AIDS Community Care Montreal (ACCM) is Quebec’s only HIV and sexual health community organization that provides education for prevention, treatment information, and support services to English-speaking communities. This February, ACCM celebrates its 35th anniversary. On January 30, I sat down with Co-President Thomas Dobronyi and Executive Director Emilie Renahy to have a conversation about ACCM’s history, its mission, its future, and the Canadian response to de-stigmatizing HIV.
This interview has been condensed and edited for clarity.
Zach Cheung for The McGill Daily (MD): So for starters, I was curious as to how you guys got involved with ACCM. How long have you been working here for?
Emilie Renahy (ER): I was actually working in the public health research field. But I decided that research was too far away from social issues. When I joined ACCM as an Executive Director I really felt like I was part of an organization that was giving a lot to people. And that’s really what I was looking for.
Thomas Dobronyi (TD): Initially I started my first interactions with ACCM as a service accessor and was kind of like: “this place is really cool. I like what it does.” Then shortly after that, I started helping with cooking dinners for the Dinner and Discussion, which is an event that we do every Monday. After COVID, there was a lot of turnover on the board of directors. So I joined the board as an honorary member, which was a way that I could build experience gradually without having the responsibilities of a full member. And then it sort of continued on after that because I can’t say no!
MD: So you guys know the community members that come here often?
TD: Absolutely. And I think it’s something that sets us apart from some of the other boards that do similar things to what we do, but there is really the emphasis on “it’s a community where people know each other.” It’s a little bit less of: “You come here, we give you a service, you leave” type of thing.
MD: Did ACCM always have the closeness with the community that you now have?
TD: It started off as a very community-led response because in the ‘80s there was minimal to no institutional government response on the AIDS crisis; they seemed content to sort of let it spiral out of control. So really, around the world at the community level, people had to take matters into their own hands. This certainly was the case in Toronto, very famously the case in New York and Paris and no different in Montreal, really.
ACCM became ACCM out of realizing that there was an unmet need for services provided to English speaking people in the early days when they started getting government funding. They found that that was going exclusively to, for example, French-language prevention services or awareness campaigns that were pretty much exclusively in French. So ACCM sort of split off to fill that need.
ER: Yes. And that’s how it started, really — grassroots. People living with HIV had to come together and do something. So they created ACCM. And indeed it was because there were no services out there.
TD: That’s where our mission comes from: the community itself. For example, we can’t make changes to our mission statement without passing it by members. Every year at our annual General Meeting, it’s the members who have final say over pretty much everything.
MD: What was the biggest change that came from a response from the community?
TD: We have a program for migrants, refugees and protected persons that has developed gradually over the past several years. The way that that program is structured had to change a lot because of the direct needs of people who were coming in. We had to shift from group activities to more individual and direct casework simply due to the nature of the workload.
ER: Absolutely. The amount of individualized support needed to get access to healthcare was a huge change. When trying to help newcomers, whether they come from another province or from another country, it’s hard to get personal access to RAMQ (Régie de l’assurance maladie du Québec) or to a physician and medication. That’s why we also needed to have a holistic approach. Our staff are trained to be able to help with things like emotional support, but also admin support, material support, going through the immigration process and helping them fill out documents — because our members may need one or many of those things.
MD: What services does ACCM offer to queer and trans people?
TD: Two of our programs are explicitly geared towards queer and trans people. Kontak, which is directed towards men who have sex with men. And then we also have ImpakT, which is directed towards people who party and play (PNP), which is basically the combination of drug use and sex.
ER: We focus on both support and prevention. For our queer or trans members who are living with HIV, if they have any questions about transitioning,medication or whatever it is — the QTO (queer and trans outreach) coordinator will support them and help with whatever they need. There’s also the prevention aspect. We have prevention messages about HIV that are directed to queer and trans people because they have different needs. There are also workshops. Our prevention team hosts workshops on not only HIV prevention, but also on sexual health, and other Sexually Transmitted and Blood Borne Infections (STBBIs).
MD: ACCM places a large emphasis on an empathetic approach to your support services. Why is it important for ACCM to provide a holistic service for both the physical and mental traumas that can come with HIV?
TD: Part of why we need to have such a holistic approach, which includes mental health care, is because the niche we serve is language based. A lot of other organizations have their own little niche, so they kind of complement each other. But since our niche is language based, we have to do it all. We have to be able to do everything because that’s where the gaps are.
MD: What do your interactions with the government look like when it comes to funding?
ER: We get federal money from the Canadian public health agency, but that’s not even enough to cover support services. We also have funding from the provincial level, but again, these are almost like pockets of money: some will cover the programs entirely, most of them do not. So on top of all that, we also have to apply to grants or find sponsorships through pharmaceuticals or do fundraising activities.
TD: What they tend to do is focus the money on testing, especially lately. So for starters, at the federal level, funding for the HIV response had been frozen for 15 years. This past summer at the international AIDS conference, the federal government announced 18 million for at-home testing, which is great — it’s a drop in the bucket, but it’s money. But personally, my critique is that it’s really them just trying to do the easy techno-solution: “There’s this new technology that lets people test themselves at home. Let’s push that so that we can reach our goals at the federal level.” What that doesn’t do is connect anyone to care after they’ve received a diagnosis. It basically stops people from finding out if the test was positive. At-home tests are great in a lot of situations, especially, in campaigns involving getting them out to rural areas and to Indigenous communities where access to health care is such a challenge in general — so it’s great stuff that’s happening in that context. But in terms of what we do, that’s not what we need.
ER: And as Thomas was saying, they only provide the money for the tests and to some extent some money for staffing as well. But the funds are only directed to pre-test and post-test counselling. There is a lot of work that comes after that and they don’t provide support for.
The second huge drawback is that the funding might stop. We still don’t know whether we’re going to receive more funds to continue. We start a program that addresses a need — it works, but then we don’t have the money to continue it because the government’s funding has stopped. So what do we do then? We either have to close the program —which is a real problem for the community — or we try to find other sources of funding and we try to do more fundraising. It’s a lot of work for us, but they’re the ones who started it. It’s kind of like one shot and no follow up.
MD: What does ACCM think about the International AIDS Conference that was hosted in Montreal this summer?
TD: I think it was embarrassing for Canada. We’re not performing like we could. And there was huge controversy over the number of people who were accepted to attend the conference by the conference itself, but couldn’t get visas from Canada to actually attend. So many presentations that I watched started with people, especially from Africa, Latin America, and South Asia, saying: “my colleagues should be here today, but they didn’t get visas from your racist country.” So that was very embarrassing for Canada.
The health minister was also supposed to speak at the opening ceremony and just didn’t show up. And so this funding announcement was made on the second to last day of the conference. And then he showed up to give a speech at the end of the conference, which was not how that should have gone.
MD: What do you think the government of Canada can do to fight back against HIV stigma?
TD: Stop the criminalization of people living with HIV. The government is, I think, in the second or third round of public consultation about amending the criminal code to address the fact that basically, if a person living with HIV doesn’t disclose that they have HIV before sexual contact with someone, it’s usually treated as aggravated assault. Even if, like in many cases, that person has an undetectable viral load, which means they cannot transmit HIV, they may in some cases still be charged with aggravated assault. And that comes with jail time, which is wildly stigmatizing.
Also, the decriminalization of drugs is a big one because that is something that makes people reluctant to access services. It makes people reluctant to be open about their status or about their drug use or about sort of “at risk behaviour.” And decriminalization of sex work, which also puts people who are at a higher rate in unsafe situations and makes it harder for them to access care.
MD: What do you see in the future of ACCM?
TD: We’re in the middleish of developing a five-year strategic plan. So that has been an interesting process. Lots of little focus groups, interviews. We have a consultant from an outside source who’s doing that for us because some past strategic plans have been a little bit DIY. But a lot of our plans just incorporate the demands that we’re seeing. We hear from our support services team that a lot of people are really looking more for material support in things like accessing health care, housing, food, and mental health services.
MD: What is the best way for McGill students or anyone reading to get involved and support ACCM?
ER: There are so many ways, but volunteering is the main one. You can volunteer for any one of our services. You can volunteer in the prevention department and or in the support department. With fundraising, you can help with fundraising events.
TD: Help me cook dinner!
ER: If you have any skills that would help, we could definitely use that. And if you are wealthy or have connections, we accept cheques, haha!
When Thomas refers to “dinner,” they are referencing ACCM’s weekly “Dinner & Discussion” nights hosted every monday from 6-9pm. The heart of activity at ACCM, Dinner & Discussion sees the community gather for wholesome group conversation paired with a home-cooked meal made by volunteer chefs.
ACCM offers volunteer opportunities across all of its departments, from SextEd Social Media and Digital Marketing to Support Buddies. Orientation sessions are hosted throughout the year, ensuring that volunteers can be informed about ACCM’s mission and values at any time. If you do not have time to give, you can always make a donation!