HIV and PrEP Stigma Affect LGBT Health Care

Recent anti-LGBT bills such as the bathroom bill in North Carolina and religious freedom bills across the U.S. have highlighted the continuing need to address discrimination towards LGBT individuals. While these laws have captured the attention of the general public, stigma and discrimination within the healthcare system continue to go overlooked.

Stigma around STDs, HIV, PrEP, behavioral health can have major implications on the health and wellbeing of the LGBT community. Cultural competency training can improve how providers engage with and treat LGBT individuals; however, this training is not a requirement for many providers.

Together, stigma and the lack of cultural competence training for healthcare providers contribute to serious health disparities for LGBT individuals. In a recent survey, the National Coalition for LGBT Health found that stigma in healthcare settings is a top issue among healthcare providers who treat LGBT individuals. Survey participants included LGBT health clinics, state and local health departments, clinical and behavior health providers, researchers and LGBT individuals.

In the healthcare system, stigma can take many forms. It can manifest in how LGBT individuals are treated in healthcare settings and in the behavior of LGBT individuals in seeking healthcare. In some cases, LGBT individuals may not disclose their sexual orientation or gender identity to healthcare providers. One in five LGBT individuals reported withholding information about their sexual history from a healthcare provider, according to a report by the National Women's Law Center. Stigma also can impact how services are provided to LGBT individuals. According to the Kaiser Family Foundation report, more than half of LGBT individuals have experienced discrimination in healthcare settings and nearly twenty percent of individuals living with HIV were denied necessary care.

For LGBT individuals, stigma around sexual orientation and gender identity in the healthcare system contributes to negative health outcomes compared to their straight peers. According to the C.D.C., one in two African American MSM (men who have sex with men) and one in four Latino/Hispanic MSM will contract HIV in their lifetime. A Kaiser Family Foundation report found that LGBT individuals are more likely to experience depres- sion, anxiety and substance abuse. The report also found that lesbian, gay and bisexual youth are four times more likely to attempt suicide. Furthermore, twenty-eight percent of transgender women live with HIV, and many do not know their HIV status.

"The negative health outcomes experienced by LGBT individuals reveal a need for healthcare providers and the general public to understand and address stigma facing LGBT individuals in healthcare settings," says Ryan Meyer, Manager of the National Coalition for LGBT Health. "The municipal government of Washington, D.C. recently passed the first-in-the-nation LGBTQ Cultural Competency bill, which would require healthcare providers in the city to receive two credits of LGBTQ cultural competency training as part of the continuing education requirements. Such requirements are a step in the right direction in improving the health of LGBT individuals."

Since 2003, the National Coalition for LGBT Health has hosted National LGBT Health Aware- ness Week. As a result of the survey, this year's theme of National LGBT Health Awareness Week was "OUTvisible: Redefining Stigma from Invisible to OUTvisible," and focused on exposing stigma that LGBT individuals face in healthcare settings and the resulting negative health outcomes. Throughout National LGBT Health Awareness Week, the Coalition partnered with nearly fifty organizations to raise awareness of stigma and LGBT health disparities on social media. The Coalition also hosted a webinar, "OUTcompetent: Cultural Competency and the Stigmatization of STDs, HIV, PrEP and Mental Health," which provided training for healthcare providers to improve LGBT cultural competency and educate healthcare providers about stigma and its effects on LGBT individuals and
their health.

The National Coalition for LGBT Health works to address LGBT health issues through education, research and advocacy. The Coalition offers resources for healthcare providers to receive free online cultural competency training through its LGBT Health Training and Certificate Program.

To join the Coalition as an LGBT consumer, apply online or email Ryan Meyer at [email protected], or to learn more about them, visit healthlgbt.org