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As One Door Closes

Continuing in its 27th year as the only statutory Public Health Service in Ireland for gay and bisexual men, MSM (Men who have Sex with Men) and the trans community, the Gay Men’s Health Service will this month close its familiar Baggot Street clinic and move to a new home on Heytesbury Street in Dublin 8. But while the location may change, the dedication of the team and the quality of service will remain. Brian Teeling captured final images of the clinic which has facilitated over 110,000 patient visits.

For the LGBT+ community, the Ireland of 1992 was a very different place to how it is now, most obviously, homosexuality was still criminalised, with many compelled to keep their sexuality a secret. Services that openly catered to the sexual health of MSM were non-existent, so the mere fact that a clinic then calling itself the Gay Men’s Health Project would open a full nine months before decriminalisation took place was rather revolutionary.

A few years before, the Eastern Health Board had set up the AIDS Resource Centre in response to an increase in HIV/ AIDS and heroin use. Among its services, the Centre provided a HIV testing only drop-in centre which was also used by many gay and bisexual men. Spurred by this knowledge, in 1991, Mick Quinlan and David Wyse, two outreach workers from drugs/ AIDS services, carried out a survey across Dublin’s gay bars, clubs and saunas on the sexual health needs of MSM. From the results of their findings, the Eastern Health Board established the Gay Men’s Health Project.

While initial concerns were raised about the upfront nature of the clinic’s title, it was believed by those involved that it would ultimately only serve to empower its users. From the beginning, the team strove to deliver the highest standards of care for a community which welcomed their dedication. That dedication was necessary to build trust, not just in those early years, but right up to today, in order to ensure that those in need could feel secure, cared for and supported, in a non-judgemental and compassionate environment. The GMHS provides HIV and STI testing, prevention, diagnosis and treatment and onward referral to specialist services where necessary.

As societal attitudes to LGBT+ people since those early years have evolved for the better, so too has the attitude of the community itself toward its own health. Once, a trip to the clinic may have been a source of embarrassment, generating feelings of being judged by others, but as Siobhán O’Dea, the Manager of GMHS, observes, “Attitudes to sexual health are much more open than they were. People now do tell their sexual partners if they have an STI. We still have a bit to go but we’re doing very well. The community has really helped towards that by starting conversations around sexual health.”

Siobhán added, “Sexual health is a really important part of our entire health, just as important as mental health and physical health. So the service users should be so proud of themselves for coming into our service and looking after their sexual health.”

The GMHS staff is made up of a multidisciplinary team of the manager, doctors, nurses, care assistants, outreach workers, psychotherapists, health advisors, medical scientists, administration and security staff, many of whom are members of the community we serve. And, as Siobhán confirmed, “The staff here are hugely committed, we are all very passionate about the level of service that we give to the people who attend our service.”

The type of service provided has also evolved with the times. In 2016, they introduced an outreach pilot programme which delivered peer-led HIV and STI education and prevention in community settings such as bars, clubs, saunas and Outhouse LGBT+ community centre. With the growth of social media, the team now provide a HSE Health and Wellbeing funded online outreach service which means they can now assist traditionally hard to reach vulnerable groups. The result is a growing number of people who may not have accessed the service in the past now make contact.

As the MSM community members are increasingly committed to minding their sexual health, (helped in no small manner by clinics like the GMHS) the demand for its services has risen rapidly over the years. Of those 110,000 patient visits since its inception, 30,000 of those have attended the service in the last three years alone. The need for newer, more suitable, facilities which would allow them to continue providing exceptional service soon became apparent.

With the closure of the clinic to facilitate the move mere days away at the time of going to press, service users need not worry – the GMHS will reopen at its new location on Monday, August 12 with clinics running as normal from that week. And while this new location is indeed a new beginning, the professionalism and compassion of the team involved will also be making the trip to its new home.

To give a true sense of how far the service and its team have come since those early days, Dr Louise Pomeroy a doctor who worked in the very first clinic in 1992 and still does sessions in the clinic today shared with us her fond memories: “When I returned from London in the early ‘90s, I was very struck by how few MSM attended STI clinics in Dublin. The results of the previously mentioned survey undertaken by Mick Quinlan and David Wyse on sexual behaviour and HIV risk in MSM in Dublin were clear: there was a definite need for a community-based service providing HIV prevention interventions (including STI screening and treatment). Our premises was a Victorian outpatient department which hadn’t been painted for 25 years and was freezing in the winter and roasting in summer: The GMHS was born: a very innovative service at the time, funded by the HSE. I remember before opening the door for the first time being so struck by the enormity of what we were undertaking that I was almost overwhelmed. Generally, I think in life we are better not being able to see around corners, but how I wish I’d had a crystal ball that night to see where the GMHS is now! Whatever we lacked in facilities at that time, we made up for with enthusiasm, commitment and determination”. GMHS is a vibrant and innovative clinic meeting the needs of the community it serves, it has a multi-disciplinary team brimming with talent, commitment and willingness to work hard, Louise says she would have felt very relieved that night 26 years ago if she had been able to see how the service would develop and she is very proud to have been part of GMHS and the service it provides (regardless of the decor!). She sees exciting days ahead for the clinic as it moves to a new building and takes on new challenges. “Here’s to new beginnings, and the next 26 years.”

The GMHS could not make this move without acknowledging the visionary leadership of one of its founders Mick Quinlan. The development of the service to what it has become is due in no small part to his hard work, drive and determination to provide a sexual health service to the community. When asked about the move out of Baggot Street, Mick said, “Built 126 years ago, Baggot Street Hospital is a unique building. GMHS being based there for 26 of those years is also very unique, serving the many thousands of clients who used the corridors. I am very proud that this was made possible by the GMHS team through their commitment and dedication, including the late Dr Nuala Kilcoyne (RIP). I wish Siobhán and the team well in the move to another historic area and look forward to having my regular STI check up there!”

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