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Why are HIV/AIDS programs for marginalized Torontonians facing the chopping block?

‘It feels like we’re under attack,’ says executive director of the Black Coalition for AIDS Prevention

Members from the Asian Community AIDS Services (ACAS) stand outside Toronto City Hall on May 23, 2017, after presenting an appeal to save their programs aimed at queer men and trans women. Credit: Courtesy ACAS Staff

A number of HIV/AIDS programs aimed at racialized and marginalized communities in Toronto are facing the chopping block after their grant applications were rejected.

Programs run by the Black Coalition for AIDS Prevention (Black CAP), Asian Community AIDS Services (ACAS), the Alliance for South Asian AIDS Prevention (ASAAP) and Prisoners with HIV/AIDS Support Action Network (PASAN) are all under threat.

Shannon Ryan, the executive director of Black CAP, says it’s no coincidence that the organizations facing cuts represent marginalized communities. 

“The larger organizations are in an absolute position of privilege within these programs that we are not,” he says. “We’re fighting to hold onto what we got.”

On May 23, 2017, the four organizations separately presented appeals to the Toronto Urban Health Fund Review Panel, arguing that they are able to effectively work with communities that aren’t well served by larger organizations.

“They’re not going to be able to accommodate the marginalized group, the people that we work with, because we are close to the community,” says Noulmook Sutdhibhasilp, the executive director of ACAS, which is trying to save programs aimed at queer men and trans women.

Haran Vijayanathan, the executive director of ASAAP, says its South Asian women’s sexual health program, which did not receive funding, is the only one of its kind in Toronto.

“That actually takes sexual health education for South Asian women out of the system completely,” he says. 

Many AIDS service organizations point to the creation of the Toronto Urban Health Fund as one of the root causes of the decline in programming.

The fund (which replaced the AIDS Prevention Community Investment Program and Drug Prevention Community Investment Program) was created in 2013 by bringing together separate funding streams for HIV prevention, harm reduction and youth initiatives. Since then, the number of HIV programs that are funded, as well as the total amount of money, has steadily declined.

Ryan and Sutdhibhasilp both say that when the fund was created, around 40 HIV prevention projects were given money. Today, less than a dozen are funded. For AIDS service organizations, the instability has been compounded by major changes to how HIV/AIDS prevention and treatment is funded at the federal level.

“This past year, we’ve seen many programs defunded,” Ryan says. “It feels like we’re under attack.”

In addition to seeking more funding, Ryan would like the City of Toronto to segment off funding streams for HIV prevention in order to provide stable funding for essential programs.

“We need that stability in addition to additional resources,” he says. “We don’t know where we stand when it comes to the city and HIV funding.”

Sutdhibhasilp says that when the pot of money shrinks, a different approach is needed to funding HIV/AIDS organizations.

“When we talk about funding programs, we should also talk about equity issues,” she says. “Because we are aware that the grassroots community organizations are going to go first if there is a funding cut.”

Black CAP’s community outreach program is one of the programs now in jeopardy of shutting down. Ryan says that cancelling the program risks harming public health.

“Black people are the second-most at-risk population after gay men,” he says. “And to lose the visibility in these spaces I think really creates new infections, it creates additional costs for the health care system, it adds to the stigma that exists for black people living with HIV and AIDS.”

A petition demanding that funding for the program be restored has received more than 200 signatures. 

“This tells a story of marginalized populations in general in terms of access to resources,” Ryan says. “This is not a new story.”