Directed towards all service providers in the health and social service sectors working with folks who use substances, this discussion guide can be extrapolated to inform and guide discussions with gay, bisexual, and other men who have sex with men (GBMSM) who PnP. Overarchingly, the guide seeks to reduce the transference of stigma by offering strategies that facilitate in safer and more respectful discussions about sexual health, substance use and STBBIs between providers and clients; as well, the guide offers ways to improve prevention, diagnosis and treatment of STBBIs.

The guide is broken down into three major sections: how to use; key strategies; and discussion steps. Under the how-to section, the guide underscores the importance of non-stigmatizing and non-discriminatory care, establishing the rationale for modeling discussion approaches to encourage validating and supporting care. Next, the guide overviews key strategies for discussing sexual health, substance use and STBBIs, emphasizing the importance of implementing rhetoric that is grounded in sex-positivity, harm reduction, trauma-and violence-informed care (TVIC) and a social determinants of health framework. 

Upon establishing the relevance of these fundamentals, the guide introduces the five Ps, which can be used to guide conversations surrounding substance use and STBBIS: practices, partners, protection from STBBIs, past history of STBBIs and pregnancy. Of particular relevance for providers working with GBMSM who PnP are the sections surrounding partners, practices, protection against and past history of STBBIs sections.

These areas prescribe to the notion that sexual health and substance use are often connected and offer tangible sex-positive and non-stigmatizing discussion points for providers to engage with in their practices. As well, above all, the guide underscores the importance of creating a safe and respectful environment for clients, which involves building rapport, practicing empathy and meeting the client where they are at. Here, the guide encourages service providers to take a moment to reflect on their own internal biases and prejudices, making space for personal check-ins and reflexivity. 

Ultimately, this guide serves as a solid resource for guiding discussions surrounding substance use and STBBIs. As well, the sample dialogue prompts and identified points to check in on during a session enhance the practicality of the resource, making it highly user friendly. See below for an informative webinar on best practices for discussing sexually transmitted and blood-borne infections (STBBIs), substance use and stigma by the Canadian Public.

Canadian Public Health Association (2017). Discussing Sexual Health, Substance Use and STBBIs: A Guide for Service Providers.