellphilms were screened and common themes identified. The interviews and cellphilms were subsequently coded according to these themes. Participants identified a number of trading risks including: physical risks (unwanted pregnancy, STIs, and violence), social risks (racism and fetishisation), and mental health risks. To mitigate these concerns, participants detailed the harm reduction strategies they used which included use of technology, screening measures, boundary setting, and actively incorporating sexual health protections. Young women who trade sex are keenly aware of the risks inherent in transactional relationships and proactively negotiate and navigate harm reduction strategies in the context of deep systemic barriers. Further intervention may be necessary for them to actualise these strategies and access important forms of health and social support.

Exploring Audience Engagement and Critical Narrative Intervention With the Celling Sex Film.

Young women who trade sex experience high rates of stigma that exacerbate existing health inequities. The products of participatory visual methodologies show promising potential for challenging stigma. In total, 15 young women who trade sex created individual brief videos to share their experiences. Following a participatory analysis, the videos were edited into one composite movie to highlight key messages. Eight facilitated screenings (cohosted by participant filmmakers and research team members) were organized with diverse community and health organizations. Audiences were led through a series of interactive writing, drawing, viewing, and discussion activities. Sessions were audio recorded, transcribed verbatim, and inductively analyzed to assess the impacts of the film on audiences. Audience reactions were categorized into four overarching themes to describe main impacts: consciousness raising, commitments to practice and organizational change, effectiveness of the approach, and limitations. Audience responses demonstrated that facilitated screenings can challenge harmful stereotypes and help viewers consider pathways to enact positive change in their personal and professional lives. However, changing deep-rooted patterns of stigma takes time, dedication, and accountability.