LGBT-friendly primary care improves STD screening rates

From medicalxpress.com

Bruce W. Furness, M.D., M.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues developed and evaluated a quality improvement initiative (Transforming Primary Care for LGBT People) to enhance the capacity of 10 federally qualified health centers (FQHCs; 123 clinical sites in nine states) to provide culturally affirming care.

The researchers found that FQHCs reported increases in culturally affirming practices, including collecting patient pronoun information (42.9 percent increase) and identifying LGBT patient liaisons (300.0 percent increase). Based on  and  (SOGI) from  among nine FQHCs, SOGI documentation increased from 13.5 to 50.8 percent of patients. Screening of LGBT patients increased from 22.3 to 34.6 percent for syphilis, from 25.3 to 44.1 percent for chlamydia and gonorrhea, and from 14.8 to 30.5 percent for HIV among the eight FQHCs reporting the number of LGBT patients.

“FQHCs participating in this initiative reported improved capacity to provide culturally affirming care and targeted screening for LGBT patients,” the authors write.

Read the full article.

The dudes who won’t wear masks

From the Atlantic

Americans are figuring out how to live with a deadly new virus now, just as gay men did in the early years of AIDS. Abstinence from sex wasn’t sustainable, and condoms became a ticket to greater sexual freedom. Likewise, Americans can’t abstain from human interaction forever, and widespread masking may be a ticket to more social and economic freedom. But trying to shame people into wearing condoms didn’t work—and it won’t work for masks either.

The public-health messaging around masks during the coronavirus pandemic has been muddled and confusing. The federal government recommended against face coverings for the public in March, with some public-health officials positing that they may even cause more harm than good. But a growing body of science, including evidence that people can transmit the virus when they don’t have symptoms, indicates that masks are an important tool for mitigating coronavirus transmission, especially in combination with physical distancing, hand hygiene, and other preventive strategies. Indeed, public-health concerns may justify mask mandates in some settings, including indoor spaces where many people gather for extended periods of time. But mandates have major downsides: Any enforcement is likely to disproportionately affect communities that are already marginalized, and some Americans—including some elected leaders in states facing serious coronavirus outbreaks—believe that requiring people to wear masks is an infringement on civil liberties. In practice, if Americans are going to mask up, public-health officials will have to cajole, not compel.

Read the full article.

Second Open Letter on COVID-19 Focuses on Nondiscrimination, Data Collection and Economic Harm for LGBTQ Communities

From the Gay and Lesbian Medical Association

On April 21, 2020, GLMA, Whitman-Walker Health, the National LGBT Cancer Network, the National Queer Asian Pacific Islander Alliance, the New York Transgender Advocacy Group, and SAGE issued a second open letter to public health officials, healthcare institutions and government leaders on the impact of COVID-19 on LGBTQ communities. The letter, joined by 170 organizations, called for action to protect LGBTQ patients from discrimination and to include sexual orientation and gender identity in data collection efforts related to the pandemic. The letter also called for action to address the economic harm to LGBTQ communities from the pandemic.

To read the full second open letter and list of signatories, click here.

The letter released on April 21 is a follow-up to an open letter signed by more than 150 organizations issued by the six coordinating organizations on March 11, 2020. Information on the first letter is available here.

Important COVID-19 Resources:

Health Alert: LGBT people may be at higher risk from COVID-19

From the Bay Area Reporter

More than 100 organizations sent an open letter to medical groups and the news media stating that LGBT people are at greater risk from the novel coronavirus due to other social and medical issues that affect the LGBT community.

Scout, who goes by one name, is a bisexual and trans man who is the deputy director of the National LGBT Cancer Network. That organization took the initiative on drafting the letter, which was released March 11, and gathering co-signers.

Scout is the deputy director of the National LGBT Cancer Network

Local organizations that signed the letter include Equality California, Horizons Foundation, National Center for Lesbian Rights, the San Francisco LGBT Community Center, and the Transgender Law Center.

The letter highlights three issues that may put LGBTs at greater risk during the COVID-19 epidemic: higher tobacco use than among the general population, higher rates of cancer and HIV-infection, and instances of discrimination on account of sexual orientation and gender identity (COVID-19 is the respiratory disease caused by the novel coronavirus.)

“We’re really concerned because we know that whenever there’s a health issue, the pre-loaded issues in our community create an issue for us,” Scout, a Ph.D., said in a phone interview with the Bay Area Reporter March 16. “We have more social isolation, more smoking. But we know how to offset that. As coronavirus expands so fast, we wanted to let the public health community know we can take steps to avoid another health disparity.”

Read the full article on the Bay Area Reporter Website.

Only 13% of the gay community utilize LGBT-specific clinics and providers Leave a reply

A new study from the Williams Institute at UCLA School of Law (Utilization of LGBT-Specific clinics and providers across three cohorts of lesbian, gay, and bisexual people in the United Statesfound that only a minority (13%) of LGB people have utilized LGBT-specific clinics and providers, but a majority (52%) expressed an interest in utilizing them in the future.

Researchers examined a representative sample of LGB people in the United States from three age groups—young (18-25), middle ( 34-41) and older (52-59)—to understand the factors that influenced past utilization of LGBT-specific clinics and providers and interest in using them in the future.

“The discrepancy between past utilization and interest in future use of LGBT-specific providers suggests there is a disconnect between the type of healthcare many LGB people would like to have and what they have access to,” said lead author Alexander J. Martos, former Research Analyst at the Williams Institute. “Younger, Black LGB people and those with lower incomes reported the greatest interest in LGBT community-based healthcare.”

Read the full article.

Scarcity of scientific studies on interventions to reduce health inequities in LGBTQ youth

From HealthNewsDigest.com

There is a dearth of scientifically investigated, evidence-based interventions to address substance use, mental health conditions and violence victimization in sexual and gender minority youth, according to a research review led by the University of Pittsburgh Graduate School of Public Health and published today in the journal Pediatrics.

After poring over thousands of research publications spanning nearly two decades, the scientists identified only nine studies that evaluated such interventions, and most of these used suboptimal study designs, thereby limiting the validity of the findings. None of the programs would be sufficient to mitigate the substantial inequities faced by lesbian, gay, bisexual, transgender and queer (LGBTQ) youth, the scientists concluded.

“While this knowledge gap is distressing, I think we can look at it as an opportunity,” said lead author Robert W.S. Coulter, Ph.D., M.P.H., assistant professor in Pitt Public Health’s Department of Behavioral and Community Health Sciences. “Promising programs are being created by community-based organizations that are ripe for rigorous evaluation by scientists to determine if they are successfully improving health among LGBTQ youth and, if so, whether they can be replicated in other communities.”

Compared with their heterosexual peers, sexual minority youth have up to 623% higher odds of substance use in their lifetimes; up to 317% higher odds of mental health conditions, such as suicidality and depression; and up to 280% higher odds of violence victimization, such as being bullied at school, or sexually or physically abused. Due to these health inequities, the federal government has designated LGBTQ youth as a priority population for research focused on preventing, reducing and treating these health issues.

Read the full article.

Thoughts of self-harm still and epidemic among gay youth

From the San Diego Gay and Lesbian News

There were 34,000 respondents in what is being called the “largest survey of LGBT youth mental health ever conducted and provides a critical understanding of the experiences impacting their lives.”

According to the Washington Blade, here are some of the findings:

• 39 percent of LGBT youth seriously considered attempting suicide in the past 12 months with more than half of transgender and non-binary youth having seriously considered it.

• 71 percent of LGBT youth reported feeling sad or hopeless for at least two weeks in the past year

• Less than half of LGBT respondents were out to an adult at school with youth less likely to disclose their gender identity than sexual orientation.

If you or someone you know is feeling hopeless or suicidal, contact The Trevor Project’s TrevorLifeline 24/7/365 at 1-866-488-7386. Counseling is also available 24/7/365 via chat everyday atTheTrevorProject.org/help or by texting 678-678.

April is STD awareness month: Good health means getting tested

If you are sexually active, getting tested for STDs is one of the most important things you can do to protect your health. Make sure you have an open and honest conversation about your sexual history and STD testing with your doctor and ask whether you should be tested for STDs. If you are not comfortable talking with your regular health care provider about STDs, there are many clinics that provide confidential and free or low-cost testing.

Below is a brief overview of STD testing recommendations. STD screening information for healthcare providers can be found here.

  • All adults and adolescents from ages 13 to 64 should be tested at least once for HIV.
  • All sexually active women younger than 25 years should be tested for gonorrhea and chlamydia every year. Women 25 years and older with risk factors such as new or multiple sex partners or a sex partner who has an STD should also be tested for gonorrhea and chlamydia every year.
  • All pregnant women should be tested for syphilis, HIV, and hepatitis B starting early in pregnancy. At-risk pregnant women should also be tested for chlamydia and gonorrhea starting early in pregnancy. Testing should be repeated as needed to protect the health of mothers and their infants.
  • All sexually active gay and bisexual men should be tested at least once a year for syphilis, chlamydia, and gonorrhea. Those who have multiple or anonymous partners should be tested more frequently for STDs (i.e., at 3- to 6-month intervals).
  • Sexually active gay and bisexual men may benefit from more frequent HIV testing (e.g., every 3 to 6 months).
  • Anyone who has unsafe sex or shares injection drug equipment should get tested for HIV at least once a year.

You can quickly find a place to be tested for STDs by entering your zip code at gettested.cdc.gov.

Black and African American LGBTQ Youth Report

From the Human Rights Campaign

In 2017, the Human Rights Campaign Foundation partnered with researchers at the University of Connecticut to conduct a groundbreaking survey of over 12,000 LGBTQ youth and capture their experiences in their families, schools, social circles and communities. More than 1,600 Black and African American LGBTQ youth responded to the survey.

This resource presents data collected from these youth, shedding light on their challenges and triumphs encountered while navigating multiple, intersecting identities. This report utilizes the full sample (any respondent who answered more than 10 percent of the survey) and provides more detail than is captured in the 2018 Youth Report.

Find out more.

When it comes to prostate cancer, ‘gay men are erased,’ patients say

From NBC News

Prostate cancer is the most prevalent invasive cancer among men, affecting nearly one in eight at some point in their lives, according to the Centers for Disease Control. But the unique challenges facing gay and bisexual men with prostate cancer have largely gone unaddressed.

Men who have sex with men (MSM) are less likely to get regular prostate cancer screenings, and those who are diagnosed are less likely to have familial and social support, according to research cited by the National Institutes of Health. And if their health care provider is not culturally competent, gay and bisexual men are much less likely to understand how treatment will impact their quality of life.

“Those in large metropolitan areas may have the option of searching for an LGBT-welcoming provider, but most Americans don’t have a choice about who treats them.”

“Many LGBT people enter their cancer treatment wary,” Liz Margolies of the National LGBT Cancer Network told NBC News. “Those in large metropolitan areas may have the option of searching for an LGBT-welcoming provider, but most Americans don’t have a choice about who treats them.”

As a result, Margolies added, many lesbian, gay, bisexual and transgender patients go back in the closet when they begin cancer treatment. Even if they don’t, providers often don’t ask about patients’ sexual behavior or identity, forcing them to bring the subject up themselves — sometimes again and again with each new specialist.

Read the full article.

Why STDs are on the rise in America

From the Economist online

Much of the increase in STDs has come from gay and bisexual men. Although a relatively small share of the population, they accounted for 81% of male syphilis cases in 2016, according to the Centres for Disease Control. As with heterosexuals, this seems to be because sex is now seen as less risky. That is due to the advent of PrEP, a prophylactic drug cocktail which gay men can take to nearly inoculate themselves from HIV. The reduced chances of catching HIV—along with the fact that a positive diagnosis is no longer a death sentence—seems to encourage men to drop their guard. A recent study of gay and bisexual men, published in the Lancet, a medical journal, found that as more began taking PrEP, rates of consistent condom usage dropped from 46% to 31%. Recent studies have shown that uptake of PrEP is strongly associated with increased rates of STD infection.

All this shows that changing sexual mores, and a reduced fear of the risks of unprotected sex, seem to be at fault—especially since the problem is not just limited to America. England experienced a 20% increase in syphilis diagnoses in 2017 and a 22% increase in those of gonorrhoea. Other countries in western Europe have seen ever worse outbreaks, sometimes exceeding 50%. Dwindling public spending on STD prevention—which in America has fallen by 40% in real terms since 2003—is not helping matters. Yet the chief methods of prevention, abstinence and condoms, are tried and true. Should these options seem too chaste or chaffing, then prospective partners ought to get an STD test (especially since most infections can be cleared up with a simple course of antibiotics). Verified testing is vital since verbal assurances, especially on the cusp of a liaison, can be misleading.

Read the full article.

The impact of sexual health on your mind, body, and spirit

From thebody.com

If you’ve googled “sexual health” recently, you know the only results are how to improve sexual performance. Well, you can’t improve anything until you know you’re educated on what you like and are being true to yourself. But what does that really mean?

Sexual health is the state of being mentally, physically and socially comfortable with your sexuality. Everyone’s definition of sexual health is personal, but here are a few universal tips anyone can practice (read the full article).

Coming out to your doctor in rural America

From NPR online

Finding the perfect doctor can be a feat for anyone. And a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health finds that 18 percent of all LGBTQ Americans refrain from seeing a physician for fear of discrimination.

One of those people is 20-year-old Alex Galvan. The moment right before he told his doctor earlier this year that he is gay and sexually active felt like a nightmare. Galvan lives in rural Tulare County in California’s Central Valley. He wanted to start a regimen of medication that helps prevent HIV infection, an approach called “pre-exposure prophylaxis,” or PrEP.

Alex Galvan

“Sitting in the waiting room was kind of like, ‘you got this, you’re just asking for a medication to help you,’ ” Galvan says, remembering what was going through his head before he came out to the doctor. “He’s not going to flip out. And then the moment before was, ‘Oh gosh, here it goes.’ ”

His doctor didn’t know about PrEP, and Galvan thought he was going to be rejected. Instead, his physician educated himself.

“I was kind of scared that he didn’t know what it was, but I was also relieved because I let him do most of the research,” Galvan says. “Yeah, and then I cried a little bit in the car, because I didn’t know what just had happened and it all kind of blurred together.”

Pediatrician Kathryn Hall knows about these concerns all too well. She has been practicing medicine in Tulare County for over a decade, and time and time again, her patients tell her they’re afraid to come out to their other doctors. A few years ago, she got so fed up that she surveyed more than 500 nearby doctors asking them basic questions about being welcoming. “I made the bar very, very low because we just didn’t get much education on LGBT health in medical school,” says Hall. “That is starting to change.”

Around 120 doctors responded to Hall’s survey, and most of them said they would be happy to serve this group. Hall says there are lots of ways that doctors can make it clear they’re accepting — a little rainbow flag on the door or taking out ad in a local magazine.

“Many of the physicians that I know are LGBT-friendly, but patients don’t know that and are very afraid that they’re being judged,” Hall says.

Read the full article on NPR.

 

‘Double discrimination,’ loneliness contribute to bisexual health disparities, study says

From NBC News online

“Double discrimination” and loneliness put bisexual individuals at “higher risk for poor mental health outcomes,” according to a recent study out of American University. The study compared the mental health of bisexual men and women to that of gay men, lesbians and heterosexuals.

“Bisexual people face double discrimination in multiple settings — bisexual people are often invisible, rejected, invalidated [and] stigmatized in the heterosexual community as well as the traditional LGBTQ communities,” Ethan Mereish, an assistant professor at American University and the study’s lead author, told NBC News. “Given that isolation and discrimination, bi people might be experiencing increase factors that might make them more lonely or isolated.”

Previous research has shown that lesbian, gay and bisexual individuals broadly face higher rates of mental health issues than their straight counterparts. Yet there are mental health disparities that the bisexual community faces at higher rates than even gays and lesbians. That said, the American University study surveyed 503 bisexual adults ranging in age from 18 to 64 to hone in on their unique minority stressors and the effects they have on mental health.

“This study adds to the growing body of research confirming that bisexual people face unique mental health disparities [that are] closely related to stigma and discrimination [they face] from straight, gay and lesbian communities,” Heron Greenesmith, a senior policy analyst at LGBTQ advocacy organization Movement Advancement Project, said. “Internal stigma adds another barrier to bisexual people.”

Greenesmith, whose organization has compiled a number of studies and reports that point to the relatively poor health of the bisexual community, said this latest study makes it “even more clear that the bisexual community needs tailored mental health services.”

Read the full article.

Smoking rampant in LGBTQ community, UIC researcher finds

From dnainfo.com

LGBTQ people smoke at twice the rate of straight people, a University of Illinois at Chicago researcher notes in a paper that offers five ideas to reduce the trend.

The paper, produced by a team led by UIC clinical psychologist Phoenix Matthews, said LGBTQ people are “at an elevated risk for tobacco related health disparities due to disproportionately high rates of tobacco use.”

Around 46 percent of gay men and 48 percent of adult lesbians smoke, according to the National Institutes for Health.

Many anti-smoking programs target specific ages, ethnicities and gender — but not sexual orientation, Matthews said in a press release about the paper, published in June by the Society of Behavioral Medicine. Cessation services, such as tobacco quit lines, “are underused by LGBT smokers,” Matthews added.

Matthews recommends that smoking surveys include gays and lesbians specifically and that anti-smoking media campaigns include messages that target them. In addition, the paper urges reducing menthol-flavored cigarettes, which are favored by young smokers, and creating a national clean air act aimed reducing second hand smoke.

Read the full article.

Gay guys: you’re douching wrong

From voice.com

…you don’t truly need to clean out before riding the baloney pony all night long. It all comes down to anatomy. As Dr. Goldstein told me, stool resides in the sigmoid colon, the part of the large intestine closest to the rectum and anus. There, you’ll find a muscle that keeps poo from going into the rectum and through the anus until you’re actually ready to, you know, poo. That means there shouldn’t be any stool where the top’s dick is going, unless your top is hung like Jon Hamm times Justin Theroux.

You’re probably about to say, “Yeah, but when I douche all kinds of poo comes out.” You’re not wrong. The thing about enemas and irrigation devices is that they were made for people with actual constipation issues, not bottoms. When we douche, the force of water propelled into the colon goes past the area that actually needs to be clean for sex, up into the sigmoid colon. That fills the feces up there with water, and then washes it all out, which is the point of the enema in the first place. An enema cleans out way more than you need to for sex, making your butthole even dirtier in the process. And many people do this repeatedly, until the water comes out clear. That’s like draining a whole pool just to get a few leaves out when you could be using a skimmer instead. (Though it’s possible for a dick to enter the sigmoid colon depending on one’s individual anatomy, it’s not common.)

Read the full article.