Trevor Hart trains in Beijing, promoting peer mental health support for people living with HIV

As a professor in the Department of Psychology and director of the HIV Prevention Lab (external link)  and HOPE Centre for Sexual and Gender Minority People (external link) , psychologist Trevor Hart’s research spans clinical psychology, epidemiology and public health. Hart and his team of researchers identify risk and protective factors associated with HIV and other sexually transmitted infections among sexual minority men (SMM), including gay, bisexual, queer, and other men who have sex with men. Hart also investigates psychotherapy and counselling programs that integrate the promotion of mental and sexual health and that reduce HIV, sexually transmitted infections, and other sexual risk outcomes. 

While Hart’s research takes place close to home in Canada, in February, he found himself across the world in Beijing, China, conducting professional training at the AIDS Prevention and Control Center of the Chinese Center for Disease Control and Prevention (external link)  (CDC). An international opportunity for outreach arose after Ran Xiong, a visiting scholar from the Chinese CDC, connected with colleagues on the possibility of inviting Hart to test the Gay Poz Sex (GPS) counselling program that Hart and his colleagues developed to reduce HIV and sexually transmitted infections among SMM. Dr. Shan Duo, the deputy director of the Comprehensive Prevention and Policy Office and project leader, invited Hart to conduct the training for the Randomized Controlled Trial (RCT), which compares GPS to standard-of-care. With the support of translators, Hart spent four days delivering training to peer educators in Beijing, aimed at cultivating their skills to enhance mental health intervention capacities for SMM living with HIV.

Hart’s training focused on training in the underlying model for the GPS program, called motivational interviewing (MI). MI is an evidence-based approach to behavioural change centred on reciprocal listening and learning, client empowerment, curiosity, and respect for autonomy. 

Motivational interviewing was chosen as more traditional approaches to health counselling, Hart shared, can pose limitations for many clients with marginalized identities or who partake in stigmatizing activities. In these settings, health education may take a more prescriptive approach, assuming clients are ready to receive and internalize health information. These more traditional approaches emphasize the unequal power imbalance between provider and patient that may undermine individuals’ confidence in speaking out and advocating for their health needs. With motivational interviewing, Hart explained, patients can be met ‘where they’re at’ and engage in open dialogue that may help empower them toward learning and well-being. As a method of communication, motivational interviewing can bring about positive change even with stigmatized behaviours such as sex or substance use. 

Hart’s training was well received by peer educators, who found that acquiring newfound counselling skills, learning to understand the patient’s experience of their life stresses and psychological strengths, and refining their ability to support the psychological health of patients were essential competencies necessary for working with marginalized communities. Peer educators are an important part of the health care network—despite not being doctors or trained counsellors—these quasi-professionals are often more accessible and can provide patients with support and solidarity. After participating in the training, the peer educators were equipped to train other members of the community, reducing HIV and other sexually transmitted infections among SMM, and extending healthcare to bring about a more positive social impact.

Hart’s training abroad provides an optimistic prospect of making the GPS counselling program more widespread and accessible, adapting to suit the needs of patients across diverse lived experiences, cultural, and linguistic backgrounds.