Gay, Two Spirit, Bisexual and Other Men who have Sex with Men

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1
Gay, Two Spirit, Bisexual and Other Men who have
Sex with Men And HIV/AIDS Jacqueline
Arthur HIV/AIDS Policy, Coordination and Programs
Division CATIE Pacific Educational
Conference Richmond, BC - October 29, 2009
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Expert Working Group

• Bill Ryan, Action Sero-Zéro, (McGill University)
• Gens Hellquist, Canadian Rainbow Health Coalition
• Phillip Banks, Health Initiative for Men Society
• Stephen Alexander, Canadian AIDS SocietyJay
  Koornstra, Bruce House
• Carlos Rivas, AIDS Committee of Toronto
• Art Zoccole Two-Spirit People of the First
  Nations
• Maria MacIntosh, AIDS Coalition of Nova Scotia
• Suhail AbualSameed, Sherbourne Health Centre
• Russell Westhaver, St. Marys University
• Ed Jackson, CATIE
• Stephen Smith, FPT Advisory Committee on HIV/AIDS
• Rhonda Kropp / Robert Lerch, Public Health Agency
  of Canada
• Moffatt Clarke, Public Health Agency of Canada
• Susannah Ogunnaike-Cooke, Public Health Agency of
  Canada
• Michael R Smith, Public Health Agency of Canada
• Geneviève Tremblay / Jacqueline Arthur, Public
  Health Agency of Canada

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Gay, Two Spirit, Bisexual, and Other Men who have
Sex with Men

• What is the status of HIV/AIDS in this
  population?
• 1985 2007
• 56.6 of positive HIV test reports among all
  adults with reported exposure category
• 67.0 of all positive HIV test reports among men
• Up to 2006
• ON (40.8), QC (28.6) and BC (19.4) represent
  the highest distribution of total AIDS cases
  attributed to MSM

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Gay, Two Spirit, Bisexual and other Men who have
Sex with Men as a "Population"

• Demographic picture difficult to construct
• traditional data sources tend not to gather data
  on sexual orientation
• more recently, data on marital status is
  emerging, but this pertains to segments of this
  group
• much of the "population description" comes from
  extrapolations on smaller studies within the gay
  population in specific sites
• we cannot generalize this to the larger
  "community"

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This is the best picture we could get
Collection and presentation of data
Methodology and scope
Lack of data
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Factors Affecting Vulnerability to HIV

• Homophobia
• Determinants of health
• Social Support Networks
• Culture
• Social Physical Environments
• Personal Health Practices and Coping Skills
• Healthy Child Development and,
• Access to Appropriate Health Services.

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Issues Affecting Vulnerability for Racial
Ethno-cultural Groups

• Minority stress - a term coined by the US
  researcher Raphael Díaz to describe the increased
  vulnerability to HIV facing minority gay men that
  may point to
• broad social homophobia or discrimination against
  their group
• homophobia or anti-HIV sentiments within their
  group
• discrimination within the gay male community as
  well.
• "When you're on a reserve, you're native, but
  when you're off the reserve you're just like
  everybody else, and ...after a while that kind of
  wears on you. It's just like you lose that
  specialness of being in your community. And
  that's very strong"

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Populations within Populations

• Several studies support the conclusion that the
  best results are to be gained by interventions
  that focus on sub-populations
• Clemon George On the importance of community in
  HIV risk-taking behaviour
• Lee, Nambiar, Poon, Bereket, Hart Murray
  Social Vulnerabilities Contributing to Sexual
  Risk Behaviors amongst Ethno-racial MSM -
  preliminary findings from a community-based
  research study
• George, Husbands, Makoroka, Adam, Remis, Rourke,
  Beyene MaBwana, Reaching Black Men who have Sex
  with Men in Toronto - the importance of community
• Mark Gilbert The Health of Lesbian, Gay,
  Bisexual, Transgendered, Two-spirited and
  Questioning Youth in British Columbia and the
  Influence of the School Environment

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HIV Vulnerability and Resilience

• Tracing the move toward gay men's health A
  paradigm shift
• From HIV prevention organizations that use gay
  men's health as a means of prevention - to gay
  men's health organizations that deal with the
  health issues gay men face, and integrate HIV
  prevention as a central priority.
• 1980's - 1995 HIV as an overwhelming crisis in
  the gay men's community
• 2000 - Health Canada sponsors the National
  Reference Group for Gay Men
• Early 2000s - USA gay men's wellness movement
  gains momentum
• 2004 - Leading Together centralized focus on gay
  community (and others)
• 2005 Gay Net/Réseau Gai emerges from CAS Skills
  Building Symposium in Montréal
• 2005/06 Gay Zone, a program area of AIDS
  Vancouver, shifts to a private group called HIM -
  Health Initiative for Men
• 2008 Montréal's Séro Zéro rebrands from a focus
  on HIV prevention to Rézo, with a broad focus on
  gay men's health

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For Information

• HIV/AIDS Policy, Coordination and Programs
  Division, Populations Section
• Jacqueline Arthur, A/Manager
• jacqueline_arthur_at_phac-aspc.gc.ca
• [phone]
• Thank You