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Developing Services for HIV+ Lesbian, Gay and Bisexual Youth



By Dino Paoletti



Dino Paoletti is the Program Coordinator of the Lesbian, Gay and Bisexual Youth Program at Central Toronto Youth Services.

A. Summary



Lesbian, gay and bisexual youth are among the most marginalized of youth. Due to the complexities of social stigma, they are frequently invisible to service providers working in health care, social services or education. When they are visible, their unique needs frequently go unrecognized or unmet. For those who are HIV+, social isolation is increased and access to supportive health care and social services is frequently compromised.



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B. Agency Description



Central Toronto Youth Services (CTYS) is a children's mental health centre working with high risk and vulnerable youth. The Lesbian, Gay and Bisexual Youth Program at CTYS provides direct service to lesbian, gay and bisexual youth and researches issues relevant to their needs.



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C. Research Background



During recent years, more lesbian, gay and bisexual clients at CTYS have disclosed being HIV+. The experiences of HIV+ lesbian, gay and bisexual youth have been largely unexplored in the literature. Most HIV-related research pertaining to lesbian, gay and bisexual youth has been prevention oriented. Most other research about HIV+ lesbian, gay and bisexual people has been adult focused.



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D. Research Description



Our goal was to access the experiences of HIV+ lesbian, gay and bisexual youth through a qualitative research study looking at their emotional, practical and service needs. The research is currently ongoing and is conducted in partnership with the HIV Social, Behavioural & Epidemiological Studies Unit, Faculty of Medicine, University of Toronto. All reported results are preliminary and were presented at the annual Canadian Association for HIV Research (CAHR) Conference, Victoria BC in May 1999.



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E. Research Objectives



The research objectives were to identify emotional and practical concerns; to identify access barriers to health care and social services and to make recommendations to improve accessibility.



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F. Results: (Preliminary)



Personal disclosure about HIV status is a key issue for most people living with HIV/AIDS (PHAs). Because they grew up in the epidemic and many had first hand experience of HIV prevention education, these youth believe that people will harshly judge them for becoming HIV+. Their perception is that people will believe that they should have known better. This fear also extends to how they perceive service providers will receive them at AIDS Service Organizations (ASOs) and youth agencies. They also talk about feeling a sense of shame at becoming infected, particularly as many knew the means of prevention.



One of the other key preliminary findings is that these youth have encountered substantial barriers to service access. On the surface, it would be reasonable to suppose that HIV+ youth might access services at either youth agencies or ASOs. However, most youth we interviewed described significant difficulties getting hooked up to both types of agencies or services.



Many youth described being afraid to enter an ASO out of concern for being identified as HIV+ just by being seen walking through the door. For those that did manage to get through the doors of an ASO, they frequently described feeling uncomfortable and unwelcome once there. These organizations were seen to be exclusively adult-focused with youth not seeing themselves represented.



While youth felt generally comfortable in the more youth-friendly environments of youth agencies, they also felt that many youth agencies were ill-informed about HIV. For those youth agencies that did provide limited HIV-related practical services, these youth felt that their HIV-related emotional support needs were not well met in youth agencies.



As a consequence, many youth were seeing neither a regular family doctor, nor an HIV primary care physician. With little access to other supports, those that did see doctors were often overwhelmed and confused by treatment decisions.



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G. Recommendations



Service providers need to recognize that these youth exist, that they have unique needs and that status quo services and programming in youth services and ASOs are not perceived to be accessible by these youth. As a consequence, agencies need to commit to developing youth-access strategies including policy change, provision of youth-specific programs, staff training and sensitive outreach strategies.



In order to be successful, these strategies need to include HIV+ lesbian, gay and bisexual youth at all levels of development. They also need to incorporate a strong peer component to reduce the substantial isolation these youth experience.




Pride & Prejudice - Services for LGTB Youth up to age 25

Office Phone: 416-924-2100 ext. 245

Office Fax: 416-924-2930

[email protected]

http://www.prideandprejudicectys.org/working.html



65 Wellesley Street East,

3rd Floor

Toronto, ON, M4Y 1G7