A clinic for gay men

Needed: A gay men’s clinic. At a location in the gaybourhood. Run by gay men for gay men with gay men in mind.

It’s still months away from fruition, but at a time when gay men clearly have unique health issues – increased HIV transmission rates, long-term disregard of HIV prevention messages and the emergence of crystal meth in the club scene – the argument for a clinic specifically for gay men seems compelling.

Barry Deeprose, co-chair of the Gay Men’s Wellness Initiative, raised the need for a clinic when the mayor met the queer community during this summer’s Pride.

“We’ve been talking about it for a couple of years – the subject keeps coming up,” says Deeprose in an interview with Capital Xtra. “When Gay Men’s Wellness had our retreat last year – about what our work plan was – it came up again, so we actually focussed on it, and brought together the people who are interested in it. We’re coming to a bit of a consensus on what our dream might look like. And it’s still a dream at this point.”

Two gay men every week in Ottawa become infected with HIV. When it was revealed in the 2001 GLBT Wellness Project study that only 44 percent of queers under age 25 were out to their family doctors, GMWI knew that action was needed. Such a clinic would go a long way to addressing these concerns.

“It would be a gay men’s wellness clinic to improve the accessibility for gay men to the health-care system, because it’s not really good right now,” Deeprose says. “A lot of young gay men don’t have family doctors, they’re not out to their family doctors and it’s hard to find a family doctor. Combined with this is the need for healthy sexuality for gay men. We felt that the current healthy sexuality clinic could still have barriers for gay men to go there, although they are very gay-positive, but you’ve got to get people in the door before they can experience that.”

To find out what gay men specifically need in a clinic, GMWI surveyed 200 people on Pride Day with a detailed informal needs assessment. The results are still being tabulated.

“We have a suspicion that there are a lot of gay men in this city who are sequestering their health care, dividing into different areas,” says Kevin Muise, Deeprose’s GMWI co-chair. “There are certain things that they will disclose to their family doctor, other things that may not be disclosed for whatever reason. We suspect that a lot of gay men may not be disclosing issues around sexuality to their family doctor, and would be more comfortable speaking to someone in a gay-positive clinic. There are some needs that aren’t being met. We have some evidence that there are a lot of people who are at high risk who aren’t getting tested for some STIs.”

Muise points out that the doctor shortage in Ottawa is a particular problem for gay men in the community. “If you’re moving to Ottawa and you’re without a family doctor, you may not be able to be that picky about whether the doctor you do select [is gay-positive] and if that’s all that you have available to you, you may not be very comfortable disclosing.”

Healthy sexuality is only a part of the equation, though. “Say, for example, you go and the doctor has examined you for syphilis,” Deeprose says. “That doesn’t tell you much much about the state of your health, so we’re trying to broaden the context.”

The informal plan for the clinic is to operate it like a family practice for gay men, hopefully starting one or two nights a week in an established medical clinic space in order to take full advantage of the existing infrastructure. This would help to reduce overhead, and to deal with the unseen aspects of running a clinic, like safekeeping a patient’s charts.

According to Muise, one of the biggest hurdles will be finding a family doctor for the clinic. “We’re making some informal requests, or checking out some doctors, and what their interest might be in working one or two evenings a week in a clinic and then having a space.”

Billing issues are another concern for prospective physicians. “They want to know a little bit about what the structure is going to be, whether it would be strictly fee-for-service, or whether we could be able to get some funding for a pilot of one or two years. Because a physician is used to billing for their time, and if the clinic is slow getting off the ground, if we had six months or a year’s salary to be able to pay or some kind of compensation to be able to offer a physician, then we would be more likely to get that kind of support.”

The hope is that such a clinic would also work with other existing agencies that operate within the gay community to pool their services under one roof for those same nights a week, as the more services that can be offered, the better.

Organizers are hoping this arrangement would allow clients to have access to testing, counselling and other “upstream” work to catch particular vulnerabilities before they turn into bigger problems.