Exposing the Determinants: Keynote to 5th Annual Gay Men's Health Summit held in Vancouver, BC on November 9th and 10th 2009.

1. 5 th Exposing the Determinants 10 th

3. A decade of surveys… 2000 Gay Health Vancouver, n=550 2001 Rapid Assessment 2002 Pride, n=1,900 2003 Pilot, n=250 2004 Pride, n=2,800, 2005 Pilot, n=440 2006 Online, n=1,300 2007 Online, n=1,500 2008 Online, n=1,450

5. Income & Social Status No observed risk gradient Exposing the Determinants

6. Social Support Networks 62% “starved for company” at times 28% often Exposing the Determinants

7. Education & Literacy 72% tertiary education 75% < $70K Exposing the Determinants

8. Employment & Working Conditions 24% career affected 55% < $50K Exposing the Determinants

9. Physical Environments 71% dissatisfied with gay spaces Exposing the Determinants

10. Social Environments Exposing the Determinants internet community

11. Personal Health Practices Exposing the Determinants HIV risk untested

12. Exposing the Determinants Child Development 30% unwanted sex prior to 18

13. Exposing the Determinants Biological Endowment 71% feel oppressed at times 30% often

14. Exposing the Determinants Health Services 50% satisfaction with gay prevention

15. Exposing the Determinants Gender 50% single 26% man-partnered 6% man-married 16% woman-married/partnered

16. Exposing the Determinants Culture 51% exposed to anti-gay opression

19. Jonathan Mann Proximate cause ≠ Root cause

20. Jonathan Mann “ HIV follows a path of least resistance through society’s most marginalized.” * International Conference on Health & Human Rights, Harvard 1994

23. Elizabeth Pisani

26. Gary Dowsett “ Homosexuality is the fundament of all suspicion about sex beyond the normative, and even casts doubt on the normative itself.” * The gay plague revisited: AIDS and its enduring moral panic, 2009

29. Michel Foucault “ One day we will look back on sexuality and wonder why we gave it so much importance.” * The History of Sexuality, 1980

30. Exposing the Determinants… Are we asking the right questions? 10 th