“River of life, rapids of change”: Understanding HIV vulnerability among Two-Spirit youth who migrate to Toronto

Like most large urban centres in Canada, Toronto is a magnet for two-spirit youth who leave reserve communities and smaller cities and towns seeking safety and a sense of community. The Youth Migration Project was a community-based research project that was formed out of increasing community concern for these youth as well as other lesbian, gay, bisexual, and transgender young people. Despite increasing HIV incidence among two-spirit youth, little is understood about how their migration experiences might heighten their risk for HIV infection. We interviewed thirteen two-spirit youth to better understand how migrating to a large urban centre like Toronto is linked to heightened HIV vulnerability. We also interviewed an additional eight key informants seeking their insights into the same questions. Two-spirit youth spoke of escaping abusive, oppressive and homophobic home communities, and their dreams of a better life in Toronto. Once they arrived in Toronto, however, the illusion of an accepting and welcoming community was shattered. Racism, poverty, unemployment, unstable housing, inaccessible services, and sexual exploitation were commonly experienced by two-spirit youth. Many coped with their new situations by engaging in survival sex to pay the bills, or by using substances to cope with isolation, loss, and emotional pain. These factors can lead to potentially heightened risk situations for HIV among migrant two-spirit youth. In addition to a series of recommendations intended to meet their immediate service needs, we propose numerous strategies for longer-term change to improve quality of life for migrant two-spirit youth