The LNP decision to de-fund the Queensland Association for Healthy Communities (QAHC) is deeply short-sighted.
Health Minister Lawrence Springborg says the QAHC shift to advocacy around health for LGBT communities shows the agency has “lost its way”, and he wants to fund a single-issue AIDS council doing HIV prevention alone. His statement also says that infection rates show the agency failing in its mission. Both claims betray an embarrassing ignorance about HIV prevention.
Three decades ago Australia and America made different choices on how to configure their HIV epidemic responses. America made it a public health issue; Australia made it a community health issue. Now, cities such as San Francisco are reporting 25% HIV prevalence among gay men. In Queensland, prevalence is about 8.8%. Tell us again, Springborg, how that constitutes failure?
The other claim deserves closer interrogation. It seems reasonable enough, if you’re funding someone to do HIV prevention, to want them to focus on that. How does advocacy around LGBT health issues, like preventing of bullying in schools, youth suicide, domestic violence, help in preventing HIV infections? It comes down to two things: the role of belonging to a community in health, and safe-s-x culture in sustaining prevention behaviours.
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Since the advent of effective treatments over 17 years ago, we are no longer living in an AIDS crisis, in the developed world at least. Prevention approaches predicated on fear/crisis just aren’t credible any more. Some people will predictably feel outraged by that statement, but I’d urge them to can it. It doesn’t signal any lack of commitment to prevention: it just means finding new themes to make our work relevant and effective.
Those themes are social justice, including marriage equality; a much broader focus on health, including drugs and alcohol, domestic violence, and mental health; and a more inclusive sense of community with lesbians, bis-xuals, trans- and inters-x folk.
With the full support of Queensland Health, QAHC took these themes and issues on, creating many more reasons for people to get involved with their organisation and activities.
It’s a classic multi-issue coalition approach, and it’s highly effective, as AdShel found out when it removed posters from the QAHC Rip ‘n’ Roll campaign. (Little wonder they made the LNP government nervous — as it plans to wind back Anna Bligh’s civil union laws.) It is also textbook health promotion.
A volunteer who gets involved because of their concern about youth suicide still benefits from activities promoting safe s-x, as well as the inclusive social spaces the organisation creates. Such spaces are vital, because social connectedness is directly beneficial to health.
For 28 years, QAHC has been a hub connecting individuals into friendship networks and those networks into a community. Healthy social networks include a mix of bonding (similar) and bridging (different) ties, which respectively afford intimacy and exposure to novel perspectives and information.
People who are isolated lack opportunities for social learning about safe s-x and relationships, as well as “bridges into care” when problems arise and they need supportive referrals for professional assistance. The outcome of defunding QAHC will be more people living for longer with gaps in their knowledge and patterns of s-xual risk-taking leading to HIV infection.
Springborg has announced plans to create a committee of experts to oversee HIV prevention in Queensland. But what does “an expert” look like to a minister of health?