The AIDS Committee of Toronto is pledging to place greater emphasis on gay men’s health issues in the next five years.
ACT, which released its new strategic plan last week, is hoping to position itself as a hub for gay men’s health in a city that currently currently lacks one.
“Part of our [rationale] for looking at gay men’s health more broadly is that’s a gap in our city,” says John Maxwell, executive director for ACT. “We have services, but they’re not coordinated.”
He points to the Health Initiative for Men in Vancouver and RÉZO in Montreal as organizations which ACT is looking to emulate in some respects.
“Given our history of working within the gay community, given HIV prevalence within the gay community, ACT really should take a lead role in helping pull together more comprehensive supports for gay men,” he says.
This would mean a greater emphasis on mental health supports, harm reduction for drug users and new forms of preventative treatment for HIV, like PrEP.
For Maxwell, a greater emphasis on gay men’s health is both a way to support HIV-positive and at-risk men while also planning for a future where HIV infections may be drastically reduced.
“What we’re trying to do as an organization is set the stage for what happens if in five years we actually see a [marked] decline in HIV infections,” he says.
However, that doesn’t mean that ACT is moving away from its HIV focus.
“The research has shown that while we’ve made great strides and we’ve seen declining HIV transmissions across many communities, the decline hasn’t been as great amongst gay men,” Maxwell says “But also we’re not ever going to address HIV unless we look at the broader health and systems that make gay men more vulnerable to HIV.”
He says that a lack of culturally competent physicians often leads to poor treatment for gay, HIV-positive men.
“If you’re a gay guy and you don’t have a doctor that you can talk to and say, look, I’m having sex with other men, they’re likely not going to be checking you for things like HPV,” he says. “They’re not going to be asking you questions about your sexual history.”
While much of the emphasis is on gay men, ACT is also looking to serve different communities: women and young people at high risk for HIV, and all people living with HIV.
Like many other AIDS service organizations, ACT has experienced some financial difficulty in recent years, partially caused by flatlined funding from the federal government.
“The federal government is our smallest funder,” Maxwell says. “They give us even less money than the City of Toronto.”
In 2014, ACT cut a number of staff positions after running structural deficits for four years. According to information from the Canada Revenue Agency, ACT has run a small surplus for the last two years.
In late 2015, ACT left the Canadian AIDS Society, which it helped found.
“What’s going on at the Canadian AIDS Society is unfortunate,” Maxwell says. “We really felt that we weren’t getting value for our membership dollars that we were paying.”
With new medical approaches to treating and preventing HIV and a new federal government that appears to be more responsive to the issue, Maxwell is optimistic.
“We actually have the possibility to end certainly HIV within our lifetime,” he says. “It’s an ambitious goal and we’re not necessarily saying by 2020 we will do this, but that’s what we’re aiming towards.”