01.07.2011 «Checkpoints» to become gay health centres
Queer health. Not only is HIV and other sexually transmitted infections (STIs) prevalence higher in average among gay men than in the general population, but their general health is much poorer too. To counterbalance this trend, five health centres designed to respond specifically to gay men’s needs are to be set up in Switzerland.
The «Santé Gaie» («Gay Health») study carried out by Dialogai Geneva and the University of Zurich, and the GAYSURVEY conducted by the University of Lausanne every four years, highlight the relatively poor health status of gay men. Signs of a negative trend have been observed in the last few years, particularly with regard to mental health. Suicides and attempted suicides are significantly more frequent among young homosexuals than among heterosexuals of the same age. This is due to coming-out problems and discrimination by other young people or other social groups.
More psychosocial support
The Federal Office of Public Health (FOPH) has been supporting «Checkpoints» in Zurich and Geneva for the last five years. These are facilities where gays can be counselled and tested for HIV and other STIs. Since the publication of the «Santé Gaie» study, the Checkpoints have extended their exclusively disease-related services to include health-promoting elements, such as psychosocial care.
This development is now to go even further, with a network of five gay health centres in Basel, Berne, Geneva, Vaud and Zurich being envisaged. They will offer comprehensive gay-friendly healthcare and health promotion services to the approximately 5% of the Swiss male population who are gay. Just as women prefer to go to female gynaecologists, gay men feel that that their problems are more specifically addressed and dealt with at gay-friendly facilities where they usually encounter greater knowledge and understanding of their situation.
Effective approaches at the Zurich Checkpoint
But what kind of services would such gay health centres provide? The Zurich Checkpoint has already made considerable progress towards becoming a gay health centre, developing many interesting services that could be a model for further centres.
– Voluntary counselling and testing (VCT): Zurich Checkpoint is one of twelve centres in Switzerland that offer voluntary rapid testing, and also risk assessments, counselling and support using a uniform, Internet-based tool.
– Queer+: This is a three-day course at which people recently diagnosed with HIV, along with their partners, receive support and information on the topics of medicine/treatment, legal issues, insurance aspects and psychosocial problems. The aim of the course is to enable people with HIV and their partners to cope more effectively with the infection and the new challenges facing them in everyday life. In addition, they will learn how to avoid infecting others with HIV and STIs and what they can do to keep themselves healthy. The evaluation of the first course (see article in spectra no. 77) has shown that it meets a great need. But, though the course was enthusiastically rated, it was found to have little lasting impact in everyday life.
The evaluation of «Queer+» has resulted in the creation of a series of open-door services for coping with the challenges of everyday life:
– «Queer Talk» is a service targeting mental health; it focuses on the investigation of mental problems and on possible referral for psychotherapy.
– «KISS» is a group-structured service aimed at controlling drug use. It is needed because HIV and other STIs are often transmitted when people are under the influence of drugs.
– «Queer Help» group: In this group, HIV-positive experts help people recently diagnosed with HIV to become experts themselves in dealing with their positive status. With other chronic diseases, treatment is easier to self-manage. Diabetics, for instance, immediately sense when something is not right with their treatment. They can perform a brief test and, if necessary, take an additional dose of their medicine. This is not possible with HIV. If people with HIV forget to take their medicines, they do not feel anything. They cannot perform a test on themselves, nor can they change the treatment on their own. But the treatment quickly loses its efficacy if not taken regularly. So in future, iPhone apps, for instance, will help people with HIV remember to take their medicines and go regularly for check-ups.
A number of the health-related services provided by the Zurich Checkpoint is aimed at HIV-negative gays, e.g.:
– «Du-bist-Du» (You are who you are): This project uses a peer-to-peer approach in which young gays help others to come out. This approach is one of the most important in preventing suicide among young people.
– «Queer Quit»: This stop-smoking project has already helped some 60 gay men give up smoking.
Most of these services have a distinctly emancipatory character, i.e. they help people living with HIV to become experts on their own situation and that of others. The idea is that members of the «Queer Help» group will eventually assume responsibility for conducting the entire «Queer+» course. Similarly, «Queer Quit» participants who have given up smoking as a result of the course will themselves become leaders of courses on quitting smoking. Experience shows that participants learn more effectively from people who have had the same problems because they regard them as possessing greater skills in dealing with difficult situations than professionals without such experience.
Martin Werner, Prevention and Promotion Section, firstname.lastname@example.org