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Toronto’s Blue Door Clinic Is Changing Lives

The Regent Park clinic promotes social justice and health equity for HIV-positive people in Toronto…

Toronto’s Blue Door Clinic is a walk-in clinic for people with HIV who do not have health insurance or immigration status in Canada. The dynamic community-based health centre provides short- term care focusing on HIV treatment, social support and assistance, and links to ongoing services.

Tell us more about Blue Door. Where does the idea for this project come from?
In recent years, there has been an increase in the number of people living with HIV/AIDS [PHAs] who don’t receive adequate health care because they’re not eligible for public health insurance. This includes temporary workers, people without Canadian immigration status and international students.

At a Gay Men’s Health planning forum in 2017, a working group came together to discuss this growing concern, and from there the Blue Door Clinic was formed. Following dialogue among service providers, community groups and members of the PHA community, 10 community agencies and groups came together to launch the Blue Door Project.

Our founding members are the Black Coalition for AIDS Prevention, Casey House, the Centre for Spanish-Speaking Peoples, the Committee for Accessible AIDS Treatment, the Hassle Free Clinic, the Ontario HIV Treatment Network, Parkdale Queen West Community Health Centre [CHC], Regent Park CHC, Sherbourne Health and Toronto People with AIDS Foundation.

What were the main needs that led to the creation of the clinic, and how did you meet them?
Thanks to the generosity of ViiV Healthcare and the in-kind contributions from our founding members, the Blue Door Clinic – which opened in August 2019 and runs for only a half-day every other week – has served 91 PHAs. Of those, 67 have already been connected to other services that help them overcome the barriers to good health they face.

These barriers can be medical in nature: being able to afford basic lab tests or not, being able to find an affordable healthcare provider with the knowledge and confidence to provide HIV-specific care. Clients also face non-medical barriers that affect their health, such as being able to afford the healthy foods we all need to maintain wellness, getting help with their immigration applications, substance use issues, or securing safe and reliable housing.

The Blue Door team include doctors, nurses, intake and linkage to care coordinators, and peer workers from our partner agencies.

What were the main difficulties you encountered during the development of the Blue Door Clinic?
Our mandate is to provide a short-term, interim solution to help stabilize these clients’ health situation, and then connect them to a healthcare provider. Unfortunately, it has been hard to find enough healthcare providers who understand how to care for HIV-positive patients and who will accept patients with precarious – or no – insurance, or without the means to pay for their own care.

Many of our clients are not English-speaking, and finding services in a client’s spoken language has been another big challenge. We prioritize providing free interpretation for clients who come to the Blue Door Clinic, either through peer workers or healthcare interpreters. That is often not available once the client is referred on to other healthcare providers.

The demand for Blue Door Clinic services is far greater than our capacity. When we first planned the clinic, we anticipated the need would be half of what we have seen since the clinic opened. The team has stretched themselves to serve as many clients as possible, but more help is always needed!

What are the gaps in patient care? How do we fill them?
Many healthcare providers need support to feel comfortable caring for patients who are HIV-positive. Community providers may not know how to help clients navigate the barriers they face as a result of not having health insurance or immigration status. One way we fill that gap is to enhance the education of healthcare providers on these fundamental issues through workshops, trainings and consultations.

The biggest gap is that the public healthcare system denies care to people without any or adequate health insurance. While a few services like CHCs do get funding to care for people without insurance, that funding is limited and does not cover the full range of healthcare costs. Some people we serve, like temporary workers and international students, are not eligible to get care from CHCs, and as such have to find their own way to pay for what are often prohibitively expensive but essential healthcare services. Ultimately, the gaps will remain until everyone can access publicly funded health care.

How can you, or other communities, recreate success with this approach? What could be done differently?
A fundamental part of our approach has been to ask clients what their needs are, and listen to their ideas on how to meet those need. That dialogue should always be part of any community-based strategy. Have conversations with the affected communities, engage partners who already work with the population, and be willing to be flexible with the services you can provide.

Voluntary collaborations like the Blue Door Clinic can be recreated anywhere, as long as willing and informed partners step forward. These are often the most successful types of initiatives, as partners share a commitment to doing what is needed to meet client needs. But relying on in-kind contributions makes it precarious from a long-term sustainability perspective. Secure funding is critical to sustaining healthcare services, and ideally that funding comes from within the government-funded healthcare system.

What’s next for the Blue Door Clinic and Regent Park Community Health Centre?
The Blue Door Clinic continues to grow! We plan to expand our services to weekly clinics, and are working on securing more funding to support the expansion. We will also be participating in research on the health outcomes of our patients, and we are launching a formally accredited workshop for healthcare providers on the ins and outs of serving PHAs without adequate health insurance. Stay tuned as the hard work continues!

The Blue Door Clinic is part of the Regent Park Community Health Centre at 465 Dundas St. E. in Toronto. The clinic is open weekly and appointments can be booked by calling (647) 730-3222. Visit

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