1. Renewing HIV
Prevention for
Gay Men in
British Columbia
Mark Gilbert, MD, FRCPC
Clinical Prevention Services
Presentation to BC Gay Men’s Health Summit
November 2013

2. Background
• Provincial Health Officer will be releasing a report in 2014 entitled
“The Current State of the HIV Epidemic among Gay and Bisexual
Men in BC: Renewing HIV Prevention”
• Includes and endorses recommendations from Community and
Public Health/Clinical Advisory Groups
Number of new HIV diagnoses by exposure
group, BC, 2003-2012

3. Conceptual approach

4. Key messages
• Is a complex epidemic, no simple solutions
• Fundamental differences to other populations, and specific focus on
gay/bi men warranted
• Not a uniform population but diverse social/sexual groups
• Traditional public health response no longer sufficient: remain
essential strategies, but need more comprehensive, multi-level
approaches
• Concerted, focused effort and partnership among government,
health agencies, community organizations, researchers
• Gay/bi men first population affected, first to mobilize, with
demonstrated resiliency in face of legacy of a devastating epidemic
and social marginalization that continues to this day
• Gay/bi men need to be empowered and meaningfully involved in the
continued response to the epidemic

5. Best practices for implementation
• Meaningful involvement & leadership by gay/bi men, which must
involve HIV positive men
• Use positive, assets- or strengths-based approaches
• Online program/outreach models which are linked to regional onthe-ground services
• Need for services specific to gay/bi men as well as working with
other sectors to improve reach and engagement of existing health
services
• Tailored to the epidemiology of the epidemic, reflect regional
differences, evolve over time in response

6. Sub-populations facing additional vulnerability
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HIV positive men
Aboriginal and Two-spirited men
Other ethnocultural minority men
Young gay and bisexual men
Men in suburban, rural and remote regions
Gay and bisexual men in active sexual networks

7. 1. Recommendations at a Policy Level
• Develop, implement and monitor a provincial HIV prevention workplan for gay and bisexual men in BC, integrated within the provincial
STOP HIV/AIDS program
• Develop a long-term provincial health strategy for gay and bisexual
men

8. 2. Addressing individual and network level drivers
• Expand HIV testing to increase uptake and frequency of testing
among gay and bisexual men, using targeted and routine
approaches in a variety of settings
• Continue to support biomedical approaches to HIV prevention
• Promote sexual health by using a sexual health framework that goes
beyond HIV, STIs and behaviour to incorporate physical, social and
mental aspects of sexual health (e.g., relationships, intimacy,
pleasure)

9. 3. Addressing Community & Relationship Drivers
• Support central role of HIV-positive men in HIV prevention
• Implement regular, periodic health promotion and education
campaigns for gay/bi men across BC
• Better meet the mental health and substance use needs of gay/bi
men in BC
• Engage and support communities of Aboriginal, Two-spirited, and
other ethnocultural minority gay and bisexual men to reduce
disparities in health and HIV prevention

10. 4. Addressing social and structural Drivers
• Improve the capacity of policies, programs and services within the
BC health system to reduce existing health inequities for gay/bi men,
in alignment with existing provincial policies for improving health
equity and quality
• Support initiatives that aim to reduce stigma and discrimination
associated with HIV at a societal level
• Promote positive mental health and wellbeing for gay and bisexual
men of all ages by fostering safe and supportive environments

11. 5. Monitoring, evaluation, and research
• Establish ongoing monitoring to identify changes in trends and
population dynamics
• Address key gaps in research, both in terms of specific knowledge
gaps as well as prioritization of research, related to HIV prevention
for gay/bi men in BC

12. Acknowledgements
• My profound thanks for the support and thoughtful
contributions of many people here today
• If you have any SFW images (photos, posters,
campaigns) for the report please send them my way
mark.gilbert@bccdc.ca
Tel: 604-707-5615