What are the structural aims?

Structural interventions do not target men that have sex with men (MSM) directly. They seek to create an environment that supports MSM HIV prevention and sexual health promotion by championing, developing and supporting HIV, sexual health and related sectors so that all have the capacity, skills and resources to implement Making it Count.

Organisational (service) aims

Summary strategic organisational (service) aim: Policy makers, commissioners and researchers increase actions that enable organisations (services) and their workforce (paid and volunteer) to reduce the HIV prevention needs of gay men and other MSM, and stop actions that make them worse.

MiC organisational aim 1: All service providers include MSM in their service planning.

MiC organisational aim 2: All service providers increase the delivery and commissioning of services which reduce the HIV prevention needs of MSM.

MiC organisational aim 3: All service providers increase their delivery of culturally appropriate HIV prevention interventions to MSM.

MiC organisational aim 4: All NHS and local authority service providers increase the equity of their generic services to MSM.

MiC organisational aim 5: All NHS and local authority service providers reduce the extent to which service users are subjected to discrimination based on sexuality, HIV status, ethnicity, migration status or gender.

MiC organisational aim 6: All NHS and local authority service providers ensure that HIV prevention interventions targeting MSM are accessible, culturally appropriate and effective.

MiC organisational aim 7: All NHS clinical staff in primary care, emergency services, specialist care and GUM services increase offers of HIV tests to MSM in line with recent NICE guidance.

MiC organisational aim 8: All GP and primary care staff increase actions that reduce HIV prevention need among MSM and stop actions which make them worse.

MiC organisational aim 9: Clinical sexual health services prioritise MSM as a client group.

MiC organisational aim 10: An increase in sexual health promotion interventions by HIV care and treatment providers.

MiC organisational aim 11: All Accident & Emergency and sexual health services (either clinic or community-based), increase the availability of post-exposure prophylaxis (PEP) to MSM that may have been sexually exposed to HIV.

MiC organisational aim 12: All school boards develop and review policies to address homophobic bullying by pupils and teachers and that promotes gay and bisexual social inclusion.

MiC organisational aim 13: Secondary schools increase the frequency with which they employ people able to teach pupils about sexual diversity, including homosexuality, in line with statutory sex and relationship guidance.

MiC organisational aim 14: All teachers and trainers of education, health and social services staff increase coverage (and quality) of sexuality and HIV awareness.

MiC organisational aim 15: Education, health and social services staff increase their input to local commissioning plans for sexual health and HIV.

MiC organisational aim 16: Police staff increase the equity of their generic services to gay men and other MSM.

MiC organisational aim 17: Prison staff increase the frequency with which they make condoms and lubricant freely and confidentially available to inmates.

MiC organisational aim 18: An increase by local health promoters in community development for HIV prevention.

MiC organisational aim 19: Service providers increase leadership of collaborative planning fora and Local Strategic Partnerships for education, health and social services.

MiC organisational aim 20: Lobbying and policy charities increase their advocacy and lobbying to policy makers for gay and bisexual men’s HIV prevention work.

Policy aims

Summary strategic policy aim: Policy makers, commissioners and researchers increase actions that enable organisations (services) and communities to reduce the HIV prevention needs of gay men and other MSM, and stop actions that make them worse.

MiC policy aim 1: The Government provides strategic and financial support for the appropriate national delivery of HIV prevention interventions for gay men and other MSM.

MiC policy aim 2: The Government increase its actions to ensure faster global progress towards the development of safe and effective HIV prevention technologies including pre-exposure prophylaxis (PrEP), vaginal and anal microbicides and ultimately a vaccine against HIV. 

MiC policy aim 3: An increase in the proportion of Strategic Health Authorities that include targets for HIV in their planning and performance monitoring mechanisms.

MiC policy aim 4: NHS and local authority commissioners ensure that HIV prevention is adequately resourced, and that such funds are not diverted to help manage shortfalls in other areas.

MiC policy aim 5: All NHS and local authority commissioners increase consortia commissioning arrangements for programmes of HIV prevention for MSM across local authority boundaries.

MiC policy aim 6: The Home Office increases its actions to enable Prisons Services to meet the (sexual) HIV prevention needs of inmates of prisons and young offenders’ institutes.

MiC policy aim 7: PCTs which have prisons within their boundaries engage with prisons to jointly develop Joint Strategic Needs Assessments that include policies for prisoner access to condoms and sexual health screening, the handling of sexual assaults and care of prisoners with diagnosed HIV.

MiC policy aim 8: The UK Border Agency and Offender Health increase their actions to ensure prison and detention services meet the HIV prevention, treatment and care needs of inmates of prisons, young offenders’ institutions and migrant detention centres.

MiC policy aim 9: An increase in the proportion of local authorities which explicitly recognise gay men and bisexual men as community groups with disproportionate social care need.

MiC policy aim 10: Anti-racist and anti-homophobic education initiatives are maintained and extended throughout the education system.

MiC policy aim 11: All agencies involved in criminal prosecutions for the reckless sexual transmission of HIV (Home Office, Crown Prosecution Services, NHS services and the Association of Chief Police Officers) continue to improve their approaches to such prosecutions in light of the detrimental public health impact that they are likely to have.

MiC policy aim 12: Researchers increase the applicability and accessibility of the national evidence base to services, the community and policy makers.

MiC policy aim 13: All policy makers, local authority and NHS commissioners responsible for HIV or sexual health, increase their contribution to the national sexual health and HIV evidence base by collecting and making available transparent data for evaluating policy change, including the publication of resource allocations.

MiC policy aim 14: Police Services develop and make known clear policies on the ways in which they support gay and bisexual victims of crime, including victims of domestic violence, sexual assault, and hate crimes.

MiC policy aim 15: Police Services develop and make known clear policies on the ways in which they respond to public complaints about the sexual conduct of gay and bisexual men.

MiC policy aim 16: An increase in leadership from MPs of the response to the MSM HIV epidemic that rejects homophobia and places civil action, human rights and respect at its centre.

MiC policy aim 17: The Government introduce an amendment to the Employment Equality (Sexual Orientation) Regulations 2003 that makes religious organisations subject to its provision.

MiC policy aim 18:The Department for Education incorporates into the national curriculum, a programme of sexual health and relationships education that reflects the experiences and practices of people of diverse sexualities and backgrounds.

Community aims

Summary strategic community aim: Community members and businesses increase actions that contribute to a reduction in the HIV prevention needs of gay men and other MSM, and stop those actions which make them worse.

MiC community aim 1: Members of the general public reduce the frequency with which they verbally abuse and physically assault gay men and other men that have sex with men (MSM).

MiC community aim 2: Gay men and other MSM increase activity with their peers and sexual partners that reduces HIV prevention need, including talking and passing on written resources, condoms and lubricant.

MiC community aim 3: Parents, families and friends of (young) gay and other MSM decrease the frequency with which they reject them and increase activities which reduce their HIV prevention needs, including talking and passing on written resources, condoms and lubricant.

MiC community aim 4: Gay and bisexual community organisations (helplines, support groups, community centres etc.) exist and increase activities which reduce HIV prevention need among gay men and other MSM.

MiC community aim 5: Editors and journalists of gay press titles increase editorial and copy that reduce the HIV prevention needs of their readers.

MiC community aim 6: Gay website managers increase features of their sites that reduce the HIV prevention needs of their users.

MiC community aim 7: Managers of gay bars, pubs and clubs increase the features of venues that reduce the HIV prevention needs of their users (eg. availability of written resources such as leaflets and posters, and also condoms and lubricant).

MiC community aim 8: Managers of saunas and other commercial premises that facilitate sex on the premises increase the features of venues that reduce the HIV prevention needs of their users (eg. availability of condoms and lubricant).

MiC community aim 9: Mainstream media reflects the variety of contemporary gay life in all aspects of the public sphere: media, community settings, education, etc.

MiC community aim 10: Providers and owners of mainstream businesses and services decrease discrimination against gay men and other MSM.

MiC community aim 11: Gay men, bisexual men and other MSM increase their non-sexual social interaction.

MiC community aim 12: Religious and political leaders reduce their verbal abuse of gay men and MSM, including members of their own organisations who come out, and increase their active contribution to reducing men’s HIV prevention needs.

MiC community aim 13: Gay men and other MSM increase reporting of unacceptable services received in the public sector.

MiC community aim 14: Gay men and other MSM increase their lay involvement in Primary Care Trusts (PCTs) and other planning and consultation structures.

Page last updated: 5 July 2013