Warm space, friendly smiles, cool atmosphere: as soon as you cross the threshold of the Spot, located near the center of Montpellier, you feel welcome. This is the idea: in this community-based sexual health center (CSSAC), the welcome is intended to be both caring and unconditional. “Here, we want to bring people affected to varying degrees by violence, precariousness or stigma back into care. We allow their words to be expressed in a non-judgmental framework, we support them towards their autonomy”summarizes Kasey, 30 years old, community guide within this Hérault Spot, one of four created in France.
Opened in July 2021, this structure supported by Aides and financed by the national health insurance fund (Cnam) received nearly 1,600 people in 2023, including 79 living with HIV. The twenty hours of weekly reception initially planned were quickly revised upwards: the doors of the Spot now remain open forty hours per week. “Our structure targets populations most vulnerable to HIV, including men who have sex with men, sex workers, as well as trans, queer or non-binary people.explains Vincent Péchenot, Spot coordinator. We offer them a comprehensive sexual health offer, based on their initial request. Then, with each person welcomed, we dig deeper together to identify possible broader needs… The objective is to co-construct their sexual health journey.”
This care offering is organized around a team of around 25 people: nurses, general practitioners and specialists (psychologists, gynecologists, sexologists, addictologists), social and administrative workers, as well as community supports (non-activist employees). caregivers). Individual and/or collective support is provided free of charge and confidentially, respecting each person’s gender and sexual orientation, according to their requests, desires and needs. In short, tailor-made. “Exchange groups, like the one dedicated to trans people, enrich the community aspect of our approach and facilitate discussions”underlines Iliès, 36 years old, Aid volunteer for two years.
The logistics put in place meet the challenges: screenings (HIV, hepatitis, sexually transmitted infections – STIs), vaccinations (hepatitis A and B, papillomavirus, mpox), treatment of STIs and prescription of Prep (this treatment which effectively protects against HIV). Of «test and treat» (“test and treat”) greatly facilitated by the samples organized on site and, above all, by an imposing device that Vincent Péchenot points out with pride: “This machine dedicated to medical biology examinations gives us, in 90 minutes maximum, analysis results for HIV, hepatitis C, gonococci and chlamydia. In the space of half a day, we can therefore have a diagnosis and implement treatment. This device also allows us to initiate Prep in a very short period of time.”
For Fred, 54 years old, “the screening system proposed here is much more effective than in the laboratory.” Because at the Spot, he said “the care is global, everything is organized with community needs in mind”. A former fan of chemsex (a set of practices combining sex and synthetic drugs), Fred found valuable help from addictologists and psychologists at the Spot. “I also participate here in a discussion group around chemsex, a phenomenon that has become a real public health problem”he warns. “Chemsex concerns a quarter of the men who have sex with men that we welcome here”notes Vincent Péchenot. For them as for other users, the Spot provides complete equipment aimed at reducing risks (syringes for psychoactive products and injectable hormones, internal and external condoms, gel, masks, etc.).
“In 2023, HIV was detected in four people received at Spot Montpellier. We are observing a drop in new contaminations”notes Vincent Péchenot, who emphasizes “the real impact” Prep and treatments. He continues: “What we are doing here is working. We started from scratch and today it really works. But we want to open up more to newly arrived migrants from sub-Saharan Africa, because the HIV curve is not decreasing among this group.” They too will find a welcome at the Spot “benevolent and unconditional”.
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