Nine Circle Community Health Centre is an amalgamation of four AIDS Service Organizations (ASOs), which emerged in the late 1980s to early 1990s. Our founding agencies were:
- Village Clinic (1984–2003), which emerged as a gay men’s health centre and was at the forefront of the community-based response to HIV testing, primary care and treatment. As HIV evolved in Manitoba, new agencies emerged to contribute to the response.
- Kali Shiva AIDS Services (1987-present), which prioritized volunteer in-home/community supports, peer involvement and empowerment. Kali Shiva would also emerge as an early leader in the advancement of harm reduction in Manitoba.
- AIDS Shelter Coalition of Manitoba (1991- 2004), which emphasized advocacy and support related to the social determinants of health: housing, income security and social justice. ASCM successfully completed Artemis Housing Co-operative, a resident-managed housing co-operative for individuals living with HIV.
- Manitoba Aboriginal AIDS Task Force (1993-2001), which led the response to HIV’s impact on Aboriginal Peoples of Manitoba including the introduction of indigenous teachings into prevention and care models, cultural safety and social justice. MAATF’s Four Doorways Project was a groundbreaking educational tool that continues to influence HIV education to this day.
In 1996, faced with limited resources and an HIV epidemic that was growing in both volume and diversity of populations impacted, Manitoba Health launched the Manitoba AIDS Strategy document. Executive Directors of the (then) five AIDS Service Organizations came together to explore better ways of coordinating HIV/AIDS services in the City of Winnipeg.
In 1997, the Health Promotion and Program Branch of Health Canada (now Public Health Agency of Canada) provided funding for this effort. At the end of this process (Phase I), the five organizations agreed to support the development of an integrated model of service delivery and released a shared statement in September 1997.
In 1998, the four ASO partners followed through on their commitments, forming the AIDS Services Planning Committee. The Committee began to develop joint programs and services and collaborated on a joint-strategic planning process (Phase II), which included a comprehensive community consultation. Committee Membership included representatives of each ASO, community members, as well as representatives of the emerging Winnipeg regionalization process (WCA), Manitoba Health and the Public Health Agency of Canada (PHAC). This initiative was co-funded by Manitoba Health and PHAC’s AIDS Community Action Program (ACAP). Approximately 345 individuals were consulted during this process, including 58 people living with HIV.
The Committee’s work resulted in the report “An Integrated Model of HIV/AIDS Service Delivery,”[1] which documented the challenges and opportunities facing individuals living with HIV in Winnipeg, recommended the integration of existing community services, and outlined the nine areas (as circles) of support articulated through the consultation and the visualization of the Model of Integrated HIV/AIDS Service Delivery.
Nine Circles’ Incorporation
Between 1998 and 2000, the founding agencies worked together to define the structure, services and processes, resulting in the incorporation of Nine Circles Community Health Centre on September 26, 2001. This work was undertaken through the Nine Circles Transitional Board of Directors. Village Clinic supported the initiative administratively under the guidance of their Executive Director. Post incorporation, the founding agencies dissolved their corporate status and amalgamated their boards, programs, staff and resources into the Nine Circles structure. During this period, Kali Shiva removed itself from Nine Circles, electing to remain autonomous and retain its original purpose. Currently, Kali Shiva provides the structure and administration for Sunshine House.
In 2002, the Nine Circles Board of Directors implemented a new leadership structure, guided by the Management Team Terms of Reference and implemented by Nine Circles’ first Executive Director, John Stinson. In 2005, this unique model of HIV service delivery continued to evolve. Nine Circles worked closely with tertiary (hospital)-based HIV treatment services, exploring ways in which tertiary and community services could partner to further strengthen integration and support to Manitobans’ Living with HIV. This resulted in the creation of the Manitoba HIV Program in 2007 as a partnership between Nine Circles Community Health Centre and Health Sciences Centre – HIV Program. In 2019, the 7th Street Access Centre in Brandon joined the program to expand access to residents in the Prairie Mountain Health region.
The Creation of a Truly Provincial HIV Program
Post-2008, the Nine Circles – Manitoba HIV Program flourished, providing support to the majority of Manitoba’s HIV-positive population and effectively advancing the quality of primary care and treatment services. By 2014, there had been no new resources in the program and the increased number of clients presented challenges to the HIV program team. HIV was moving well beyond the boundaries of Winnipeg, with new diagnoses presenting from every region of Manitoba.
To that end, Nine Circles secured financial support from the Public Health Agency of Canada, allowing the HIV Program Leadership Team to engage health partners and health system leadership to articulate a vision for expanding comprehensive HIV programs and services provincially. The work was supported by the Manitoba HIV Program Advisory Committee. The Advisory included representation from the HIV Program partners, Regional Health Authorities (RHAs), Manitoba Health and the Public Health Agency of Canada. The resulting report “Manitoba HIV Program Consultation 2014” articulates the experiences and recommendations of a broad range of stakeholders, although it is acknowledged that the opportunities for fulsome consultation with individuals living with HIV requires further exploration. Work is ongoing in advancing the quality of primary care and treatment services for those living with HIV.
[1] October, 1998, Prepared by Linda Kutcher, Ellen Olfert and John Schellenberg
