Abstract
OBJECTIVES: To 1) create a space where men who have sex with men (MSM) feel comfortable accessing sexually transmitted infection/human immunodeficiency virus (STI/HIV) testing, and 2) reduce STI/HIV incidence.
PARTICIPANTS: Gay men in Ottawa and its surrounding regions.
SETTING: A preponderance of diagnoses of sexually transmitted infections and HIV continue to occur among MSM. Meanwhile, other literature identifies that many MSM are reluctant to access STI/HIV testing services or to disclose their sexual practices to primary care practitioners.
INTERVENTION: In Ottawa, in an effort to surmount these issues and decrease STI/HIV incidence among MSM, the local public health unit in collaboration with community partners created “GayZone”, a three-hour-per-week STI/HIV testing and STI treatment clinic for gay men. In this paper, we report on the uptake and STI/HIV diagnosis outcomes for this clinic from January 2010 through December 2013.
OUTCOMES: GayZone is a well-utilized clinic that yields a number of STI/HIV diagnoses per year. Overall, the positivity rates of the STI/HIV tests at this clinic are above-average, although lower than what might be expected by local epidemiological data. While the results of this clinic validate anonymous HIV testing, they bring into question the utility of pharyngeal swabs to test for gonorrhea and chlamydia.
CONCLUSION: The results of our study demonstrate the utility of a gay men’s STI/HIV testing clinic and highlight some areas for improvement. Public health practitioners, frontline clinicians, and community workers in other regions who wish to implement such an STI/HIV clinic would do well to consider our results beforehand.
Keywords: Clinical services, gay men, HIV, MSM, public health, sexually transmitted infections
Résumé
OBJECTIFS : 1) Offrir un endroit où les hommes ayant des relations sexuelles avec d’autres hommes (HARSAH) n’hésitent pas à se rendre pour obtenir des services de dépistage des infections transmises sexuellement (ITS) et du virus d’immunodéficience humaine (VIH); et 2) réduire l’incidence des ITS et du VIH.
PARTICIPANTS : Hommes gais d’Ottawa et des environs.
CONTEXTE : Alors même que les diagnostics d’ITS et de VIH demeurent nombreux pour les HARSAH, il y a différentes indications à l’effet que ces hommes sont réticents à recourir aux services de dépistage ou à divulguer leurs pratiques sexuelles aux pourvoyeurs de soins primaires.
INTERVENTION : Dans le but de surmonter ces difficultés pour parvenir à diminuer la prévalence des ITS et du VIH chez les HARSAH, les services de santé publique de la ville d’Ottawa ont mis sur pied, en collaboration avec des partenaires communautaires, la Zone gaie, une clinique spécialisée où les hommes gais ont accès trois heures par semaine à des services de dépistage des ITS et du VIH et de traitement des ITS. Le présent rapport traite du taux de fréquentation de cette clinique et des diagnostics d’ITS et de VIH qui ont pu y être établis entre janvier 2010 et décembre 2013.
RÉSULTATS : La Zone gaie est une clinique abondamment utilisée qui établit chaque année un bon nombre de diagnostics d’ITS et de VIH. La proportion de tests de dépistage positifs y est au-dessus de la moyenne, bien qu'inférieure à ce que l'on pourrait attendre selon les données épidémiologiques locales. Le travail de la clinique a mis en lumière l’importance du dépistage anonyme du VIH, mais nous amène par ailleurs à nous interroger sur la pertinence des prélèvements pharyngés pour dépister la gonorrhée et la chlamydia.
CONCLUSION : Non seulement les résultats obtenus témoignent-ils de l’utilité d’une clinique semblable, mais ils font également ressortir quelques points à améliorer. Les praticiens en santé publique, les cliniciens de première ligne et les travailleurs communautaires qui envisagent l’établissement d’une telle clinique spécialisée dans leur région seraient bien avisés de prendre d’abord connaissance des résultats de notre travail.
Motsclés: services cliniques, homes gais, VIH, HARSAH, santé publique, infections transmissibles sexuellement
Footnotes
Acknowledgements: The authors thank the Ontario Government Ministry of Research and Innovation for funding received in the form of an Early Researcher Award.
Conflict of Interest: None to declare.
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