For over 12 years, Health Initiative for Men (HIM) has played a role in promoting GBQ men and gender diverse people health through the translation of knowledge and provision of custom-tailored programs to the communities of GBQ men and gender diverse people on Coast Salish territories in the Vancouver Coastal Health and Fraser Health Authority regions. We work as peers to GBQ men and gender diverse people in local communities because we understand how it feels to be excluded from healthcare. However, in the case of our activities related to raising awareness of and increasing access to PrEP for all GBQ men and gender diverse people, we have failed Indigenous (inclusive of First Nations, Inuit and Métis) people who are also members of these communities.
In February 2016, Health Canada approved Truvada (tenofovir and emtricitabine) as a viable method of pre-exposure prophylaxis (PrEP), preventing people who are HIV negative from becoming HIV positive. Although the use of the medication was approved by Health Canada, it was not made readily available through BC’s Medical Service Plan. However, the First Nations Health Authority (FNHA), whose work involves providing health and wellness programming for First Nations people in BC, had already approved the medication on their provincial medication formulary, which meant that PrEP was available immediately (February 2016) to any First Nations members who were residents of BC. In addition to this, Inuit residents were also eligible to receive PrEP at no cost through the NIHB (Non-Insured Healthcare Benefits) program.
HIM realized it did not take sufficient action in promoting PrEP among First Nations and Inuit people who were eligible for PrEP at no cost. We did not conduct adequate outreach and relationship building during this time. By not including information specific to First Nations and Inuit people in the first iteration of our PrEP resource, we acknowledge that we have caused harm to First Nations and Inuit people who also identify as gay, bi, queer, Indigiqueer, trans and Two-Spirit. By not doing this work sufficiently, we have contributed to systemic racism, discrimination, and the diminishment of Indigenous lives. HIM cannot undo the injury inflicted on these communities by our silence and lack of appropriate action.
To make reparations, restore relationships, and demonstrate the value of the health and well-being of First Nations and Inuit community members, HIM will:
- publish this apology, which has been endorsed by all levels of leadership at the organization;
- work to ensure the effective promotion of PrEP among Indigenous gay, bi, queer, Indigiqueer, trans and Two-Spirit people;
- increase intentional involvement of Indigenous GBQ men and gender diverse people and their communities in the work that HIM does;
- commit to engaging FNHA and explore a mutually intentional partnership to ensure that all future work is done collaboratively;
- seek out and learn from examples of positive reconciliation efforts by others, including opportunities to unlearn and change our thinking and behaviours.
HIM leadership recognizes and regrets the mistakes we have made, acknowledges them and apologizes for them. We have taken steps to understand their impact and commit to future work as outlined above. HIM is committed to listening to feedback and suggestions from Indigenous communities as well as peer organizations involved in supporting Indigenous communities.