In the 1970s, the first gay and lesbian organizations launched projects and a few clinics (ex. Fenway in Boston ) were created to offer health services to the gay and lesbian community in North America and some European cities.
When AIDS appeared at the start of the 1980s, Dialogai and most health services in Geneva realized they had to re-evaluate their priorities in order to respond to the crisis set off by this epidemic. Only in the late 1990s when antiretrovirals for HIV became available did a number of researchers and influential figures in the fight against AIDS express the need to take into account other health problems which had been neglected for years.
International
The rebirth of the gay health movement following the appearance of HIV antiretroviral tritherapies culminated in the USA at the first Gay Men’s Health Summit in 1999 and then the first LGBTI Health Summit in 2002, both of which took place in Boulder, Colorado. Dialogai sent representatives to meetings in the Gay Men’s Health Think Tank in 2001 and 2002 in San Francisco and Sydney, as well as the Gay Men’s Health Summit in 2003 in Raleigh, North Carolina. The Gay Men’s Health Think Tank brought together around fifty activists, researchers, and gay and AIDS organization leaders, primarily from English-speaking countries, all of whom were interested in promoting the overall health of gay men.
At the same time in the USA, researchers and the public health world started to say that preventing HIV would also mean taking stock of other health needs and the social context. In 1999, the American Public Health Association (APHA) published calls for further research on links between health and sexual orientation and began using the terms “sexual minorities” and “sexual minority health”.
In 2001, Canada was the first country to put gay health into its national HIV prevention plan, and its initiative was a model for the first stages of the gay health project in Geneva. The document “Valuing Gay Men’s Lives” lays out the approach used in Canada.
In France, an association called Warning was the first to take an interest in gay health and organized an international conference in 2005 where the main advocates, researchers and gay health figures in Australia, Canada, the United States, the UK and Switzerland were invited to submit their ideas, actions and projects. This conference gave rise to the publication of a volume titled Santé Gaie (Gay Health) in 2010.
Since 2010, the European chapter of the International Association of Lesbians, Gays, Bisexuals, Trans and Intersex Association, ILGA-Europe has also addressed health issues facing LGBTI people, particularly regarding the right to health.
Switzerland
In 2000, the notion of gay health arrived to Dialogai. Founded in 1982 to provide a space to welcome, listen and give information and solidarity to gay men, Dialogai immediately joined the Swiss AIDS Federation upon its founding in 1985. Dialogai is the only gay organization in Switzerland to develop professional AIDS prevention activities, advocacy for HIV-positive individuals’ rights and treatment access. It was this experience, expertise and notoriety which allowed Dialogai to develop the gay health project in 2000.
Checkpoint was launched as part of the gay health project in 2005 and was an immediate success that was replicated in Zurich and Lausanne in the following years . This project also gave notoriety to Dialogai’s gay health project beyond Geneva and highlighted the importance of social and mental health for gay men. Originally conceived of as a sexual health voluntary counseling and testing (VCT) center for gay and bisexual men, Checkpoint has since added mental health services over the years and most recently comprehensive health services.
In 2006, Fondation Agnodice was born with the goal of pushing for a Swiss society that considers gender identity and sexual development variations as valuable parts of human diversity. One of the goals of this foundation is to guarantee access to quality health care services for young trans people.
In 2007. the group Santé PluriELLE which belongs to the Swiss Lesbian Organization (LOS) began a project to address the health of lesbian and bisexual women. It was this group that was involved in the first health survey of women who love women in 2013 and the work done by the PREOS health group.
In 2008, a group was formed to address the lack of sexual health information on women who love women. This group became the association Les Klamydia’s in 2012. Les Klamydia’s have developed prevention tools such as a board game called Lez Gam.
The Swiss Lesbian Organization (LOS) and the Swiss Gay Federation (Pink Cross) organized the PREOS days, with events in Lausanne and other cities in French-speaking Switzerland about preventing rejection based on sexual orientation and gender identity . As part of that initiative, a health group authored a very good report called “Towards a fair, inclusive health care system for LGBT people” (“Vers un système de santé equitable et inclusif à l’égard des personnes LGBT”) which took stock of the current situation and made recommendations so as to improve the health care system’s ability to address those needs.
Currently, The LGBT Health Platform (“Platforme Santé LGBT”) brings together all of the LGBT organizations in French-speaking Switzerland and experts in order to set up training modules for health care providers.
The Gay Health Project
Dialogai’s AIDS Commission started thinking about the future of HIV prevention and other gay men’s health issues after tritherapies became available for AIDS at the end of the 1990s. In 2000, the general assembly of the association decided to broaden the scope of its health activities and put Michael Häusermann in charge of drawing up a strategy and proposed actions for gay health. This strategy was laid out in the “Gay Health, Discussion Paper” (“santé gaie, papier de discussion”). It showed how other gay organizations that dealt with HIV, particularly in English-speaking countries, were facing the same challenges as Dialogai. It proposed analyzing the health needs of gay men in Geneva as part of a community action/research project., namely “the gay health project”. Known for its leadership role in the gay community in Geneva and the knowledge and skill acquired through its AIDS work and Dialogai was in the perfect position to push overall health and improve quality of life in the community.
In 2001, a partnership was launched with the Institute for Social and Preventative Medicine at the University of Zurich and Jen Wang, an epidemiologist and researcher specialized in community research. This was done in order to guarantee the quality of research methods and outcomes, receive assistance in presenting the findings to the gay community, implement intervention projects and access research funding.
Given the total lack of health data (except for AIDS) on gay men in Switzerland at the time, in-depth qualitative and quantitative research began with that idea in mind. In 2001, based on the qualitative data emerging from multiple focus group discussions, the baseline quantitative survey of 570 gay and bisexual men was then carried out in 2002. The baseline survey revealed that social and mental health were where gay men have the most serious problems that most negatively effect their quality of life. These findings were put in a publication for the general public titled “Initial Findings of the Baseline Study on the Health of Gay Men” and were presented to the gay community in Geneva in order to set priorities and determine which community projects should be implemented in order to respond to the needs identified. Furthermore , the following projects were then also set up. The program “Being Gay Together” (Être gay ensemble) (2004), the list of gay-friendly therapists (2004) and Checkpoint (2005).
Given the seriousness of the findings on mental health and suicide, two additional surveys were carried out in the gay community in 2007 and 2011 around these two subjects. Afterwards, there was a comparative analysis of the findings from all three surveys. The two additional mental health surveys were used as pre- and post-intervention benchmarks to assess the impact of the Blues-Out project. Launched in 2008, the Blues-Out project was an unprecedented initiative to de-stigmatize, inform and give counseling around depression in the gay and lesbian communities.
The research findings on suicide were presented in a very successful national press conference in 2013 and inspired implementation of the Suicide Prevention Plan in Switzerland which was approved by the Federal Council in 2016.
The article “Dialogai’s Gay Health Project: From research to action” (“Le projet santé gaie de Dialogai: de la recherche à l’action”) lays out in detail the background of the gay health from 2000 to 2009.
