Category Archives: Sexual Health

5 Ways Bisexual Women Can Pursue Better Healthcare

Many individuals in the LGBT community face significant issues with regard to health care. For example, bisexual women face a high risk of physical and mental health problems and have a higher likelihood of experiencing violence and addiction. Discrimination is often experienced within the healthcare system. The bisexual community is fighting this, to spread education and make quality healthcare more accessible.

There are some general guidelines that may be helpful for bisexual women who are looking for quality health care. Read on to learn the five ways bisexual women can take care of their health, even while facing exceptional challenges.

5 Ways Bisexual Women Can Pursue Better Healthcare

Be aware of risks
Bisexual women are more likely to experience addiction, smoke, have depression and have suicidal thoughts and/or attempts, compared to other groups. Bi woman are also at a higher risk for cancer than heterosexual women or lesbians and less likely to get screening. Amy André, a co-author of Bisexual Health: An Introduction said, “Research shows that bisexuals experience more discrimination, violence, and stigma than gays and lesbians.” She believes that the fact that bisexuals have the worst health is directly linked to the violence, stigma and discrimination.

Seek quality health care
Unfortunately, it’s not possible to assume that every doctor is able to cater to the unique needs of LGBT patients. It is easier in urban areas, but still more difficult to find a provider that doesn’t group bisexual patients with gay or straight women. There is a list of providers in the Gay and Lesbian Medical Association directory and the Bisexual-Aware Professionals Directory. Everyone deserves to be treated with respect and compassion.

Be your own advocate
You’ll need to be more assertive at times because some doctors will ask questions that are heteronormative. If you find that the doctor assumes you are a sexuality that you aren’t, you may need to answer broadly. You’ll want to make sure that you’re giving proper information about your past and current partners, and your sexuality. Some women will find it more difficult if they live in a small community with few doctors. Push yourself as far as you feel comfortable and remember that you can request certain types of screening for your physical and mental health.

Know your financial barriers
According to LGBT MAP’s Unfair Price study, bi women are more than twice as likely to live in poverty than the general population, and 29% of LGBT women have trouble finding affordable health care, compared to 19% of heterosexual women. Women in rural areas may experience even more difficulty. It’s of vital importance to have access to affordable health care. This could mean a visit to a free clinic, Planned Parenthood or a doctor’s office that takes your health insurance.

Get the word out
Form a support system and be supportive to others in a similar position. Doing this not only positively affects your chances of receiving affordable health care, it improves your health.

Many Transgender People are Completely Avoiding Doctors

It can be difficult for many individuals to have discussions about their sexual history with a physician. It’s not uncommon for people to consider it uncomfortable. But, for many transgender people, the conversation never happens because they do not seek out health care, according to Adrian Juarez, PhD, a public health nurse and assistant professor in the University at Buffalo School of Nursing.

A preliminary study (“Examining the Role of Social Networks on Venue-Based HIV Testing Access and Decision Making in an Urban, Transgendered Population”) that examined health-based decision making and access to HIV testing in urban, transgender populations, showed that many transgender individuals withheld from pursuing necessary care due to social stigma and lack of affordability.

Many Transgender People are Completely Avoiding Doctors

“There is evidence that health care providers do tend to be judgmental, and it’s unwelcoming,” says Juarez.  Of course, people are not going to visit health care providers if they fear that they’re going to face discrimination and stigma.

The results of the study are especially cause for concern because, according to a 2009 report from the National Institutes of Health (NIH), about one third of transgender people in the U.S. are HIV positive. And, transgender women of color are even more at risk of HIV infection. According to the NIH study, more than 56 percent of black transgender women are HIV positive.

Among other reasons, an inability to afford medical care is keeping transgender patients away from doctors. Transgender people are more than twice as likely to be homeless and four times more likely to experience extreme poverty (compared to the general population)…having a household income of less than $10,000 per year. This data comes from a 2011 report from the National Center for Transgender Equality. It’s not as if it’s easy for transgender people to get work, either. According to the National Center for Transgender Equality, out of more than 6,000 transgender people surveyed in the nation, 90 percent said they were subject to mistreatment, harassment, and discrimination at work.

If a transgender person does happen to visit a healthcare provider, some doctors are not informed on how to properly treat the  patients. Juarez says, “It puzzles me how doctors will still refer to trans individuals by their biological name. That’s their identity.”

The line between identifying and biological gender can be blurry in healthcare settings. For example, transgender men still need Pap smears and transgender women need prostate screenings, but some health care providers might not offer these tests in order to keep from making suggestions that go against the patient’s identified gender. There is an urgent need to address stigmatization and provide health care professionals education on how to appropriately and compassionately treat transgender patients.

Important Ways Parents Contribute to LGBT Teens Health

Many parents of teenagers have their hands full, to put it lightly. Being a parent is not an easy job. You have to work on your own issues and those of your children. LGBT teens have particular health issues that need to be addressed and many heterosexual parents are either not aware of them or they don’t know where to start when it comes to helping their teens be healthy. Here are some steps you can take to help your teenager:

Seek out a pediatrician who is LGBT-friendly
This is important because your child might not be comfortable with the doctor they had in childhood. You may find a healthcare provider that’s LGBT or who is an ally. In order to find out, you must ask them. It’s also possible that they will be listed online. The Gay and Lesbian Medical Association (GLMA) has a database that is searchable by zip code.

Look into mental health care
Even if your teenager doesn’t appear to have signs of mental distress, they might. They might need someone with whom they can speak and feel comfortable saying things that they may not with a parent. Check out GLMA’s website for this information if you want. Also, consider someone to talk with for your own needs.

Remember that safe sex is still important
If your teen is with a same-sex partner, they still need to learn about safe sex practices. Make sure they’re tested for HIV and STIs and follow up with testing regularly. Make sure they know how to protect themselves in many ways, including not allowing themselves to be pressured into having sex before they’re ready.

Important Ways Parents Contribute to LGBT Teens Health

Vaccinations are important
Health care providers are not recommending that the HPV vaccine Gardasil is given to girls and boys. It’s important to get them vaccinated. For example, health care providers recommend that men who have sex with men (MSM) are given vaccinations against Hepatitis A & B, HPV, and the flu (annually) to begin with.

Keep watch of their online personas
This is important for everyone, whether or not they have LGBT kids. Your children are vulnerable to being lured into unsafe experiences or relationships by predatory adults. Make sure to pay attention to their online activity and have talks with them about how they appear in their online world. A harsh and constant reality is that bullying and violence against LGBT people exists; this includes child abuse and exploitation.

Speak about substance use/abuse
LGBT people are at a higher risk for substance abuse. Talk with your kids about the risks and the pressures they might face. If your child has a problem, seek treatment.

Love them unconditionally
Good health depends a great deal on a child’s supportive, loving environment.

Mental Health’s Influence on HIV Prevention

The HIV epidemic has changed a lot within the past 20 years, and still yet, continued high risk behaviors have remained the same.  Contributing factors to these behaviors include a lack of power or oppression, marginalization, sexual abuse, sexual compulsivity, low self esteem, depression, and loneliness.  These are not issues that can be fixed quickly.  Addressing these issues requires effort and time and may extend beyond the capabilities of many HIV programs for prevention.

An important thing learned from HIV prevention research is one size doesn’t fit all. Programs require different components that address the various different needs of clients.  Increased access to syringes for people who inject drugs, and condoms to those who have sex are necessary to win the battle against HIV.  Skill building and increasing knowledge about HIV are good methods for prevention, but they don’t work for everyone.  For most, the obstacles related to behavior changes involves dealing with mental health problems.

What people experience and what they do have effects on their mental health. Substance abuse and use (even when the drugs are not abused), marginalization, poverty, and discrimination are all serious factors that can have a big impact on one’s mental health and can place some people at a higher risk for contracting an HIV infection.

Mental Health's Influence on HIV Prevention

Do Issues with Mental Health Affect HIV Risk?

Yes. When someone decides to engage in a risky drug or sexual act, it doesn’t always occur due a consciously made decision.  Instead, these decisions are sometimes based on an attempt to get satisfaction for another need related to a mental health condition. For example:

  • Low self-esteem: For many men who have sex with other men (MSM), internalized homophobia and low self-esteem can impact their risk of of contracting HIV.  Internalized homophobia is a feeling which results in a person having a lack of self-acceptance, feeling unhappy, or self-condemnation for being gay.  In one study, it showed that men who did test positive for HIV were the ones that were in fact the ones that experienced internalized homophobia.  These men seemed to spend less time with others who lived the same lifestyle, and they also showed less satisfaction in their relationships.
  • Male to female transgender persons, also known as MTFs, identify depression, rejection, feelings of isolation, and low self esteem as barriers to risk of HIV reduction.  Many MTFs state that they take part in unprotected sex because it verifies their identity and helps boost their self esteem.
  • Post traumatic stress disorder:  People who are diagnosed with PTSD seem to partake in high-risk sexual behaviors.  One study showed that 59% of the women who were HIV positive had full PTSD due to traumas, such as rape, assault, or witnessing a murder. Non-violent traumas including serious accidents, loss or children, or homelessness.  Still yet, these women were not being treated for PTSD.  A national study performed on veterans found that substance abusers who had PTSD were more than 12 times as likely to be HIV infected than those veterans who were not suffering from PTSD or substance abuse.
  • Depression and anxiety: Those suffering from depression and anxiety are more likely to take part in high- risk sexual activities, such as substance abuse, including injection drug use, prostitution and choosing a high-risk partner.  A study following city youths for over a several year time period found that the change in risk behaviors wasn’t associated with access to information, counseling or knowing someone had AIDS.

What can be done?

As you can clearly see, mental health conditions by far increase risky sexual behaviors.  In order to address mental health issues, it is important that a person visit an individual therapist or counselor, as well as a physician to be put on appropriate medication(s). It’s also important for such people to have access to structural and community level programs that address mental health needs and HIV.

Individuals with HIV Age 14 Years Faster, According to Study

A diagnosis of HIV is no longer the death sentence it used to be; we’ve come a long way. However, there is a new study that was published in PLOS One that shows that although HIV positive individuals are typically living longer, they may be aging more quickly than expected. The study shows that those with HIV are at a greater risk of age-related diseases including kidney disease, frailty, osteoporosis, neurocognitive disease and some cancers.

Researchers are not pointing to the medications used to treat HIV as being the reason for faster aging; they think it’s HIV itself and that it speeds the process by 14 years.  Scientists from the Multi-Center AIDS Cohort Study and the UCLA AIDS Institute and Center for AIDS Research looked at whether HIV induced epigenetic changes that are age-related, meaning those changes to the DNA that do not change the genetic code, lead to changes in expression of genes. These types of transitions are triggered by the aging process itself or environmental factors.

Individuals with HIV Age 14 Years Faster, According to Study

One of the study’s senior authors, Beth Jamieson, professor of medicine in the division of hematology/oncology at the David Geffen School of Medicine at UCLA, director of the UCLA Flow Cytometry Core said, “While we were surprised by the number of epigenetic changes that were significantly associated with both aging and HIV-infection, we were most surprised that the data suggests HIV-infection can accelerate aging-related epigenetic changes by 13.7 to 14.7 years.”  There is published data and anecdotal evidence that lines up with this number. It suggests that treated HIV positive adults may develop age-related diseases, about a decade sooner than those who are uninfected.

The study looked at 96 samples of white blood cells from both young and old HIV patients before they began Antiretroviral Therapy (ART). DNA was then extracted and looked at for changes. When studied, there was a lot of overlap when the pattern of changes was compared to the pattern connected with aging. After extrapolating the biological ages of the HIV positive patients, researchers found that the patients were 14 years older than their actual age on both a cellular and physiological level.

Researchers say that this data suggests that HIV speeds up some aspects of the aging process, and there are common mechanisms found in both HIV-related aging and general aging. They consider the results of the study to be an important start in the attempt to find therapeutic approaches to mitigate the effects of HIV and aging.

Gay Men “Serosort” to Prevent Contracting HIV

One study in Seattle showed that approximately 40 % of men who are HIV negative make sure to only have sex with others who share their serostatus in order to attempt to prevent contracting the virus. A similar German study found that 10 percent of HIV positive gay men believe they are noninfectious if they have a viral load that is undetectable. Both studies’s results were presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

In Seattle, two different questionnaires that included 1902 gay men accessing an HIV/ STI clinic between February and August of 2013,  were conducted by researchers.  The first one asked questions about their recent sexual behavior.  For example, the HIV status of their partners, what role they played during sex, whether they use condoms, and other topics were brought up. The second questionnaire asked about what they did to reduce their risk of HIV.

Both questionnaires were completed by a total of 964 people, including 835 (87%) who were HIV negative and 129 (13%) who were HIV positive. Forty-two percent of HIV negative men were strict serosorters; they reported to only have sex with other HIV negative men (with or without a condom). Thirty-nine percent of these men said this was a deliberate strategy. A total of 6.5% practiced condom serosorting, which means they only  reported  having sex without a condom with other HIV negative men. 5.2% said this was deliberate. Lastly, 7.1 % were seropositioning, which means they only had condomless sex if they were the top, no matter their partner’s HIV status; 6.5% said this was a strategy.

Gay Men "Serosort" to Prevent Contracting HIV

Thirty-two percent of HIV positive men were strict serosorters, 25% of them doing this deliberately. Eleven percent engaged in condom serosorting and 10% in seropositioning.

In the German study presented at CROI, researchers asked 269 gay men who were HIV positive about whether they thought they could infect somebody if they had a viral load that was undetectable.  Ten percent of this group thought they were noninfectious, with a fully suppressed virus and they held this belief when making choices about sex.  Of these viral sorters, 57.5 %  reported condomless sex,  compared with 36% of men who were not viral sorters. Nineteen percent of the viral sorters said that recently they told someone about their status, while 22 % had not discussed HIV recently at all.  On these two counts, the respective figures for the rest of the men were 42% and 44%.

A Dating App for Lesbians Created by a Lesbian

The dating app called “Her” was created exclusively for lesbians.

The service used to be named “Dattch” (a combo of the words date and catch), but people were having trouble pronouncing it, remembering it or knowing what it meant. In addition, Dattch was made for romantic relationships and dating. Her, on the other hand, has the option for pursuing relationships that are strictly platonic. This occurred because a lot of people wanted to be in on the social side of Her–the events posted and what everyone’s up to, for example. Her is a place to find a community of lesbians.

A Dating App for Lesbians Created by a Lesbian

Even though people of any sexual orientation are able to use OkCupid, Match.com, and Tinder, Her was the first dating app created for lesbians. The other sites usually have a limited dating pool for lesbians, with men even pretending to be women sometimes. There is another popular app that was created for lesbians. It’s called Brenda and was created by a man. Some people would not consider that encouraging or appealing.

When users of Her visit the site they are shown one profile at a time. This gives them the option to “like” the profile. Both users can exchange private messages if they “like” each other. Users are encouraged to upload photos of themselves to be displayed. There’s a lot going on with Her as far as social events go, too. There are blog feeds on the app, for eight cities across the US that show what’s going on in entertainment.

There have been some obstacles along with the creation of Her. Exton said that she had issues trying to find investors, some even doubting her sexuality because she has long hair. She was also told there wasn’t any market, but thankfully this has proven to be false because the app has seen consistent, month-to-month growth.

6 Major Reasons We Need to Rethink HIV Prevention

Many HIV prevention campaigns rely on appealing to our emotions, but are not taking a good look at the HIV research and information available. Read on to see why we should rethink HIV prevention.

60 Percent of young people with HIV do not know their status
According to the Centers for Disease Control (CDC), 60 percent of young individuals have no idea that they have HIV. Some men and women who are HIV negative think that it is too big of a risk to be with someone who discloses that they are HIV positive, yet they might go on to have sex with someone who believes they’re HIV negative, but hasn’t been tested to verify. Those undiagnosed carry a higher viral load than those who are aware of their status and on treatment.

91 percent of new HIV transmission happen by those who are not diagnosed or haven’t been treated
This statistic comes from a new study released by JAMA Internal Medicine. In 2009, there were more than 1.1 million people living with HIV; of these people 207,600 were undiagnosed and 519,414 knew they were HIV positive, but were not receiving medical care. In comparison to those who were undiagnosed, those who knew about their status, yet not receiving medical care were 19 percent less likely to transmit the virus.

6 Major Reasons We Need to Rethink HIV Prevention

Those who are HIV positive and receiving antiretroviral therapy (ART) who have achieved an undetectable viral load are 96 percent less likely to spread HIV
There hasn’t been a reported case of anyone living with the virus with an undetectable viral load who has transmitted the virus.

Truvada has been shown to reduce HIV transmission by 96 – 99 percent, when used daily
One new study also shows when PrEP is used as needed (a user taking Truvada 2-24 hours before sex and one pill 24 and 48 hours after) has shown to be 86 percent effective in preventing HIV. With all that’s available–TasP, PrEP and condom use, there seems to be much less of a reason to fear sex with someone with someone of opposite HIV status. Be open and honest with your partner.

Three out of 10 in the US have their virus under control
The care continuum, which is also known as the HIV treatment cascade, showed that even though 86 percent of people living with HIV were diagnosed, only 30 percent of them had  an undetectable viral load. The majority of those living with HIV know they have it, but are either too scared or unable to do what is needed to control it.

You can expect to live an additional 51 years if you’re newly diagnosed in your 20’s
That is, if you enter proper treatment. This is roughly the same number of years as a person without HIV would live. Many need only take one pill each day to manage HIV. Of course, there are mental and emotional health issues to treat as well.

Study Shows LGBT Women among Most at Risk for Poverty

A study conducted by The National LGBTQ Task Force, Movement Advance Project, and Center for American Progress, called Paying an Unfair Price: The Financial Penalty for LGBT Women in America, shows that LGBT women are presented with challenges that obstruct their economic well being in health coverage, jobs and getting legal recognition from their families. The study emphasizes the many obstacles that LGBT women in the US face, including exclusion from insurance coverage, wage differences and inflexible workplaces.

LGBT women (transgender in particular) risk employment discrimination
Sixteen percent of LGB individuals said they lost their job because of sexual orientation and 35 percent said they were harassed by their employers, as recently as 2008. Sixty-two percent of LGB people in the study said they heard jokes about lesbians and gays while at work. Out of the transgender women surveyed, 55 percent of them said they were turned down for employment due to their gender identity.

LGBT women are asked by healthcare providers to pay higher rates
They are twice as likely as non-LGBT women to not have a doctor who they visit on a consistent and regular basis. LGBT women with incomes at or below $47,000/yr tend not to have healthcare coverage. The fact that there are exclusions in care for transition-related issues, it’s incredibly expensive for needed services for trans women.

LGBT women are more likely not allowed to be legal parents of their children
They often lack protected family or medical leave at work, and face obstacles in obtaining safe, affordable health care for their families. This is due to the lack of marriage equality throughout the US.

Study Shows LGBT Women among Most at Risk for Poverty

LGBT women pay higher rent and longer rental applications
One study by H.U.D. showed that opposite-sex couples were favored over same-sex couples by 16 percent when they applied for the same rentals. Same-sex couples were given higher prices, longer application processes and less incentives about promotions.

LGBT women lack intimate partner violence protection
The study showed that bisexual women were less “out” in the workplace, which may cause them to stay in an abusive relationship because they fear being outed by their partner. It’s also possible that women who report domestic violence when they’re in same-sex relationships are not taken seriously because of gender stereotypes.

LGBT women/families may not be aware of their eligibility for government assistance
It’s challenging for same-sex couples to navigate state and federal benefit systems because of the legal jumble of relationship recognition for them.

Doctors Need to Initiate Communication with LGBTQ Patients

LGBTQ patients are faced with a variety of health obstacles.

Within the community are high rates of substance abuse and suicide. Men who have sex with men (MSM) make up the majority of new cases of HIV. In order to narrow and eventually close the health gaps between LGBTQ patients and those who are straight, doctors need to talk about sexual orientation and gender identity with their patients.

Dr. Harvey Makadon, director of the National LGBT Health Education Center at the Fenway Institute in Boston said that few physicians talk to patients about sexual behavior, desires and issues of identity.

It’s important for doctors to speak up about sexual orientation and gender identity with patients. It’s a huge part of one’s life and certain issues need to be addressed that affect both mental and physical health. Doctors are potentially missing some of the big issues. Those in the transgender community are of particular concern. Statistics in the community are unsettling. Transgender individuals suffer high rates of poverty, crime and STDs. Almost one-third of transgender women have HIV. According to Makadon, that’s a rate 49 percent higher than other adults of reproductive age.

Doctors Need to Initiate Communication with LGBTQ Patients

Physicians who are not afraid to treat transgender patients hold the key to preventing significant medical issues. It’s tricky because not all MSM identify as gay and some transgender people may have trouble defining gender clearly, particularly those who are younger and. It’s important for people to become comfortable and get to know LGBTQ people. It will allow individuals to feel at ease in seeking care.

Health issues may start early; children and teens struggle with sexuality. LGBTQ teens have a higher suicide rate than straight teens—two to three times higher, in fact. There are also issues with regard to lack of support systems, as many of them have faced parental rejection. This often leads to homelessness, which leads to risky behaviors that include drug and alcohol abuse and sex work. Transgender and gay minorities face rates of HIV infection that are even higher.

Makadon says, “Most people who I’ve had this discussion with say that the duty to care for everybody has to outweigh personal values. For people who continue to feel too conflicted, they probably shouldn’t continue to be in a caring profession. That may sound harsh, but I do think it’s a reality that if we do provide healthcare that we have to provide healthcare for everybody.