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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 sexual orientation and gender identity (SOGI) from electronic health records 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.
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.
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.
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.
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.”
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.”
It shouldn’t be that hard to find a health care professional who’s up-to-date and sensitive to specific needs of the LGBTQ and HIV-positive communities. Yet, for many, it still is.
In some smaller suburbs, it’s nearly impossible to find a doctor who is knowledgeable about issues like PrEP, hormone replacement therapy, anal pap smears, and other queer health care requirements. In fact, most people living with HIV have to specifically see an infectious disease specialist when, in theory, their primary care physician should know how to help them achieve and sustain an undetectable viral load.
These days, HIV is a manageable condition, similar to diabetes. It shouldn’t be the responsibility of HIV-positive and/or queer people to find a doctor adept at treating them. That’s why the #WeNeedAButtoncampaign is putting the responsibility on doctor-patient matching sites.
I’ve teamed up with DatingPositives.com, a dating site for poz people, and Waxoh.com, its sex-positive digital magazine, to promote the effort. DatingPositives.com embraces those managing all STIs and takes their issues very seriously. Given that the LGBTQ community often overlaps with this community, the partnership was a perfect match — so to speak.
Together, we have a mission to improve our community’s health care experience and minimize stigmatization. Our simple solution? A single button to identify queer-friendly doctors.
As trauma psychologists, we’re leading a team to help alleviate psychiatric distress in gay, bi and trans males who have been sexually abused or assaulted. In collaboration with two nonprofit organizations, MaleSurvivor and Men Healing, we recruited and trained 20 men who have experienced sexual abuse to deliver evidence-based online mental health interventions for sexual and gender minority males – an umbrella term for individuals whose sexual identity, orientation or practices differ from the majority of society.
This study should help men in this group who have been sexually assaulted know that they are not alone, that they are not to blame for their abuse, and that healing is possible.
But, there are some things that trauma psychologists already know about these men, such as how prevalent sexual abuse of men is and ways to help men recover.
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.”
• 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.
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.
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.
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.
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.
Lesbian, gay, bisexual and questioning (LGBQ) teens are at least twice as likely as their heterosexual peers to use illegal drugs like cocaine, ecstasy, heroin and methamphetamines, a U.S. study suggests. Previous research suggests that stressors related to being closeted or coming out and being rejected by family or friends could contribute to an increased risk of substance use among sexual minority teens, senior study author John Ayers of San Diego State University in California said.
For the new study, researchers looked at data from roughly 14,703 high school students who had been surveyed about their lifetime and prior-month use of 15 different substances, including illegal drugs as well as tobacco, alcohol and prescription drugs that weren’t given to them by a physician.
Overall, LGBQ teens were 12 percent more likely than other teens to report any substance use in their lifetimes and 27 percent more likely to report substance use in the previous month, the study found.
LGBQ youth were more than three times more likely to try heroin or methamphetamines at least once, and more than twice as likely to try ecstasy or cocaine, the study also found.
Stressors faced by LGBQ teens, such as stigma and isolation, “may make drugs foolishly appear attractive as a coping mechanism,” Ayers said by email. “Even experimentation with these harder drugs can derail a teen’s future,” he said.
The vast majority of teens didn’t use illegal drugs, regardless of sexual orientation, researchers report in the American Journal of Public Health.
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.
Young men who have sex with men (MSM) who disclose their sexual orientation or behavior to a health care provider are more likely to receive appropriate healthcare, new data suggest.
Dr. Elissa Meites of the Centers for Disease Control and Prevention (CDC) and her colleagues studied 817 MSM, ages 18 to 26, who had seen a healthcare provider in the past year. Men who had disclosed were more than twice as likely as those who had not to have received the full panel of recommended screenings and vaccines, the researchers found.
The CDC and the Advisory Committee on Immunization Practices recommend that MSM be screened for HIV, syphilis, gonorrhea and chlamydia at least once a year, and immunized against hepatitis A and B and human papillomavirus (HPV), Meites and her colleagues note the journal Sexually Transmitted Diseases. Overall, 67 percent of the study participants had received all four recommended STI screenings, but that was true for only 51 percent of the MSM who had never disclosed. Nine percent overall had received all vaccinations, compared to six percent of those who hadn’t disclosed.
The pattern was similar when researchers looked to see how many participants received all seven recommended services. The rate was just seven percent for the overall study population, but it was even lower – at less than four percent – for the MSM who hadn’t disclosed.
Navigating the healthcare world as a queer person can be tricky, which is why HERE asked aspiring healthcare professionals who have *been there* to share their advice for how to make trips to the doc work best for you. A little about this duo: Mia is enrolled in an accelerated nursing program and Maggie is taking pre-requisites for a future degree in occupational therapy. And one thing that they agree on is that their roles as future providers will be heavily influenced by their experiences as queer patients. “Now in our early 20’s, we have grown up navigating doctors’ visits and other healthcare experiences that were not always LGBTQ+ friendly, if we even ‘outed’ ourselves to our doctors at all,” says Mia. “In reflecting on some of these experiences, we’ve realized how important and rewarding, albeit difficult, advocating for your own care can be.”
The research team analyzed data on 7,731 male participants between the ages of 20 to 59. They were divided into four groups based on their sexual identities: gay men, heterosexual men, bisexual men, and heterosexual men who have sex with men.
The two objectives of the study were to examine heart disease diagnoses among men of different sexual orientations and also measure their modifiable risk factors for heart disease.
While no correlation was found between sexual identities and heart disease diagnoses, bisexual men were found to have higher rates of several risk factors for heart disease compared to heterosexual men. These included mental distress, obesity, elevated blood pressure, etc.
The other three groups were found to have similar heart disease risk. The only difference observed in health behavior was that gay men reported lower binge drinking than straight men.
“Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of men and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in bisexual men,” said lead author Billy Caceres, an adjunct faculty member at Rory Meyers College of Nursing, New York University.
It’s well known to the point of stereotype that gay men experience higher rates of HIV, substance abuse, and suicide. But it’s less known, and hardly talked about, that we also have much higher rates of depression, especially those of us living with HIV, despite the causal relationship of depression and self-medicating and self-harming behavior.
You might call depression the big gray elephant in the room staring us in the face as we do our best to ignore it.
The 2013 fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) defines depression clinically as a depressive mood or loss of interest or pleasure in nearly all activities over a two-week period, along with four of these symptoms: “changes in appetite or weight, sleep, and psychomotor activity; decreased energy; feelings of worthlessness or guilt; difficulty thinking, concentrating, or making decisions; or recurrent thoughts of death or suicidal ideation or suicide plans or attempts.”
Although depression affects both men and women, men kill themselves at rates four times higher than women. Of the 41,149 suicides in the U.S. in 2013, nearly 80 percent were men.
An American study of gay men found that those who perceived increased homophobia and danger were more likely to report depressive symptoms. Feeling unaccepted and rejected by the gay community—as do too many gay and bisexual men of color and those living with HIV—were also found to increase the risk for depression.
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?