By Ryan Conrad
ast October GayZone, Ottawa’s weekly sexual health walk-in clinic and wellness centre that serves guys into guys, hosted its 10th anniversary celebration at City Hall. The mayor Jim Watson, Centretown city councilor Catherine McKenney, and representatives from the partner organization that make GayZone possible were all on hand to celebrate alongside the community.
It is imperative to celebrate our community’s successes, especially at a time of increasing fiscal austerity, health care privatization, and homophobic/transphobic retrenchment in Ontario. Yet this is no time to sit back and relax.
The pressing need for GayZone to expand and evolve in order to remain the point of pride that it has been in the queer community for over a decade now is painfully obvious. If queer and AIDS activist histories have taught us anything, it’s that we need to demand and agitate for this change.Nothing is won by simply asking for it nicely.
While some may argue that municipal tax dollars shouldn’t be stretched to test and treat those from ‘outside’ Ottawa, it makes poor public health sense — or cents. When was the last time anyone chose a sexual partner based on whether or not they had an OHIP card?
According to well-known gay Ottawa activist Barry Deeprose, GayZone’s origin stems from a dissatisfaction with the meager sexual health services that the city of Ottawa was providing in the early 2000s, when rates of HIV infection rose again after years of decline. Tension was also boiling over between gay health activists and the well-funded AIDS Committee of Ottawa, which was accused of not doing enough to serve gay and bisexual men, who continue to bear the brunt of the HIV epidemic in the region.
These frustrations were amplified by a serious syphilis outbreak among gay and bisexual guys in Ottawa at the time and Public Health’s ineptitude at delivering culturally competent sexual health services to stem the rate of infection. Cultural competence is defined as the ability of providers and organizations to effectively deliver health care services that meet the social, cultural, and linguistic needs of patients.
Through the organizing efforts of people like Deeprose, Orhan Hassan, and others, a vision for a satellite clinic dedicated specifically to the health and wellbeing of guys into guys was formulated. Funding for the effort was secured through conversations with the Medical Officer of Health for Ottawa and a reallocation of funds from Ottawa’s sexual health clinic at 179 Clarence Street.
No new public funding has ever been made available for GayZone, but the clinic launched in 2008 nonetheless and has been packed every Thursday night from 5-8pm since. So packed, in fact, that it’s been years since GayZone has even been advertised. After all, it continues to turn people away due to overcapacity on a weekly basis, despite the addition of a few staff last year.
Between Ottawa’s three types of sexual health clinics staffed by Ottawa Public Health (OPH), GayZone is allocated the least resources. This is despite OPH’s own reporting that gay and bisexual men are considered at higher or highest risk for nearly all reportable STIs.
The sexual health clinic at 179 Clarence Street is open nearly 30 hours a week for walk-ins and scheduled appointments. Three suburban youth-oriented clinics in Barrhaven, Kanata, and Orleans are open for a total of nine hours a week combined.
This means that between the 40+ hours that OPH-supported sexual health clinics operate, a mere three hours is dedicated to providing culturally appropriate, low-barrier services to a marginalized group of people — who, according to the recent Mobilise! study, most often cite stigma, shame, and discrimination as primary reasons for not getting tested. Furthermore, the national SexNow! survey of gay and bisexual men indicated that in 2015 less than half of the guys surveyed had been tested in the last year. These studies speak volumes to the need for the expansion of culturally competent sexual health services immediately.
GayZone used to test and treat anyone who came by the drop-in clinic, regardless of municipal residency or citizenship status. Unfortunately, OPH has made GayZone more and more restrictive. It has erected barriers through residency requirements that exclude anyone without an OHIP card from accessing services — gay and bisexual men from Gatineau, international and out-of-province students studying in Ottawa, immigrants who don’t qualify for OHIP, and migrant workers here without official status.
Adam Hodgins, a resident of Hull who works in Ottawa recalls, “I went to GayZone for years because it was hassle free and easy to access, until I showed up one Thursday and was told that they were no longer seeing Québec residents. Unfortunately there are no equivalent services in Gatineau. There is no queer-friendly option and drop-in hours at the CLSC [Centre local de services communautaires, the province-run clinics in all of quebec] are only for people that have symptoms, not for regular testing. Rapid HIV testing is also not available.”
While some may argue that municipal tax dollars shouldn’t be stretched to test and treat those from ‘outside’ Ottawa, it makes poor public health sense — or cents. Gay and bisexual men from all these constituencies are having sex with one another. Indeed, when was the last time anyone chose a sexual partner based on whether or not they had an OHIP card?
Not treating everyone puts all gay and bisexual men at greater risk and increases the cost by having to repeatedly test and treat those who can access services.
Furthermore, residents of Gatineau with a Québec health card, and many others living in Ottawa without OHIP, cannot access GayZone’s clinical services, while anyone with an OHIP card is accepted, whether they’re from Thunder Bay, Windsor, or Old Ottawa South..
If Appletree clinics and public hospitals like Élisabeth Bruyère can figure out how to accept Québec provincial health cards while operating on the Ontario side of the river, clearly the problem is a lack of political will to negotiate the funding of health services between the two municipalities/provinces. Gay, bisexual, Two-spirit, and queer guys, both cis and trans, do not have time for this bureaucratic idiocy when so many of us live, work, and play on both sides of the river.
Many of us who utilize GayZone’s services would like to see new funding made available to expand its services from a once-a-week to a twice-a-week drop-in clinic, with lower barriers to accessing the testing and treatment services it provides. We understand that finding new funding for this is a difficult task in a time of ongoing austerity. That is why short term solutions should be considered immediately, like reallocating resources that are used less efficiently at other OPH-funded sexual health clinics.
According to Matthew Harding, the Community Engagement Coordinator at the GayZone partner agency MAX, “The expansion of GayZone has been explored and proposed many times at the clinic’s steering committee meetings. We hear over and over again that there are no funds available to expand the clinic even though guys into guys are considered the highest risk demographic for most sexually transmissible or blood borne infections (STBBI).”
“The clinic turns guys away on a weekly basis,” Harding continued, “redirecting them to other OPH-operated clinics instead of serving them directly and efficiently in a culturally sensitive setting. All of this makes it clear that culturally competent service delivery and public health management of STBBIs within our community is not a priority.”
As under-resourced as it is, GayZone does a disproportionate amount of the sexual health work in Ottawa. The clinic is responsible for a disproportionate amount of STI positives not just because the higher risk levels within the community it services, but because folks don’t like going to clinics where they experience homophobia and hostility from staff. That should warrant a reallocation of resources from less efficient testing sites.
In the long term, OPH should be coordinating with partner organizations and provincial health authorities to adopt the proven model of fully-operational, standalone queer and trans sexual health clinic like l’Actuel in Montreal. Gay, bisexual, Two-spirit, queer, and other guys who are into guys, both cis and trans, in the capital region deserve better. As a user of GayZone’s services myself, I demand better of my municipal health authority. The time to act was yesterday, but better late than never!