This morning I wrote about how I didn’t want anything to do with the day. I’ve celebrated World AIDS Day dutifully for the past 11 years, I volunteer several times per month at Nebraska AIDS Project providing free HIV tests to anyone who walks through the doors, and I just finished leading an organization that provides sexual health education to inmates in the county jail. I haven’t been doing HIV/AIDS activism nearly as long as some people, but I’ve definitely put in some time.
And I’m getting tired. I wanted a break.
But then today I sat in on a meeting to plan a conference for healthcare providers who see children across the state of Iowa. This particular conference is going to be held in a more rural part of western Iowa in order to give a geographically realistic opportunity for continuing education credits for those providers who don’t want to drive to Des Moines or Ames. As we were deciding on the conference agenda, a psychiatrist who is also on the planning committee announced that we no longer needed to have a session on LGTBQ competent care for these healthcare providers because “Gay kids in the western part of the state are just driving across the state to go to the doctor anyway. Plus no kid from a small town is going to come out to their doctor.”
…are you serious?!
Right. So there are a lot of troublesome things in those statements (like why is she making assumptions about gay kids in Iowa and where they go for their medical care or their comfort in sharing their sexuality with the people they are receiving healthcare from…and why would anyone want to discourage healthcare providers from giving better care regardless of who the care is for?...and why is a psychiatrist saying these things?...and really the list goes on), but on this World AIDS Day I was most troubled by the fact that a leader in the mental health community was suggesting that it wasn’t important to give healthcare providers the tools in order to make their LGTBQ patients feel more comfortable disclosing deeply personal, oftentimes stigmatized information.
It matters that patients are comfortable with their healthcare providers in sharing their sexual history, regardless of who they are having sex with. And it also matters, especially for gay and bisexual boys and men, that they feel comfortable disclosing what sex their sexual partners are to their doctors because almost 70% of new HIV cases in the United States are attributed to transmission between men who have sex with men (MSM)1. If healthcare providers don’t have the skills to ask this information, they will not be able to discuss STD risk reduction techniques and they won’t be able to talk about appropriate STD testing schedules.
We should be encouraging more providers, not fewer, to improve their comfort level in talking to youth about their sexual preferences and sexual histories. We should be encouraging more providers to provide LGTBQ culturally competent services so that their patients can get appropriate care to be as healthy as they can be. And we certainly should be making sure that members of the healthcare community are able to talk about these topics in an accessible and accurate way since, especially for the rural youth that sparked the conversation, they are not getting this information in schools (or sometimes from other trusted adults) and misinformation is spreading.
This year’s theme for World AIDS Day is “Leadership. Commitment. Impact.” Today I am learning that there is still work to be done in Iowa regarding the commitment to HIV prevention. Today I am learning that although I might be tired, there’s no time to take a break. We have come a long way in 29 years since World AIDS Day began, but we still need more leaders (in the healthcare field and otherwise) to embody the World AIDS Day theme….”Leadership. Commitment. Impact.”
I had a bit of a moment with that physician and (as calmly as I could possibly muster) mentioned that perhaps its even more imperative that rural physicians have this training so that their patients feel more comfortable with them so that the LGTB youth don't have to drive halfway across the state to visit a healthcare provider. I'm not sure we ended in the same place, but I'm sure there will be continued conversation and teaching moments over the remainder of this conference planning. I know for sure I'm not going to give up or take a break again anytime soon...
Bonus: If you’re looking to get yourself tested so you know your own status, use this handy resource to locate something near you: https://locator.aids.gov/
1HIV/AIDS Basic Statistics. Centers for Disease Control and Prevention. 2016. http://www.cdc.gov/hiv/basics/
