Subscribe to our RSS feed

Popular News Stories

  • Fuck poz guys!
  • Tom Hanks in Philadelphia Changed my Life
  • Canadian AIDS Society’s AGM and PHA Forum in Ottawa: some scholarships for HIVers available
  • Semen goes viral – or does it?
  • BareBackRT.com  - the interview

General Health

Nov17

Thinking in silos

Monday, 17 November 2014 Written by // Ken Monteith - Montreal Correspondent Categories // General Health, Health, Opinion Pieces, Ken Monteith

Ken Monteith says "If we are going to take a holistic approach to health and address the people turning to us for help as whole people, when can we start expecting coherence from the government and from our corporate citizens?"

Thinking in silos

For a number of years now, our public health authorities have been pushing the idea that we need to respond more holistically to health promotion and disease prevention. To them, this means pushing organizations working in HIV/AIDS to broaden their reach, to address not only the whole spectrum of sexually transmitted and blood-borne infections (STBBIs), but also complicating factors like mental health, addictions and aging. 

These things are not news to the community response to HIV/AIDS: we have been doing them for years. Prevention activities have long included information on how to avoid, detect and treat other STBBIs, and many of us remember the bad old days when no one would help the people living with HIV with their other problems, so those fell to us, too. Problems with the landlord, fired from a job, refused dental treatment, getting older faster than one’s peers…all of these came back to the HIV/AIDS organization to deal with.

Somehow, the challenge of learning how to integrate knowledge about HIV into their own work was never the responsibility of those other services, so we took that on to make them do their own jobs for our people. 

What is particularly distressing about the current push from government health funders for this massive “integration” is their blindness to their own practices of thinking and acting in silos without regard to impacts in someone else’s field. 

Let’s look at a couple of decision put into place by the Minister of Citizenship and Immigration at the federal level in Canada and the reactions of his peers in cabinet.

First, cutting the interim federal health benefits for refugee claimants (since declared unconstitutional, so the coverage is back, probably temporarily, in a reduced form). No analysis on the health impacts of such a move. Response of the then Minister of Health? “Not my file. See the Minister of Citizenship and Immigration.” That’s the person you want in charge of the health of Canadians, right? 

Second action, much more recent: travel ban for people coming from countries in West Africa affected by Ebola. The World Health Organization has criticized the move, rightly pointing out that this is an action that will not prevent a single person from contracting Ebola and will instead worsen the crisis by heaping stigma atop misfortune (my words, not theirs). I have even heard people in the HIV movement, or at least its peripheries, express their support for this idea, having forgotten what travel bans and a misunderstanding of the transmission of HIV have done for us. The current federal Minister of Health? “Not my file. See the Minister of Citizenship and Immigration.” 

Then there’s that other problem we face with alarming regularity: the criminalization of the exposition to a risk of transmission of HIV (we say HIV criminalization to be brief, but you really have to be precise to grasp the breadth of what is being criminalized in these cases). Public health authorities have pronounced themselves against criminalization and for a more health-based approach to the issue of risk and non-disclosure. [In]Justice marches on, doing what it wants to do without regard to the possible effects on testing, prevention, treatment and the quality of life of people living with HIV. 

There’s a duality in how our corporate citizens act, too. I was quite impressed to hear tell of a Canadian mining company doing business in South Africa that had adopted a policy of providing medical care and support to its employees living with HIV and their families. Want to bet that the same corporation here would quietly not hire or let go the person who disclosed his or her status in Canada? I guess the limits of tolerance are inversely related to the alternatives one might have in the situation (greater selection of non HIV-infected candidates, less tolerance and support). One rule for there, a different rule for here.  

If we are going to take a holistic approach to health and address the people turning to us for help as whole people (like we have been doing since we were created by the affected communities), when can we start expecting coherence from the government and from our corporate citizens?

Arts and Entertainment Section

Activism Section

  • HIV after Armageddon; a Jeremiad

    HIV after Armageddon; a Jeremiad

    Michael Bouldin frowns on invoking our history "Concerned but misguided gay men of a certain age hear whatever the latest HIV infection rates are, and they pull the AIDS Crisis Card."
  • We are not Charlie

    We are not Charlie

    The dangers of speaking out. Michael Yoder on how free speech is curtailed in the AIDS movement by rules which ban advocacy work for those receiving government funding
  • Success in 2014

    Success in 2014

    Our LA guy Kengi was diagnosed with HIV while homeless. From Skid Row to successful activism projects, Kengi takes a look back at the path he has travelled

Current Affairs Section

Events Section

Features and Interviews Section

  • Military justice?

    Military justice?

    An extraordinary example of HIV criminalization gone awry in the States. Bob Leahy talks to Lt. Colonel Ken Pinkela, court martialed and sentenced to a jail term for allegedly exposing another officer to HIV, when no sexual contact occurred, says Pinkela.
  • What was the top HIV or Hep C research news story of 2014?

    What was the top HIV or Hep C research news story of 2014?

    From CATIE: “From prevention methods to treatment options, new HIV and hepatitis C research made headlines in 2014. We’ve selected some highlights from the past year below, in no particular order.”
  • These are not your grandmother’s female condoms!

    These are not your grandmother’s female condoms!

    Marc-André LeBlanc recently sat down with advocate extraordinaire Jessica Terlikowski to talk about female condoms. Despite being around for 20 years, they are not well known, understood or used. But that is quickly changing,

Health Section

International Section

Legal Section

Lifestyle Section

  • What’s resonating in the community?

    What’s resonating in the community?

    Marc-André LeBlanc on the Resonance Project, undetectable viral load and PrEP: how Canadian gay men view and incorporate new and emerging HIV information into their sexual practices
  • Nobody likes a showoff!

    Nobody likes a showoff!

    Positively Dating says “I know I blame my HIV status on my subpar dating life. But in reality there are much bigger factors at play that have nothing to do with being positive and everything to do with me being socially awkward”
  •  My gonorrhea nostalgia

    My gonorrhea nostalgia

    Condom use is still being urged for people with undectectable viral loads or on PrEP because of the danger of contracting STIs. But, asks, Mark S King “When did avoiding every possible STI become the new goal for gay sexual behavior?”

Living with HIV Section

Media Section

Opinion Pieces Section

Population Specific Section

Sex and Sexuality Section

MarketPlace