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Scholarship on the HIV/AIDS epidemic in the United States and Canada has foregrounded the importance of direct-action activism within gay community responses to the epidemic. However, community mobilization efforts in Vancouver were varied and did not begin with direct-action activism. Drawing from oral history interviews with long-term survivors who are living with HIV and caregivers, I argue that the story of Vancouver’s HIV/AIDS epidemic cannot be adequately told unless early AIDS service organizations (ASOs) are placed front and centre. While maintaining an apolitical façade, early ASOs frequently took up roles that blurred the line between activism and care. Direct-action activist organizations built on these existing organizational responses to the epidemic in Vancouver, such as the safe sex education initiatives and treatment advocacy undertaken by the city’s first ASOs, and crucial continuities and overlaps existed within various community organizations’ political goals if not political tactics. While the development of various organizational responses to the epidemic in Vancouver mirrored the trajectory followed in other Canadian and US contexts, political mobilization in Vancouver ultimately developed in response to the particular local political conditions faced by the city’s gay community, particularly the inaction and homophobia of the provincial Vander Zalm government. In order to understand community responses to HIV/AIDS in Vancouver, we need to broaden our conceptions of activism to make space for various, complementary organizational responses to the epidemic alongside overt acts of resistance and protest, and pay close attention to the shifting local political context in the city., BC Studies: The British Columbian Quarterly, No. 213: Spring 2022

Additional file 1. Sex Now 2018 DBS Qualitative Interview Guide.

Scholarship on HIV/AIDS in the United States and Canada has foregrounded the importance of direct-action activism within gay community responses to the epidemic. However, community mobilization efforts in Vancouver were varied and did not begin with direct-action activism. Drawing from oral history interviews with HIV-positive long-term survivors and caregivers, I argue that the story of Vancouver’s AIDS epidemic cannot be adequately told unless community caregiving efforts and early AIDS service organizations (ASOs) are placed front and centre. By providing care to those who were sick and dying and restoring value to the lives of gay men and persons with AIDS, caregiving served as a foundational practical and political response to the epidemic that predated direct-action activism by several years. Indeed, direct-action activism grew out of existing organizational responses to the epidemic in Vancouver – such as safe sex education initiatives – undertaken by the city’s first ASOs. Activists built on the political foundation provided by caregivers and early ASOs while responding to the particular local conditions faced by the city’s gay community. In order to understand community responses to HIV/AIDS in Vancouver, we need to broaden our conceptions of activism to make space for caregiving and various organizational responses to the epidemic alongside overt acts of resistance and protest.

Canadian Blood Services (CBS) Qualitative Interview Guide. (DOCX 35 kb)

NPT Qualitative Questions HIV Negative. [HIV Negative] ARV-based Prevention Interview Guide. The interview guide used with HIV negative participants in the Momentum Study who had experience using ARV prevention strategies. (DOCX 27 kb)

Background: The emergence of biomedical and seroadaptive HIV prevention strategies has coincided with a decline in condom use among gay men. Methods: We undertook a social ecological analysis of condom use and perceptions using nineteen semi-structured interviews with HIV negative gay men in Vancouver, Canada who used HAART-based prevention strategies. Results: Contributors to inconsistent condom use were found at various levels of the social ecological model. Ongoing concern regarding HIV transmission and belief in the proven efficacy of condoms motivated contextual use. When condoms were not used, participants utilized seroadaptive and biomedical prevention strategies to mitigate risk. Conclusions: These findings indicate that notions of “safety” and “risk” based on consistent condom use are eroding as other modes of prevention gain visibility. Community-based and public health interventions will need to shift prevention messaging from advocacy for universal condom use toward combination prevention in order to meet gay men’s current prevention needs. Interventions should advance gay men’s communication and self-advocacy skills in order to optimize these strategies.