Presentation to BC Gay Men’s Health Summit  Thursday November 25, 2010 Chris Boodram  Senior Policy Analyst, HIV/AIDS Poli...
Outline  <ul><li>Purpose </li></ul><ul><li>Overview of PHAC’s Population-Specific HIV/AIDS Status Reports  </li></ul><ul><...
Purpose  <ul><li>To describe PHAC’s work on a Population-Specific HIV/AIDS Status Report for Gay, Bisexual, Two-Spirit and...
PHAC’s Population-Specific HIV/AIDS Status Reports <ul><li>Federal Initiative to Address HIV/AIDS in Canada  identifies 8 ...
Scope and Methodology <ul><li>Defined methodology which includes:  </li></ul><ul><ul><li>Scoping review of grey and academ...
HIV/AIDS and GB2MSM  <ul><li>PHAC 2008 epidemiological estimates show:  </li></ul><ul><ul><li>Between 2300-4300 new HIV in...
Mental Wellness of Gay, Bisexual, Two-Spirit and other MSM (GB2MSM) as a Determinant of Vulnerability To/Resilience Agains...
Canadian Evidence on Mental Wellness and Gay/Bi/2-Spirit Men  <ul><li>Poorer self-reported and measured mental health, hig...
Why do GB2MSM Have Poorer Mental Health Outcomes as a Population?   <ul><li>Internalized and interpersonal homophobia and ...
How does GB2MSM Mental Wellness Affect  Vulnerability/Resilience to HIV?   <ul><li>Well-documented that individual stress,...
Summary of Recommendations in the Literature   <ul><li>More research on interpersonal and systemic heterosexism/homophobia...
Influence of Heterosexism/Homophobia on Key Health Determinants, Mental Wellness and HIV Vulnerability Homophobia exclusio...
Contact  <ul><li>Chris Boodram  </li></ul><ul><li>Senior Policy Analyst </li></ul><ul><li>HIV/AIDS Policy, Coordination an...
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Mental Wellness of Gay Men as a Determinant of Vulnerability to & Resilience Against HIV/AIDS: Review of Canadian Evidence

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Chris Boodram, Public Health Agency of Canada, presents at the 2010 Gay Men's Health Summit.

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Mental Wellness of Gay Men as a Determinant of Vulnerability to & Resilience Against HIV/AIDS: Review of Canadian Evidence

  1. 1. Presentation to BC Gay Men’s Health Summit Thursday November 25, 2010 Chris Boodram Senior Policy Analyst, HIV/AIDS Policy, Coordination and Programs Division Mental Wellness of Gay/Bi/2-Spirit and other MSM as a Determinant of Vulnerability to and Resilience Against HIV and AIDS – a Preliminary Review of Canadian Evidence
  2. 2. Outline <ul><li>Purpose </li></ul><ul><li>Overview of PHAC’s Population-Specific HIV/AIDS Status Reports </li></ul><ul><li>Scope and Methodology </li></ul><ul><li>Canadian Evidence on Mental Wellness </li></ul><ul><li>Impact on Vulnerability/Resilience to HIV/AIDS </li></ul><ul><li>Summary of Recommendations in the Literature </li></ul><ul><li>Conceptual Map </li></ul><ul><li>Contact Information </li></ul>
  3. 3. Purpose <ul><li>To describe PHAC’s work on a Population-Specific HIV/AIDS Status Report for Gay, Bisexual, Two-Spirit and other Men who have Sex with Men </li></ul><ul><li>To present preliminary report findings on the impact of mental wellness on vulnerability/resilience to HIV </li></ul><ul><li>To seek feedback and additional suggestions for resources </li></ul>
  4. 4. PHAC’s Population-Specific HIV/AIDS Status Reports <ul><li>Federal Initiative to Address HIV/AIDS in Canada identifies 8 key populations particularly affected by HIV/AIDS </li></ul><ul><ul><li>People living with HIV/AIDS </li></ul></ul><ul><ul><li>Aboriginal Peoples </li></ul></ul><ul><ul><li>Women </li></ul></ul><ul><ul><li>Youth </li></ul></ul><ul><ul><li>Gay, two-spirit, bisexual and other men who have sex with men </li></ul></ul><ul><ul><li>People who inject drugs </li></ul></ul><ul><ul><li>People in prison </li></ul></ul><ul><ul><li>People from countries where HIV is endemic </li></ul></ul><ul><li>Population-Specific HIV/AIDS Status Reports are part of federal efforts to develop discrete approaches to address HIV/AIDS for key populations: </li></ul><ul><ul><li>Establish a baseline of evidence related to HIV/AIDS among each population </li></ul></ul><ul><ul><li>Use this evidence to inform research, policy and program development </li></ul></ul>
  5. 5. Scope and Methodology <ul><li>Defined methodology which includes: </li></ul><ul><ul><li>Scoping review of grey and academic literature </li></ul></ul><ul><ul><li>Key word search </li></ul></ul><ul><ul><li>Standard inclusion/exclusion criteria </li></ul></ul><ul><ul><li>Collaboration with other departments and governments </li></ul></ul><ul><ul><li>Advice and guidance from a National Expert Working Group </li></ul></ul><ul><li>Final report will include: </li></ul><ul><ul><li>Chapter 1: Overview </li></ul></ul><ul><ul><li>Chapter 2: Demographics </li></ul></ul><ul><ul><li>Chapter 3: Epidemiological information </li></ul></ul><ul><ul><li>Chapter 4: Determinants of health as they impact HIV/AIDS among the population </li></ul></ul><ul><ul><li>Chapter 5: Currently funded research in Canada on HIV/AIDS among the population </li></ul></ul><ul><ul><li>Chapter 6: Program and policy responses to HIV/AIDS among the population </li></ul></ul><ul><ul><li>Chapter 7: Conclusions </li></ul></ul>
  6. 6. HIV/AIDS and GB2MSM <ul><li>PHAC 2008 epidemiological estimates show: </li></ul><ul><ul><li>Between 2300-4300 new HIV infections </li></ul></ul><ul><ul><ul><ul><li>44% attributed to MSM exposure category </li></ul></ul></ul></ul><ul><ul><li>65,000 persons living with HIV in Canada </li></ul></ul><ul><ul><ul><ul><li>48% (about 31,330) attributed to MSM exposure category </li></ul></ul></ul></ul><ul><ul><ul><ul><li>19% (about 6000) of MSM exposure category unaware of their infection </li></ul></ul></ul></ul>
  7. 7. Mental Wellness of Gay, Bisexual, Two-Spirit and other MSM (GB2MSM) as a Determinant of Vulnerability To/Resilience Against HIV and AIDS
  8. 8. Canadian Evidence on Mental Wellness and Gay/Bi/2-Spirit Men <ul><li>Poorer self-reported and measured mental health, higher incidence of depression, anxiety, bipolar disorder, other mental disorders </li></ul><ul><li>Some findings of higher rates of alcohol and drug use </li></ul><ul><li>Higher rates of suicidal ideation and suicide attempts </li></ul><ul><li>GB2 youth especially at risk of depression, anxiety, low self-esteem, isolation, suicidal ideation, suicide attempts </li></ul>
  9. 9. Why do GB2MSM Have Poorer Mental Health Outcomes as a Population? <ul><li>Internalized and interpersonal homophobia and structural heterosexism seen to have a broad impact on GB2MSM mental health </li></ul><ul><li>Personal experiences of homophobia, ability to come out, correlated with mental and overall wellness </li></ul><ul><li>Institutional and systemic heterosexism impacts, safety, support and access to care </li></ul><ul><li>2-Spirited/Aboriginal gay/bi men, racialized/ethnocultural minority gay/bi/MSM face multiple forms of marginalization (i.e. racism and heterosexism/homophobia), with a significant cumulative effect on mental health </li></ul>
  10. 10. How does GB2MSM Mental Wellness Affect Vulnerability/Resilience to HIV? <ul><li>Well-documented that individual stress, personal turmoil, depression, low-self-esteem, predict risk behaviours such as UAI </li></ul><ul><li>One study explicitly linked GB2MSM youth experiences of harassment, bullying, exclusion, discrimination and violence with higher rates of HIV risk behaviours (multiple partners, early sexual debut, UAI) </li></ul><ul><li>Individual-level analysis leads to individualized solutions that may not address population-level factors </li></ul>
  11. 11. Summary of Recommendations in the Literature <ul><li>More research on interpersonal and systemic heterosexism/homophobia and their effects on mental wellness and HIV vulnerability </li></ul><ul><li>Specifically, more focus on interpersonal/social challenges GB2MSM face in coming out, establishing social networks, dating, may shed light on social vulnerability factors </li></ul><ul><li>In terms of interventions, move from specific HIV focus to a broader focus on GB2MSM wellness </li></ul><ul><li>In terms of policy, consider sexual orientation's impact on determinants of health, and develop/implement policy with the unique health needs of GB2MSM in mind </li></ul>
  12. 12. Influence of Heterosexism/Homophobia on Key Health Determinants, Mental Wellness and HIV Vulnerability Homophobia exclusion, discrimination, harassment, bullying, violence Heterosexism Systemic Bias Invisibility of GB2MSM Key Determinants Social Support Networks, Social Environments, Culture,Healthy Child Development, Health Services, Personal Health Practices and Coping Skills Mental Wellness low self-esteem, anxiety, depression, bipolar disorder, suicidal ideation HIV Vulnerability increased risk factors increased likelihood of risk behaviours
  13. 13. Contact <ul><li>Chris Boodram </li></ul><ul><li>Senior Policy Analyst </li></ul><ul><li>HIV/AIDS Policy, Coordination and Programs Division </li></ul><ul><li>Centre for Communicable Disease and Infection Control </li></ul><ul><li>Public Health Agency of Canada </li></ul><ul><li>613-960-1578 </li></ul><ul><li>[email_address] </li></ul><ul><li>Jacqueline Arthur </li></ul><ul><li>A/Manager, Populations </li></ul><ul><li>HIV/AIDS Policy, Coordination and Programs Division </li></ul><ul><li>Centre for Communicable Disease and Infection Control </li></ul><ul><li>Public Health Agency of Canada </li></ul><ul><li>613-946-3565 </li></ul><ul><li>[email_address] </li></ul>

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