Preliminary findings from ACT’s community consultation
By Mike Smith - Gay Men's Health Systems Navigator, ACT
ACT is honoured to participate in the Advance Pan-Canadian Community Alliance to help cis and trans GBQ men in Toronto and across Canada achieve their optimal health goals. ACT is currently investigating experiences in clinical settings to inform the design of new, low-barrier services geared to increase the uptake of STBBI prevention technologies and wellness strategies. Since June, 45 community members and service providers have participated in various consultation activities providing narratives and observations of primary care, sexual health care, and mental health care services in Toronto. Informed by research findings from CBRC’s 2015 Sex Now study, we investigated the sources of reported fear, shame, and anxiety when accessing health services. Some of the findings include:
Service users perceive a deficit in knowledge and skills among healthcare providers to provide care to GBQ men. This deficit would often result in experiences of homophobia and sex shaming. To avoid reliving these experiences, service users choose to access GBQ-focused sexual clinics instead of their family doctor to seek STBBI testing and treatment services. As well, many service users report their family doctor was unaware of PrEP or were referred to an HIV specialist to access PrEP.
Service users perceive a lack of control when accessing health services. Some informants report being denied services or feeling forced to take certain tests without understanding why. Many informants feel rushed at the doctor’s office, not being able to explain how they feel or ask the right questions. Informants feel frustrated that they can only present one issue to a doctor.
Service users experienced heightened anxiety as their privacy is often violated in medical clinics, especially in crowded sexual health clinics.
To reduce the rates of new STBBIs in Toronto, therefore, we believe we must focus on service user experience to motivate service users to access combination prevention services more frequently.
Focus on COMFORT– reduce the sources of anxiety, shame, and oppression when accessing services.
Focus on CONNECTION– link service users with GBQ-identified and GBQ-ally care providers; increase queer and trans representation in medical clinics with visuals and resources; link service users with ethno-specific support services when appropriate.
Focus on CONFIDENTIALITY– design services to uphold privacy expectations.
Focus on CONVENIENCE– increase the number of GBQ-specific services; provide more services outside of the downtown core.
Focus on CHOICE– support service users to navigate health systems in ways that help them accomplish their health goals.
These 5 C’s will help ACT design and implement pilot interventions aimed to increase uptake and access to combination prevention services. ACT will continue to invest in community consultation projects to better understand the needs of GBQ men in Toronto.