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Day 2 1530 - mark gilbert


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Day 2 1530 - mark gilbert

  1. 1. Renewing HIV Prevention for Gay Men in British Columbia Mark Gilbert, MD, FRCPC Clinical Prevention Services Presentation to BC Gay Men’s Health Summit November 2013
  2. 2. Background • Provincial Health Officer will be releasing a report in 2014 entitled “The Current State of the HIV Epidemic among Gay and Bisexual Men in BC: Renewing HIV Prevention” • Includes and endorses recommendations from Community and Public Health/Clinical Advisory Groups Number of new HIV diagnoses by exposure group, BC, 2003-2012
  3. 3. Conceptual approach
  4. 4. Key messages • Is a complex epidemic, no simple solutions • Fundamental differences to other populations, and specific focus on gay/bi men warranted • Not a uniform population but diverse social/sexual groups • Traditional public health response no longer sufficient: remain essential strategies, but need more comprehensive, multi-level approaches • Concerted, focused effort and partnership among government, health agencies, community organizations, researchers • Gay/bi men first population affected, first to mobilize, with demonstrated resiliency in face of legacy of a devastating epidemic and social marginalization that continues to this day • Gay/bi men need to be empowered and meaningfully involved in the continued response to the epidemic
  5. 5. Best practices for implementation • Meaningful involvement & leadership by gay/bi men, which must involve HIV positive men • Use positive, assets- or strengths-based approaches • Online program/outreach models which are linked to regional onthe-ground services • Need for services specific to gay/bi men as well as working with other sectors to improve reach and engagement of existing health services • Tailored to the epidemiology of the epidemic, reflect regional differences, evolve over time in response
  6. 6. Sub-populations facing additional vulnerability • • • • • • HIV positive men Aboriginal and Two-spirited men Other ethnocultural minority men Young gay and bisexual men Men in suburban, rural and remote regions Gay and bisexual men in active sexual networks
  7. 7. 1. Recommendations at a Policy Level • Develop, implement and monitor a provincial HIV prevention workplan for gay and bisexual men in BC, integrated within the provincial STOP HIV/AIDS program • Develop a long-term provincial health strategy for gay and bisexual men
  8. 8. 2. Addressing individual and network level drivers • Expand HIV testing to increase uptake and frequency of testing among gay and bisexual men, using targeted and routine approaches in a variety of settings • Continue to support biomedical approaches to HIV prevention • Promote sexual health by using a sexual health framework that goes beyond HIV, STIs and behaviour to incorporate physical, social and mental aspects of sexual health (e.g., relationships, intimacy, pleasure)
  9. 9. 3. Addressing Community & Relationship Drivers • Support central role of HIV-positive men in HIV prevention • Implement regular, periodic health promotion and education campaigns for gay/bi men across BC • Better meet the mental health and substance use needs of gay/bi men in BC • Engage and support communities of Aboriginal, Two-spirited, and other ethnocultural minority gay and bisexual men to reduce disparities in health and HIV prevention
  10. 10. 4. Addressing social and structural Drivers • Improve the capacity of policies, programs and services within the BC health system to reduce existing health inequities for gay/bi men, in alignment with existing provincial policies for improving health equity and quality • Support initiatives that aim to reduce stigma and discrimination associated with HIV at a societal level • Promote positive mental health and wellbeing for gay and bisexual men of all ages by fostering safe and supportive environments
  11. 11. 5. Monitoring, evaluation, and research • Establish ongoing monitoring to identify changes in trends and population dynamics • Address key gaps in research, both in terms of specific knowledge gaps as well as prioritization of research, related to HIV prevention for gay/bi men in BC
  12. 12. Acknowledgements • My profound thanks for the support and thoughtful contributions of many people here today • If you have any SFW images (photos, posters, campaigns) for the report please send them my way Tel: 604-707-5615