HealthLink E-Summit: One Day Down, One to Go!

logoCorey Prachniak serves as Chair of LGBT HealthLink’s Steering Committee and is an attorney focused on health policy, as well as a current Zuckerman Fellow at Harvard University. Corey tweets @CPrachniak.

Wow.

When the LGBT HealthLink Steering Committee decided to host an online “E-Summit” to bring together people interested in LGBT health, we didn’t know if it would work… Mostly because we made the idea up! But we wanted our committee and staff to be able to interact with the community we serve, and since we couldn’t fly everyone to HealthLink’s sunny home in Florida, we thought we’d give it a try.

Yesterday, we had over a hundred registrants for a full afternoon of sessions, featuring many members of our Steering Committee, HealthLink’s staff, and even special guest Jessica Hyde from the Texas Comprehensive Cancer Control Program. Over the course of the afternoon, we engaged in discussions on LGBT rights in healthcare, the disproportionate burden of cancer in LGBT communities, and the way that LGBT-based disparities interplay with disparities based on other aspects of people’s identities.

And it’s not over yet! Join us today (Friday) at 4:00pm Eastern for a fabulous presentation on LGBT tobacco disparities by no fewer than four members of our stellar Steering Committee and HealthLink’s Policy Manager, Juan Carlos Vega. This session, “We’re a Movement, Not a Market!,” is open to the public and is going to be an amazing way to cap off Day 2 of our events. HealthLink started as a tobacco control group, and even as we’ve grown and diversified to take on an array of LGBT health disparities, fighting tobacco remains at the heart of our mission. I’m sure the passion for positive change in our community will come across loud and clear this afternoon.

So, a big thank you to all who joined us yesterday and who will join us today. And a particularly big thank you to Jenna Wintemberg, a member of our Steering Committee and the co-chair of this event, for her many hours of hard work in putting this together. (You can even hear from Jenna at today’s tobacco session and thank her yourself!)

Oh – and if the work we’re doing is your kinda thing, you may be interested to know that we’re preparing to launch a brand-new membership program in the near future. You can sign up to learn more here.

Join Us for our LGBT Health E-Summit, October 15th and 16th

 

Corey Prachniak serves as Chair of LGBT HealthLink’s Steering Committee and is an attorney focused on health policy, as well as a current Zuckerman Fellow at Harvard University. Corey tweets @CPrachniak.


For the past few months, I have been working with our fabulous steering committee and staff to put together a two day virtual conference, or “E-Summit,” on LGBT health issues. I’m excited to invite you to join us this Thursday and Friday, the 15th and 16th of October. Once you have registered for the event, you’ll be able to jump onto the webinar during any of the sessions that interest you.

On Thursday 10/15, we will kick things off at 3:00pm Eastern Time with a session on LGBT rights in healthcare, followed by a session on LGBT cancer issues at 4:00pm Eastern and finally a session on intersectionality of identities and health disparities at 5:15pm Eastern. On Friday 10/16, we will finish up with a terrific session on tobacco use in LGBT communities at 4:00pm Eastern.

You can get all the details on these presentations by downloading the program, and you can register to participate here. All of these events are open to all.

By the way – if you like the work that HealthLink is doing, and want to be involved in events like this in the future, I have good news! We are in the process of launching a free membership program that will allow individuals interested in LGBT health to partner with us in exciting ways. You can sign up to learn more here.

I hope to “see” you this Thursday and Friday!

LGBT HealthLink Conference Commentary: Not So Straight

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LGBT tobacco researchers at SRNT

by Jenna Wintemberg, MPH

What: Society for Research on Nicotine and Tobacco Conference

Where: Philadelphia, February 25 to 28, 2015

 

The Society for Research on Nicotine and Tobacco (SRNT) conference in Philadelphia is the one I look forward the most each year, where the leading researchers in tobacco control come together to share their research. Session topics range from basic and clinical science, to behavioral and social science, to marketing and policy. I was proud to be there representing the Out, Proud and Healthy in Missouri project and LGBT HealthLink. I was also happy to share that this year I attended the conference as a travel scholarship award recipient for increasing diversity in nicotine and tobacco research. Of the 10 travel award scholars, representing many tobacco health disparate populations, I was the only LGBTQ research scholar.

Some of the LGBTQ presentations (titles and lead authors) that took place:

  • Is There a Relationship Between the Concentration of Same-Sex Couples and Tobacco Retailer Density? (Joseph Lee)
  • Rates of Tobacco Use Among Young Adult LGB Subpopulations (Amanda Richardson)
  • Minority Stress, Smoking, and Cessation Attempts: Findings From a Community Sample of Transgender Women in the San Francisco Bay Area
  • Sexual and Gender Minority Community-Based Tobacco Cessation Program: Tailored Recruitment and Evidence-Based Intervention (Jenna Wintemberg)

I always start the SRNT conference by looking through the program booklet for all of the LGBTQ tobacco presentations, but this year someone beat me too it. Joseph Lee, a graduate student at University of North Carolina Chapel Hill, emailed all of the LGBTQ researchers on the first day of the conference suggesting that we have lunch together and attend each other’s sessions. We were told to look for the rainbow flag tablecloth at lunch today to find each other. We may have been only 15 out of 1,200+ researchers at the conference, but the quality of LGBTQ tobacco research being done is outstanding and we can network in a very individual and personal way. For example, during our lunch meeting we workshopped the projects we are working on such as developing cessation interventions for LGBTQ couples who both smoke, enhancing cultural competency at state quitlines and marketing these services to our communities and addressing cancer disparities. I left with great new connections, new research avenues, and a renewed passion to tackle tobacco in LGBTQ communities.

Jenna Wintemberg

Jenna Wintemberg, MPH is a Health Education and Promotion doctoral candidate at the University of Missouri and works as a Graduate Research Assistant on the Out, Proud and Healthy Project. Her research interests are Tobacco-Related Health Disparities in Minority Populations, Tobacco Cessation, and Policy Change.

 

 

Missouri Coalition Pushes State to National Leadership on LGBT Health

Missouri might not top many LGBT people’s lists of great places to live, but after today you might want to rethink the charms of the Show Me State. For the last year a local coalition has been pushing adoption of LGBT-welcoming policies at hospitals. In this week’s release of HRC’s Healthcare Equality Index, Missouri zoomed from 37th in the country to sixth in the number of local LGBT leader hospitals.

We don’t see policy changes this quickly very often, especially when they require many companies to adopt new policies. What’s the secret to this unlikely success? A few years ago Missouri Foundation for Health funded a partnership with the local Equality Federation partner, PROMO, and SAGE Metro St. Louis. My project, LGBT HealthLink, was also brought on board to provide them with technical assistance. With funding and staff and policy expertise all in place, the Missouri team got down to business to see what they could change to affect LGBT health disparities in their state.

If you just look at the situation today, you’d think they immediately stumbled on the equivalent of oil and a match for policy change, but, like many good projects, they started slowly. First they mapped the policy environment; then they tried a few different strategies for change. One of the things they identified was a big gap: While most hospitals were required to have LGBT-nondiscrimination policies by the agency that accredits them, they could find little evidence of those policies by searching. And if we can’t find them, then patients couldn’t either.

For a while the PROMO staff played nice with the hospitals, trying to build relations and seeing how to move the changes gradually. Some hospitals did respond, but the work was crawling forward. Eventually, we switched to a different tactic, blanketing many hospitals with letters pointing out that these policies were required. Then, of course, the PROMO staff person, Andrew Shaughnessey, was there following up with multiple phone calls offering to help them with policy resources. The new strategy, which we’ve taken to calling the “terrier approach,” worked. Eventually even the hospitals that said they weren’t interested started to call Andrew back. And if they needed LGBT-cultural-competency training as part of the new policy changes, Sherrill Wayland from SAGE was ready to step in to set up in-person trainings at a moment’s notice.

The upshot of all of this work was that, while in 2013 seven hospitals had LGBT-nondiscrimination policies in place, now 31 do. While seven hospitals protected LGBT status in employment, now 30 do. While two had achieved Healthcare Equality Index leader status in 2013, now 19 have. Today several of those hospitals are putting out their own press releases lauding their LGBT-welcoming policies. It’s a far cry from 2013, and that means much better access to health for thousands of LGBT people in Missouri.

What I want to see now is this amazing level of success replicated. I’ve worked in policy change for a very long time, and trust me, a model to change policies this fast comes extremely rarely. While they had a funder in Missouri giving them the time to experiment with different strategies, any other community center or equality organization in another state can take advantage of that work and just do what worked for them. Nicely, the PROMO team has documented their steps really clearly in the LGBT HealthLink blog. See the first post about it here.

Kudos to everyone in Missouri. From the amazing staff team at PROMO and at SAGE to Missouri Foundation for Health, who cared enough to invest, and the many hospital systems who jumped on board, this is an amazing job by all, and it’ll really affect the health of the LGBT communities in your state.

Now who else wants to do it for their states?

New Tips From Former Smokers Ad Features Effects of Tobacco & HIV

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     Felecia King

    Project Specialist

   The Network for LGBT Health Equity

 
 

This week, the CDC launched the next phase of the Tips From Former Smokers Campaign, and this time they are tackling the issue of tobacco and HIV. The ad features Brian, who smoked for 30 years, and suffered a stroke as a complication of his HIV and tobacco use. (read more about Brian’s story HERE)

Smoking is especially harmful to people who are living with HIV. For example, smokers with HIV:

  • Are at higher risk than non-smokers with HIV of developing lung cancer, head and neck cancers, cervical and anal cancers, and other cancers;
  • Are more likely than non-smokers with HIV to develop bacterial pneumonia, Pneumocystis jiroveci pneumonia (PCP), COPD, and heart disease;
  • Are more likely than non-smokers with HIV to develop two conditions that affect the mouth: oral candidiasis (thrush) and oral hairy leukoplakia; and
  • Have a poorer response to antiretroviral therapy.
  • People with HIV who smoke are also less likely to keep to their HIV treatment plan and have a greater likelihood of developing an AIDS-defining condition and dying earlier than non-smokers with HIV.

(the above examples are from Aids.gov <– Click the link for more info!)

For these reasons, smoking is a significant health issue for all individuals, but it is even more of a concern for people living with HIV, who tend to smoke more than the general population. According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 19% of adults in the United States are smokers. However, the smoking rate is two to three times higher among adults who are HIV-positive.

 

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New Study Looks at Smoking Cessation among People with HIV

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Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.

 

 

 

What makes smoking cessation successful among people living with HIV?  That was the question posed at an event last week at the American Legacy Foundation in Washington, DC.

Dr. Donna Shelley explained that ending smoking among people living with HIV is especially important because “smoking increases the risk of HIV-related infections” and leads to “poorer adherence to HIV meds, higher viral load,” and other health problems.  NAM, an HIV/AIDS organization, notes that HIV-positive “smokers are approximately three times more likely than non-smokers to develop the AIDS-defining pneumonia PCP” and that “oral thrush, a common complaint in people with HIV, is also more common amongst smokers.”  Dr. Shelley’s study focused on testing cessation strategies among people with HIV in New York.

When it comes to quitting smoking, it could be seen as a positive or negative that people living with HIV are already likely to have complicated medical adherence needs.  On the one hand, adding smoking cessation interventions and medications adds to the burden that many people living with HIV already face.  But on the other hand, many people living with HIV have found success at incorporating medication regimens into their lives and are used to managing their care, either on their own or with the support of a medical adherence team.  For people who are doing well adhering to their HIV-related medications and treatments, they may well be able to incorporate tobacco cessation measures with a high level of adherence.

In fact, that is what Dr. Shelley’s preliminary data suggested.  “Adherence at baseline to HIV meds,” meaning how well people remembered to take their HIV medications at the start of the study, “was closely correlated to adherence to cessation medications” by the study’s sixth week, she said.

Dr. Shelley also noted that the people for the study were recruited from healthcare clinics, which often are in more regular contact with their patients than are other types of medical providers.  That’s because these settings tend to offer multiple, highly coordinated services.  So, for example, if a client comes in to see her therapist but has missed an appointment with her primary care doctor, the staff person checking her in can make sure she reschedules with her doctor or gets the prescription refill or referral that she might need.

The research tested three adherence regimens: smoking cessation medication alone; medication and adherence text messages; and medication, text messages, and adherence counseling phone calls.  Interestingly, the research found that the group with the best adherence were those who received the medication and text messages, but not the phone calls, which many people reported as being “too much.”  People also stressed that they liked texts with positive reinforcement – like “stay on track” or “look how much money you’ve saved this month” – versus messages that just reminded them to take their medication.

It’s unclear whether the results are unique to people living with HIV, or would have been the same for others, as well.  But it’s worth noting that people who are already managing HIV-related care preferred quick positive reinforcement on quitting smoking rather than lengthy counseling on taking their meds or daily messages telling them to take their pill.

It’s true that HIV is not just a problem for the LGBT community.  But given that 63% of new HIV infections in 2010 were among men who have sex with men, and that LGBT people smoke at a rate that is 68% higher than the population in general, the intersection of smoking and HIV is a critical topic for LGBT health advocates to keep in mind.

#SaludLGBTT Summit: E-Cigs are a New Face for an Old Addiction

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Corey Prachniak is an LGBT rights, HIV policy, and healthcare attorney. He serves on the Steering Committee of the Network for LGBT Health Equity and tweets @LGBTadvocacy.

This is a series of posts covering Corey’s work in Puerto Rico for the Salud LGBTT conference.

 

 

“Que es?” Dr. Jeannette Noltenius asks the crowd as she “lights up” an electronic cigarette on stage. Despite its flashy look and hidden interior, it’s nothing more than another mechanism for delivering nicotine, she says.

Dr. Noltenius is here to finish up the plenary sessions at the first day of the Salud LGBTT summit. Her presentation focused on the timely issue of electronic cigarettes, or e-cigs, which I have been told have been growing very popular across Puerto Rico in the past few years.

In a regular package of cigarettes, there are 21 grams of nicotine. In one electronic cigarette, there can be as many as 26 grams – so in a few minutes, you could get a pack’s worth of the addictive chemical.

And these companies aren’t stopping with regular e-cigs. They’ve also developed a liquid version of the product that can be smoked inside an e-cig but also inhaled, mixed with drugs like Cialis, or consumed in any other number of ways. Furthermore, niche products like e-Hookah seek to draw in as many consumers as possible.

Dr. Noltenius explains that 95% of ads for e-cigs have featured the concept that they are healthier than cigarettes. Other marketing strategies include promoting that it reduces second-hand smoke and can be smoked anywhere, even indoors. But these claims ignore the addictive properties and unhealthy chemicals that define these products, as well as incidents of poisoning and even a few instances of explosions, one of which lit a three-year-old child on fire.

Distributors have been marketing heavily and handing out free products on the streets as a way of getting people hooked. By and large, they are unregulated in how they can advertise, unlike traditional cigarettes are today; the FDA hasn’t yet exercised its power to regulate them. They are targeting the LGBTT community with club promotions and sexy ads the same way cigarettes were pushed upon our community. And Dr. Noltenius cautions that they will be trying to “buy” the LGBTT community with offers of funding for issues like HIV prevention that allow them to infiltrate our social spheres. You will end up repaying them, she warns, in the long run.

Tobacco companies might have been threatened by the rise of e-cigs, but they solved that problem by buying them out. Today, most of the e-cigs are owned by the same corporations that have caused millions of smoking-relating death. Now they are marketing e-cigs as a safer alternative to their own more traditional products.

E-cig makers are seeking to re-normalize smoking, Dr. Noltenius says, with the tobacco companies now projecting that consumption of e-cigs will exceed that of traditional cigarettes in just ten years. If that’s the case, this issue will only become more important for us to tackle as a community.

Stay tuned to the Network blog and my twitter account, @LGBTadvocacy, for lots of live coverage of the summit!