Staff at the Hassle Free Clinic are telling some sexually active gay men that they don’t need sexual health testing more than once a year.
Firsthand reports paint a picture of gay men being turned away because they had been tested less than a year previously and weren’t worried about a “specific incident.”
Sexually active gay men should get tested every three to six months, according to Toronto Public Health. Sexually transmitted infections (STIs), and especially HIV, are often transmitted by people who don’t know they are infected.
Jane Greer, a counsellor at the clinic, admits that it’s “not perfect,” but says the clinic is doing its best to put resources where they’re most needed.
“It’s no secret that we struggle with capacity. Something we talk endlessly about is how to maximize the number of people we see,” says Greer.
Demand at the clinic far outstrips the available hours, she says. The clinic runs six days and has 50 hours of clinical time a week.
“Especially for gay and MSM guys, we feel very proud of our record, but it’s not enough. We’re not enough. It’s clear we’re not enough. That’s why we get jammed up with all these things,” says Greer.
The clinic has developed other policies to help triage clients: they open one day of new HIV testing appointments each day, two weeks ahead. That list often fills up quickly.
On some days, the clinic restricts tests to those who are symptomatic.
That still leaves many people unable to easily access STI and HIV testing.
The top doctor in charge of STI work at Toronto Public Health, Dr Rita Shahin, says that the system across the city is “strained.”
“All the sexual health clinics in the city are struggling with capacity issues,” says Shahin.
Both Greer and Shahin recommend that people who are having trouble getting seen at the Hassle Free Clinic should call the AIDS and Sexual Health Info Line, a city-run project that connects people with clinics in their area. Sexual health testing can also be done by a family physician, if someone has access to one.
Toronto Public Health, the government agency responsible for sexual health testing, runs five clinics and funds three additional clinics, including the Hassle Free.
The Hassle Free Clinic sees more clients for STI testing than all the rest of the testing sites in the city combined.
John Maxwell, the communications and policy director for the AIDS Committee of Toronto, is agitating for more funding, especially since a syphilis outbreak in Toronto that has seen historic infection rates since 2002.
“It’s a Catch-22 situation, where Toronto Public Health is encouraging sexually active gay men to get tested, and then men are facing barriers when they try to get testing,” Maxwell says.
He says the Hassle Free Clinic is the default clinic for gay men who don’t do their STI testing at a family doctor’s office. Therefore, the crunch at the Hassle Free Clinic “speaks to the broader issue of where gay men fit into priorities.”
In 2007, Toronto Public Health asked the Board of Health — made up of six city councillors and six citizens — for more money for STI and HIV testing. That proposal was turned down. In the meantime, incidence of both HIV and syphilis are on the rise in Toronto.
The city councillors who sit on the Board of Health were not immediately available for comment.
Beaches councillor Janet Davis sent a brief, presumably misdirected email to Xtra — “I’m ignoring it. I passed it on to staff” — but declined our invitation to clarify.