Removing stigma, improving health


The Halifax Sexual Health Centre doesn’t have “an easy product” but a dedicated team works to build a healthier city.
John Britton starts his business day with inventory. In his case, that includes counting condoms, IUDs and other birth control. It’s a regular day at the Halifax Sexual Health Centre.
Formerly known as Planned Parenthood Metro Clinic, the HSHC is a highly specialized, non-profit clinic focusing on treatment, testing and counselling around sexual and reproductive health. “The clinic started in direct response to the decriminalization of abortion,” says Britton, HSHC’s executive director. Over time, the clinic began to focus on more than reproductive health. “It soon became very obvious that reproductive and sexual health went hand in hand,” he says.
From pregnancy options and counselling to STI testing, including the only anonymous HIV testing clinic east of Montreal, the HSHC has provided all manner of services to people in the Halifax area. The clinic saw 5,665 appointments in 2008, increasing to 7,294 in 2012 with an average of around 28 per day.
John Britton started as executive director at the HSHC last December, previously serving on its board of directors. Britton is interested in what he views as social justice issues and inequities, especially when it comes to access to healthcare. For a few months last year, the clinic operated without an executive director, so Britton left his day job working for a large health charity, resigned from the clinic’s board of directors and applied for the vacant position. “The job is perfectly aligned with my skills and it speaks to who I am and what I believe in,” he says.
Although it’s common for a non-profit to temporarily operate without an executive director, Britton’s new job was one of many changes at the HSHC, including a recent loss of funding and staffing restructures which eliminated the bookkeeper and community educator positions. Those roles would be the responsibility of its executive director. Britton says that the decisions to do so were made by the board of directors to ensure the longevity of the clinic. “There’s never any danger of this clinic closing its doors but financially it has been a tough few years for the HSHC,” he says.
On top of the newly added responsibilities, one of the biggest roles of any executive director at a non-profit is to help bring in revenue to the clinic. But getting people to open up their chequebooks can be a little trying at times.
“If you want to think about it in  business terms, we don’t have an easy product,” says Britton. “We have a stigma attached to us because a lot of what we deal with are what people perceive to be lifestyle choices. You try asking for money to support emergency contraception, morning after pills, or anon HIV testing. It’s sticky. People don’t want to talk about it and there is a sense of ‘Oh, that’s them.’” But Britton is undeterred by such arguments. “It’s not just about sexual health, it’s about inequity, and that’s the point I am trying to make with people,” he says. “You’re supporting health equity and that’s what it boils down to.”

John Britton.

Britton goes on to explain that while people seem to know the HSHC exists, he’d like to see it having more of an impact in the community. “I’d love to have a billboard by the bridge,” he says. “I’d like people to think of us when they’re doing a bake sale at work, like people think of the Heart and Stroke Foundation, or the Canadian Cancer Society. I’d like to get on that radar.”
But instead of “shaking the tin” for finding revenue, Britton and his team at the HSHC have been looking at fundraising in a different manner. One of the ways they’ve done this is through the clinic’s youth committee—along with eager students from Dalhousie—by putting on the Sexy Dance Party at Pacifico. Britton acted as steward to the students, who gained valuable public relations and event management skills, while the event raised more than $7,000 dollars on a $300 budget and had more than 700 participants. “I am interested in fundraising where everybody benefits,” says Britton.
Leslie Shaw has been involved with the HSHC since its inception in 1971. Shaw says that she was “radicalized” as a teenager in the 1960s. “I remember an acquaintance of mine needed an abortion, and we looked everywhere,” she recalls. “I went to my dad who was a keen guy, and he went around riding in taxis, asking drivers where he should go to get someone an abortion. They directed him to a very well known Halifax madam named Ada MacCallum. But it was so clandestine, so scary and so expensive, and late by the time we got the information.”
Although abortions are no longer illegal in Nova Scotia, there’s still stigma around sex and sexuality, says Shaw. She wants to remove that and give people—especially those who are marginalized due to their circumstances in life—the capacity to be their own agents for change.
“I think we have more and more people who are marginal than we ever had before,” she says. “They’re not getting all the support that they need to survive as healthy people, sexually and otherwise.” Shaw also wants youth to have access to information and services as well. “There is a lot of sexual activity in younger ages now and we don’t say, ‘No, you can’t do that,’ but we do say, ‘How are you going to protect yourself so you have a healthier life?’”
More people are looking to protect and educate themselves. Chantal Caissie is one of them. In her mid-20s, Caissie moved to Halifax from Moncton in 2007 and accesses the HSHC for routine pap tests and STI testing. “A lot of the times women are made to feel ashamed of their sexuality, which in turn makes some women feel uncomfortable discussing sex and sexual health,” she says. “By having access to a welcoming space where you won’t be made to feel ashamed or guilty about your sexual history, I think it helps to remove that stigma and promotes overall better sexual health.”
Caissie had originally gone to the HSHC to talk about non-hormonal birth control, as she was unsure about her options. “The doctor I saw was really knowledgeable and helped me decide on a copper IUD,” she says. “She was incredibly reassuring and I’ve had it for about two years now and I’m really happy with it. I’m glad I had somewhere to go to talk about alternative birth control where I felt comfortable, especially with something I wasn’t very familiar with beforehand.”
“I’d like to see it be normal for people to get their sexual health in check,” says Britton. “As normal as it is to get their cholesterol tested. But that’s not just a medical shift but also a cultural shift that is required.” Britton and the team of doctors, nurses and volunteers at the HSHC are working hard to bring that shift about.
Britton argues that it’s the very stigma around sex and sexuality that keep STI rates steady, if not growing. “People get diagnosed with STIs,” he says. “People respond to it as if their life is over and that makes me sad because it’s part and parcel of sex and the age that we live in. Nobody wants them, but we can treat it. Other than abstinence, which isn’t possible for 99 per cent of the population, there is no other alternative, so…do what you need to do. If you pick up something along the way, understand how to treat it and how to be responsible to yourself and other people.”
“I think that’s what I would like to see,” says Britton, “that change in attitude.”

This story was originally published in Halifax Magazine.

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