Estamos Aqui (We Are Here): Mobilizing Creative-Relational Inquiry for an Arts-Based Project With Venezuelan Gay and Bisexual Migrant Sex Workers in Medellin,Colombia

Laying the Foundation: Adapting CRI Through Learnings From LASM-CH

In our arts-based research with Venezuelan gay and bisexual migrant sex workers in Colombia, we employed CRI as a methodology to center relational, embodied, and co-creative modes of knowledge-making. Our approach was informed by the Latin American Social Medicine and Collective Health (LASM-CH) theoretical movement (Iriart et al., 2002; Tajer, 2003), which challenges biomedical reductionism by foregrounding the social, political, and historical dimensions of health. LASM-CH emphasizes participatory and emancipatory practices rooted in collective experience and action, offering a natural affinity with CRI’s relational and process-oriented ethos. We adapted the CRI method following two key Latin American thinkers: Paulo Freire and Victoria Santa Cruz. Their work shapes our approach’s theory, praxis ethics, and purpose. Drawing from Paulo Freire’s concept of conscientization (Freire, 1974, 2021), we view research as a dialogical and transformative process that cultivates critical awareness of power, inequality, and social injustice among all involved. CRI, in this context, is not about knowledge extraction but about co-producing understanding through reflection, dialogue, and action. Research becomes a collective praxis, where inquiry is inseparable from the pursuit of liberation. This shift requires acknowledging and examining the researcher’s positionality and embracing the ethical responsibility to challenge systems of oppression within the research encounter.

Victoria Santa Cruz’s (2023) conception of rhythm as an integrative life force also has been essential to reimagining how we understand knowledge, embodiment, and transformation. Santa Cruz challenges the fragmentation of dominant Western disciplinary practices by offering rhythm as a mode of knowing that connects body and space. Rhythm, in this sense, is not merely an aesthetic or sensory element but a relational and embodied epistemology that honors both the singularity of lived experience and the collective pulse of social life. Central to this vision is the idea that transformation occurs through reciprocal movement between inner reflection and external engagement – healing the self while remaining open to the world as both influence and catalyst for positive change like exercising agency in making art. Rather than positioning participants as passive informants, our CRI arts-based processes are structured to generate shared meaning through embodied expression – voice, drawing, movement, sound. These forms allow knowledge to emerge organically, through rhythm and presence, rather than being reduced to discrete units of analysis.

Who Are the Participants? Blurring the Lines of Research Subject

While recognizing its limitations, we use “participant” as an inclusive term to describe all individuals involved in the study – ranging from those who contributed artistic expression to those who co-led workshops and data interpretation – acknowledging the relational and collaborative nature of the research process. Reflecting a Freire (1974) commitment to mutual learning knowledge exchange, this term acknowledges the diverse forms of involvement and co-construction that characterized the research process.

Institutional ethics guidelines required that participants self-report as Venezuelan migrants, identify as gay or bisexual, engage in sex work, be over 18, and reside in the Medellín metropolitan area. In early workshops and following MQ3L’s community guidance, participation was initially limited to those living with HIV to create a safe space for exploring HIV-related experiences; later workshops were open regardless of HIV status. We limited workshop participation to migrant men who identified as gay or bisexual to create a culturally safe, relevant space grounded in trust and shared experience. This decision, shaped by our partnership with MQ3L and the research team member’s shared identity as a gay man, supported open dialogue. While sexuality was not an explicit theme, it was interwoven through facilitator prompts and case examples reflecting participants’ lived realities.

It is important to note that in Colombia, voluntary adult sex work is neither illegal nor criminalized (Caicedo Vasquez, 2022). The Criminal Code (Law 599 of 2000) contains no provisions penalizing consensual sex work between adults, nor does any national law define it as a criminal offense. Law 1482 of 2011, which amended Colombia’s Penal Code, criminalizes acts of discrimination based on sexual orientation to protect individual rights. Although that law does not explicitly mention HIV status, discrimination against people living with HIV may be covered under provisions related to disability.

Spatial Considerations That Facilitate Creativity

The workshops took place at a rented art space within Fundación Universitaria Bellas Artes in the city center of Medellín, intentionally chosen to support both individual reflection and collective creation. The space was not merely a backdrop but an active, co-constitutive element of the research – shaping how participants engaged with one another, materials, and narratives. Its layout offered a mix of open communal areas and semi-private zones, allowing participants to move fluidly between collaborative interaction and focused, introspective work. This spatial design fostered creativity and supported the emergence of shared meaning through embodied and relational practices. All sessions were led by a trained artist from MQ3L, who provided all necessary materials and emphasized flexibility to accommodate diverse modes of engagement. These spatial dynamics reflected our methodological commitment to relational and embodied knowledge-making, offering participants autonomy in how they positioned themselves – physically, emotionally, and socially – within the evolving creative process. The first author attended and participated in all workshops, documenting the process through notes, photographs, and videos, while also assisting the artist in facilitating discussions designed to inspire and deepen participant engagement.

Relational and Research Ethics

Our project centered relational ethics as an ongoing, in-practice commitment rather than a procedural formality. Trust-building, shared decision-making, and blurred roles between participants and facilitators replaced traditional hierarchies. Participants were recognized as co-leaders, shaping both the content and process of the workshops. This ethical orientation was evident in moments when participants’ artistic outputs did not directly respond to the workshop prompt but were nonetheless deeply valued for their expressive and dialogical contributions, as they facilitated further group reflection and discussion. These acts of creative divergence were understood not as deviations but as legitimate and meaningful forms of knowledge production – reflecting the embodied, situated, and emergent nature of rhythm as conceptualized by Santa Cruz.

The project received approval from two institutional ethics review boards: University of Toronto (#46624) in Canada and Profamilia in Colombia (CEIP-24-2024). All participants read and signed an informed consent form that affirmed their ownership of their artistic work, including the option to retain their pieces and choose whether their artwork could be photographed or their reflections audio recorded. Consent was reviewed with participants in an open, conversational format to ensure clarity, and any questions that emerged were addressed in a group-based forum unless participants sought more private consultations. The group setting was acknowledged as one in which confidentiality could not be guaranteed, but mutual respect and discretion were emphasized as shared responsibilities among all present. Participants received 80,000 Colombian pesos (∼$19 USD) per workshop in recognition of their time and contributions. Food and beverages were also provided to support a welcoming and participatory environment.

Grounding Horizontal Learning and Establishing Workshop Commitments

Every workshop began with a shared commitment to grounding the principles of horizontal learning and collectively establishing workshop commitments. Horizontal learning refers to a non-hierarchical approach to knowledge exchange, where participants learn with and from one another as equals. Rather than positioning the facilitator as the sole expert, this model fosters mutual teaching through peer dialogue, shared experiences, and co-created insights (Freire, 1974; Lahiri & Rajan, 2022; Tschirhart et al., 2016). Aligned with Freire’s emphasis on critical consciousness (conscientização), this approach enabled participants to interrogate and resist dominant narratives surrounding migrant sex workers living with HIV, generating awareness rooted in their lived realities. These principles were further demonstrated as participants organically deviated from structured prompts to create artistic outputs that reflected their own priorities, interests, and political commitments. Following this approach, the artist facilitated a range of icebreaker and trust-building activities - such as collaborative drawing and group storytelling - to foster a sense of safety, belonging, supportive environment, and mutual respect. These opening activities also invited participants into reflective and imaginative engagement with the workshop theme, laying the foundation for collective creativity and relational accountability throughout the session.

In the first workshop’s opening activity, the artist distributed long strips of white paper to all participants (see Figure 1) to emphasize the project’s central commitment to shared authorship and horizontal learning. To root the session in the collective spirit of the project, participants were invited to complete the prompt “Estamos aquí” (“We are here”) - the title of the project - with any words or thoughts that came to mind. The artist stressed that there were no right or wrong responses. After writing a sentence, each participant folded the strip to hide their contribution and passed it to the person on their right, who then added a new “Estamos aquí” sentence without reading the previous ones. This process continued until the strips were filled. At the end, participants read the completed strips aloud to the group, creating a layered and collective narrative that set the tone for relational and reflective engagement.OPEN IN VIEWER

This opening exercise served also as a tool for collectively shaping the workshop’s ethical and relational commitments. The phrases generated centered on optimism, resistance, solidarity, and self-affirmation, which then laid the groundwork for a shared sense of purpose and mutual respect. For instance, phrases like “Estamos aquí manifestando alegría” (“We are here manifesting joy”), “Estamos aquí y somos importantes” (“We are here and we are important”), and “Estamos aquí y exigimos una vida digna” (“We are here and we demand a life with dignity”) reflect a collective assertion of agency and resilience. Additionally, the theme of sex work as a site of empowerment and self-affirmation was evident in statements like “Estamos aquí orgullosamente putas” (“We are here as prideful whores”). Another interconnected theme was reframing agency in having an HIV diagnosis, as expressed in phrases such as “Estamos aquí con VIH” (“We are here with HIV”), “Estamos aquí con terapia y sin muerte” (“We are here with therapy and without death”), and “Estamos aquí viviendo con VIH y somos felices” (“We are here living with HIV and we are happy”). In doing so, participants co-created workshop commitments that emphasized respect for lived experience, ownership over narrative, and the right to be seen and heard fully.

This moment also reflects Freire’s (1974) notion of conscientização – the development of critical awareness through reflection and action – as participants collectively named their realities, articulated shared struggles, and reimagined their presence in affirming and transformative ways. The presence of affirmative and empowering statements disrupts dominant narratives that frame migrant sex workers and people living with HIV through victimizing discourses. Expressions of optimism, solidarity, and collective strength highlight how CRI captures affective and embodied ways of knowing that extend beyond verbal articulation, structured data collection techniques or predetermined research outcomes.

Disrupting Notions of Linear Growth: Centering Iterative Co-Learning and Un-Learning

Across workshops, the goal was to explore how migrant sex workers enact agency and autonomy in their migration journeys while navigating intersecting stigmas. In doing so, the project aimed to co-design counter-narrative visual campaigns (e.g., photojournalism, graffiti, digital stories) that challenge discrimination and affirm migrant belonging in contexts of relocation. Recognizing that creative processes are inherently heterogeneous, the project embraced flexibility and openness as critical to ethical, participatory knowledge production. Each workshop included brainstorming and drafting activities facilitated by the artist. Using prompts such as “What were defining moments of your migration experience?” and “What does sex work represent for you?”, participants were encouraged to draw or write anything that came to mind, with the understanding that creative exploration would help refine their ideas over time. Sometimes, this process was individual, each person working on their own page, while other times it was collective, with participants gathered around a large sheet of paper. In both formats, open-ended group dialogue allowed conversations to flow organically, often sparking new insights later reflected in participants’ final pieces. This flexible, participant-led process supported diverse forms of expression and reflection, as ideas evolved through collective engagement and the researcher’s gentle prompts. This structure echoed Freire’s rejection of fixed developmental trajectories, offering space for participants to move back and forth between creation and reflection. When ready, participants had the opportunity to share their final pieces with the group – affirming each person’s contribution as part of a broader co-learning journey, following Santa Cruz’s (2023) idea of integrative knowledge as rhythm.

For example, Figure 2(A) shows a participant’s brainstorming draft and Figure 2(B) his final art piece: a painted and hand-stitched cloth bag responding to the workshop’s theme: migration. Comparing the content of the two photographs, it is evident that the brainstorming draft contained many details that were not fully reflected in the final product. Notably, the draft includes key words and phrases such as “resilience” and “pain → transformation,” along with a representative account of how receiving an HIV-positive diagnosis in Venezuela served as the primary motivation to migrate to Colombia in search of access to antiretroviral treatment. Additionally, while the final product features the representation of a butterfly, the brainstorming draft illustrates the complete life cycle of a butterfly, from caterpillar to chrysalis to fully developed butterfly. This visual progression, as described by the participant, more explicitly conveys his self-representation of a personal journey of change, resilience, and renewal. The life cycle metaphor reinforces the notion of migration as a transformative process - one shaped by hardship but also by the possibility of rebirth and new beginnings. The “simplification” evident in the final artwork reflects not only aesthetic decisions but also the condensation of complex emotions and narratives into symbolic form, demonstrating how the creative process can serve as a medium for self-reflection and meaning-making.OPEN IN VIEWER

Figure 3 shows a collective brainstorming activity, during which all participants gathered around a large sheet of white paper to draw and write elements that came to mind in relation to the workshop’s theme determined by the artist: experiences of living with HIV. The brainstorming draft reflects both individual expression and the relational dynamics of group discussion. Some were more visually expressive, occupying larger sections with drawings and sentences; others contributed more selectively, yet all actively participated in co-constructing themes. This brainstorming activity also serves as data, capturing key aspects of conversation and emergent reflections on HIV stigma. Reflexive prompts and open-ended exercises supported this recursive process, encouraging the layering of insights and the surfacing of new perspectives throughout the workshops.OPEN IN VIEWER

As seen in Figure 3, a key discussion centered on shared frustration with the conflation of HIV and AIDS, documented by one participant who wrote, “Why do they think that HIV is AIDS?”. Another major discussion focused on the combined stigma faced by sex workers living with HIV. Participants rejected stereotypes linking sex work with HIV acquisition, particularly the assumption that sex workers contract HIV due to sexual compulsivity, reflected in the words “zorra” and “arrechera”, which in their cultural context connote hypersexuality. These pejorative terms reinforce sex work stigma. Additionally, bisexuality emerged as a theme, with participants discussing harmful portrayals of bisexual men as responsible for “introducing” HIV to women.

The group brainstorming activity functioned as a relational space where lived experiences were articulated, negotiated, and contested in real-time. Moreover, it highlights the importance of co-construction, ensuring that knowledge does not remain confined to pre-existing frameworks but is shaped by participants’ discursive strategies and affective responses. For instance, the critique of the HIV and AIDS conflation and the rejection of hypersexuality stereotypes were not predefined research themes by the research team but emerged organically through collective dialogue, demonstrating how participants actively reframed dominant narratives about their identities. The fluidity of the process – shaped by laughter, frustration, storytelling, agreements and disagreements – demonstrates that meaning is not simply extracted from participants but emerges dynamically through relational engagement between participants. For example, moments of collective laughter or silence were noted in field observations and later discussed with community collaborators as a possible signal of shared understanding or discomfort, helping to identify how topics (e.g., stigma, belonging) resonated emotionally within the group.

Leveraging Creativity to Foster Mutual Presence

The research team member took detailed notes on participant interactions and group dynamics during the workshops when appropriate, to avoid disrupting the flow of engagement. For example, note-taking would typically occur while participants were working individually on their artistic pieces and after the workshops. However, note-taking was not always possible because the research team member was actively engaged in conversations with participants to maintain relational presence and avoid disrupting natural interaction or causing discomfort. Participant observation combined with notetaking proved to be invaluable in capturing elements of interaction that were not reflected in the final artistic outputs – particularly the development of friendships between participants, shared humor, and the informal camaraderie that emerged throughout the workshops.

For example, workshop 3, which focused on sublimation printing, required participants to print a short, impactful sentence onto synthetic fabric and display it in a public space. Given that the workshop’s principal theme was sex work, participants were tasked with selecting a phrase or question to anonymously provoke thought and challenge dominant perceptions of sex work. While the final messages carried strong activist undertones, observation notes reveal a stark contrast between the weight of these statements and the workshop’s atmosphere of humor, playfulness, and collective storytelling amongst participants. One moment stood out: a participant brought back a handstitched painted bag from a previous workshop. Another participant humorously commented on the peach design, noting it looked like a posterior, prompting laughter when the first participant replied that he “found a lot of asses on his migration journey to Colombia.” This remark sent the group into collective laughter, setting the tone for the workshop. The playful tone continued into the brainstorming phase. As participants struggled to craft short, powerful messages, one participant jokingly suggested writing “solo en efectivo” (“cash only”), which once again sparked laughter across the room. This moment of levity then transitioned into a spontaneous, 45-min group discussion in which participants shared humorous anecdotes about diverse experiences with clients. Some recounted encounters with clients whose requests were unexpectedly simple, prompting jokes about how certain clients made their job “too easy.” Others playfully teased each other about strategies for maintaining erections with clients, sharing advice and experiences in lighthearted exchanges.

These conversations, while filled with humor, also served a deeper function within CRI. They allowed participants to collectively articulate their identities as sex workers outside of victimizing or pathologizing narratives. Humor became a strategy of resilience, a way to reclaim agency over their experiences, and a means of fostering solidarity within the group. These relational interactions were not just moments of amusement; they were critical sites of meaning-making, revealing how participants used humor to reframe stigma, challenge stereotypes, and cultivate a sense of belonging. From a CRI perspective, these spontaneous, unscripted exchanges enrich the research process. The documentation of humor, playfulness, and camaraderie adds layers of insight that would otherwise be absent from a strict analysis of the final art products. While the sublimation printing activity produced activist-oriented messages around sex work such as: “¿Qué pasó con la puta desaparecida?” (“What happened to the disappeared whore?”), “El puteo no es un fin, es un medio” (“Whoring is not an end, it is a means”), “¿Por qué no es normal ser puta?” (“Why is it not normal to be a whore?”) – these statements alone do not capture the full breadth of participants’ experiences. The juxtaposition between the serious and provocative messages and the workshop’s playful atmosphere underscores the complexity of identity negotiation among sex workers.

The workshops functioned not only as spaces for artistic expression but as environments for community formation, mutual care, and personal validation. Explicit acknowledgement of this methodological strategy is particularly significant given that migrant sex workers often experience social exclusion (Goldenberg et al., 2016). Conversations during the workshop around how participants wanted to be represented in public-facing artworks also created space to reflect on power within the research: who these messages were for, and how narratives about sex work, migration, and HIV might circulate. Through these reflective moments, power was made discussable – not abstractly, but in terms of lived experience and collective authorship.

The researcher’s presence in all workshops also functioned as a data-generating instrument, shaping knowledge through engagement (Finlay, 2002; Pezalla et al., 2012). During a workshop on migration, participants invited him to join the activity, arguing that he too was a migrant. This invitation initially served as an inclusive gesture, recognizing shared experiences of movement. However, as the dialogue unfolded, participants critically redefined this inclusion by contrasting his voluntary mobility as a Canadian with their own forced displacement. Unlike the participants – who migrated under precarious conditions – the researcher retained the privilege to return home. Through this exchange, participants invited a reflexive discussion on privilege and mobility, ultimately proposing that he instead identify as a nomad (i.e., someone whose mobility is enabled by privilege rather than forced by circumstance), a term he later integrated into his artwork (see Figure 4).OPEN IN VIEWER

This moment exemplifies how CRI foregrounds relational co-construction of meaning. Positionality is not static; it is relational, continuously renegotiated through the research process (Rose, 1997). The participants’ engagement in defining the researcher’s identity highlights their agency in shaping the encounters during the research project, demonstrating that participatory methodologies extend beyond data collection to actively co-construct meaning. This point aligns with broader discussions in qualitative research about the ethical and epistemological implications of researcher positionality and the need for reflexivity in participatory projects (Bourke, 2014; Pillow, 2003). In this study, the researcher’s social location directly shaped participant dynamics. Rather than accepting his identity at face value, participants challenged and redefined it, generating new meaning and insight in the process. This interaction illustrates how researcher positionality does not simply influence interpretation after the fact; it is a live, negotiated element of the participatory encounter itself, shaping the knowledge that emerges.

By foregrounding such exchanges, this project reinforces the value of embracing emergent and processual data in qualitative research, particularly within arts-based participatory frameworks. The dialogue around the label migrant versus nomad was a significant moment of meaning-making, revealing the socio-political dimensions of migration, privilege, and forced displacement. It shows how qualitative research benefits not only to planned data collection but also to spontaneous interactions in the creative-relational process that provide deeper, often unexpected, layers of analysis when doing arts-based research with communities in vulnerable contexts. Foregrounding these researcher–participant interactions reveals how creativity became a conduit for building trust, co-producing meaning, and sustaining presence across power differentials. In CRI, mutual presence is not a precondition but a dynamic outcome of relational engagement – one that unfolds through spontaneous, situated encounters like those described above.

Opportunities to Support Solidarity Within and Beyond the Research

As part of Phases 1 and 2 of the Estamos Aquí project – which is being implemented across two sites: Medellín, Colombia, and Lima, Peru – participants take part in arts-based workshops that not only generate visual counter-narratives but also foster transnational forms of connection. While the project is ongoing and has thus far only been implemented in Colombia, plans are underway to carry out the second component in Peru, engaging Venezuelan cisgender women sex workers, as the partner community organization in Peru works with women engaged in sex work. To foster transnational solidarity between participants in both countries, the artist facilitated an activity in which participants in Colombia wrote handwritten letters to the participants in Peru, with the hope that those in Peru would later write back. While some participants found this activity intuitive and engaged readily, others expressed difficulty finding the “right” words, reflecting on what felt meaningful, supportive, or appropriate to share. Ultimately, all participants completed their letters – some offering brief but heartfelt notes, while others composed longer, reflective messages. Although initially conceived as an informal engagement exercise rather than a core data collection component, it aligned with the project’s strength-based approach and was also shaped by our partner organizations in Colombia and Peru, which are the two largest receiving countries for Venezuelan migrants. Further, given the pervasive xenophobic discourses migrants face, the activity sought to leverage shared experiences as a foundation for regional solidarity and collective belonging.

This activity also exemplified anti-oppressive research methods by offering participants a creative and relational space to define their modes of expression. The handwritten letters surfaced critical insights into participants’ self-representation, affective solidarities, and how they imagined connection and kinship with unknown community members across borders. One notable moment emerged when a participant explicitly requested that their letter not be read by the research team. While traditional research projects often view missing data as a limitation, in this CRI project, the participant’s decision to withhold their letter was not considered a loss but a meaningful assertion of agency within a non-extractive, relational approach to knowledge production.

As part of the participatory, arts-based data collection process, the letter-writing activity offered a generative site for reflection, creativity, and shared meaning-making. The iterative nature of CRI, which is structured around a dialogic process, where insights and new meanings emerge through ongoing interaction, allowed this exercise to evolve into a rich source of insight. While participants initially wrote their letters individually, the artist organically invited them to read and discuss their messages as a group. This spontaneous shift was intended to support community-building and deepen relational engagement at the start of the workshop. Through these discussions, two key thematic patterns emerged. First, nearly all participants positioning their letters as messages of encouragement and solidarity, despite not knowing who the recipients in Peru would be. Many offered words of support and reassurance. As one participant wrote in the closing lines of his letter (see Figure 5), “I don’t know if someone already told you today, but you are the best person that exists – although I think you already knew that,” accompanied by a winking smile. These letters became more than symbolic gestures; they reflect a conscious effort to foster relational empowerment, affirm shared experiences, and build cross-border solidarity.OPEN IN VIEWER

Another key dimension of relationality was using Venezuelan identity as a shared foundation for connection and solidarity. Many participants incorporated elements of Venezuelan vernacular into their letters, such as addressing their peers as “chama,” a distinctly Venezuelan colloquialism for a woman friend. Others referenced their hometowns, establishing a point of relationality by emphasizing where they came from in Venezuela. In several cases, participants added their social media handles, inviting their peers in Peru to follow them – an act that transforms this research-based activity into a real-world relational network of mutual support beyond the confines of the workshops.

The letters offer a counterpoint to the dominant narratives of precarity and exclusion that often frame discussions of Venezuelan migration and sex work. While these themes are undoubtedly part of participants’ lived realities, the affective, relational content of the letters underscores an alternative discourse centred on care, mutual recognition, and resilience. Through this activity, participants positioned themselves as active relational agents of support, solidarity, and cultural continuity. Their decision to integrate Venezuelan expressions and references into the letters demonstrates the enduring significance of national identity, even in displacement, and suggests that these transnational exchanges serve as an affirmation of belonging.

The range of responses to the letter-writing activity – from hesitation to enthusiasm – revealed the varying degrees of emotional labor involved in storytelling and self-representation within participatory research. Some participants expressed difficulty in finding the “right” words, underscoring the weight of responsibility they felt in crafting a message that would resonate with someone in a similar situation. This deliberation reflects a critical awareness of the ethics of representation and the impact of language. Rather than simply generating data, the activity highlighted how power dynamics were reimagined by creating a space for aligned personal and collective purpose. Here, participants actively negotiated their engagement in decision-making– through selective disclosure, linguistic choices, or the inclusion of social media handles – to construct relationships, co-produce meaning, and navigate affective connections to help sustain impact across borders. As such, this solidarity-building exercise exemplifies how participatory arts-based research functions not only as a means of expression but also as a mechanism for cultivating social connection, mutual recognition, and transnational kinship among communities made vulnerable by displacement, stigma, and exclusion.