HIV Prevention for Transgender Women & Tobacco Use Among Sexual and Gender Minorities

Two of the presentations I attended at the National LGBTI Health Summit in the Indiana Memorial Union (pictured above) yesterday included: The Invisible Life: Using Peer-Led Programs to Address the HIV Prevention and Treatment Needs of Transgender Women, presented by Dana Hanes from Indiana University School of Nursing, and Occasional smoking status by sexual and gender minority (SGM) status in Missouri, presented by Jane McElroy from University of Missouri School of Medicine.

The Invisible Life: Using Peer-Led Programs to Address the HIV Prevention and Treatment Needs of Transgender Women (Marissa Miller and Dana Hines)

Dana Hines is a pre-doctoral fellow at Indiana University School of Nursing and the Quality Program Manager for the Ryan White HIV Services Program at Marion County Public Health Department in Indiana, and is currently working with a community-based agency to assess HIV service access needs of transgender women. She was presenting on behalf of her colleague, Marissa Miller, the Consumer Access Chair for the Ryan White Planning Council, a member of the Indiana State Community Planning Group (CPG), and facilitator of Pillow Talk, the only active Transgender Support Group in Central Indiana, through community agency Brothers United.

This talk focused on the fact that while transgender women are at high risk for HIV/AIDS, they are often unaware of their HIV status and, upon learning that they are HIV infected, are less likely to seek treatment, so are more likely to experience AIDS-related illnesses and death.  Hines and Miller cited a lack of HIV/AIDS knowledge, gender discrimination from providers and health care facilities, and an inability of transgender women to access needed services as contributors to the heightened risk of HIV and lower likelihood of treatment among this population.

Hines discussed Miller’s peer-led support group, Pillow Talk, that empowers transgender women and educates them about HIV and other health concerns. According to Ms. Miller, “The “Pillow Talk” group is a positive outlet for the Transgender community… We named the group “Pillow Talk” because we felt our problems weren’t being addressed. Our meetings are held the last Thursday of each month in non-traditional locations to offer an atmosphere of comfort, security, as well as serenity, the type of comfort one would receive at home on their favorite pillow. We gather to help one another, offer a therapeutic value as only one girl can give another. We don’t judge, we listen, love, and learn from one another. Our meetings provide prevention risk reduction education and support services to those in need.”

What does it mean for service providers to be more trans-inclusive? To start, providers need to recognize that not everyone fits into the traditional gender binary. Providers (and their staff!) must show their patients respect by referring to them using their chosen name that reflects their gender expression. Providers should become familiar with local expertise and hormone/transition protocols for transgender women. Additionally, transgender cultural competency training is a great step in the right direction for providers and staff of healthcare facilities. Hines also discussed that providing transgender women safe access to hormones is one way to reach this medically underserved group and reduce risk of HIV transmission from injecting street hormones.

Occasional smoking status by sexual and gender minority (SGM) status in Missouri
(Jane McElroy and Kevin Everett)

Jane McElroy, PhD is an Assistant Professor in the Family and Community Medicine Department, part of the Epidemiology Group at MU Research Reactor and an Adjunct Assistant Professor in the Master of Public Health Program at the University of Missouri-Columbia. She is co-director on the Out, Proud and Healthy in Missouri Project, a serial funded project examining tobacco use and intervention to reduce tobacco use in the LGBT community in Missouri.

In this presentation, McElroy discussed the heightened rates of smoking among sexual and gender minority (SGM) groups as compared with the general population. She noted that while tobacco use is a salient health issue among SGM populations, it has not been embraced as such in SGM communities. The assessment phase of Out, Proud and Healthy in Missouri found that LGBTQ community members in Missouri were 1.5 times more likely to smoke than Missourians in general, but did not believe that they smoke more than the overall Missouri population. LGBTQ community members in Missouri were also found to be less likely to plan on quitting within the next six months. Smoking was viewed by participants as a coping tool and immediate stress reducer. Additionally, this study found that participants had a general lack of understanding of tobacco companies’ targeting of LGBTQ consumers – many though of tobacco companies’ financial support for pride festivals as inclusive rather than exploitative of sexual and gender minority communities.

The survey used in this study also asked participants what they think would be an effective way to quit smoking and, in a separate question, what they would actually do if they wanted to quit smoking. This assessment found a great amount of cognitive dissonance – the difference between what we say we would/should do and what we actually do. For example, while almost 70% of those surveyed said that attending a support group would be an effective way to quit smoking, only 4% reported that they would actually attend such meetings.

If you would like to learn more about tobacco use among sexual and gender minority individuals, check out the National LGBT Tobacco Control Network.

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