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Local HIV/AIDS groups criticize cuts in federal grants

Feds cut $1.1 million to Children’s National Medical Center

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Gay News, Washington Blade, HIV/AIDS

Adam Tenner, executive director of Metro Teen AIDS (Blade photo by Michael Key)

Local HIV/AIDS service providers have criticized the Health Resources and Service Administration’s decision to cut more than $1 million in grants that fund case management and other programs designed to prevent the spread of the virus.

Children’s National Medical Center had received $1.1 million in annual grants from HRSA under Part D of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act that specifically supports women, children and families living with HIV. Metro TeenAIDS and the Sexual Minority Youth Assistance League are among the local groups that received HRSA funds through the Northwest Washington hospital.

“From my perspective, that $1.1 million was meant to keep HIV-positive women, children and families connected to medical care,” Adam Tenner, executive director of Metro TeenAIDS, told the Blade. He said that his group had a “very modest contract” with Children’s. “This is critically important to our city and our country as we implement a national HIV/AIDS strategy that encourages HIV positive people to get care.”

SMYAL executive director Andrew Barnett told the Blade his organization received an annual grant of slightly under $60,000 from Children’s that funded a care advocacy program that connected young people newly diagnosed with HIV to the hospital. “Unfortunately with this grant ending, we are no longer able to provide this service directly,” he said.  “We continue to work with Children’s Hospital. They’ve been a great partner of ours.”

HRSA spokesperson Elizabeth Senerchia confirmed to the Blade that her agency reopened the Part D grant application process as a way to ensure funding dollars reach “areas with unmet needs” as the National HIV/AIDS Strategy outlines. MedStar Health Research Initiative in Hyattsville will receive $350,000 annually over the next five years to provide Part D services to D.C.

Senerchia acknowledged that this figure is a decrease in funding, but she noted that the city will receive $30,987,607 this year through Part A of the Ryan White CARE Act that funds HIV prevention efforts in urban areas. Washington will also receive $20,138,009 in 2012 through Part B that funds state AIDS Drug Reimbursement Programs and other initiatives to support those with the virus. Senerchia further noted that Whitman-Walker Health, Family Medical and Medical Counseling Service, the Carl Vogel Center, Unity Health Care, Inc., the Howard University Hospital Center for Infectious Disease and Research and MedStar Research Institute received $2,996,116 this year to fund primary care services under Part C.

“HRSA’s Project Officer for D.C’s Part A and Part B grants has reached out to discuss the decreased Part D resources with District officials and we are working with Medstar to ensure continuity of program and client transitions,” said Senerchia.

City officials were quick to note that this decrease in funding will not impact D.C. government’s efforts to combat the city’s HIV/AIDS epidemic. Brendan Williams-Kief, spokesperson for D.C. Councilmember David Catania (I-At Large,) expressed concern over the cut.

“Any reduction of federal grant funding is unsettling, particularly if it impacts such important programs,” he told the Blade. “We will work with Children’s and the Department of Health to determine the impact of the reduction and potential next steps.”

 

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D.C. urges gay, bi men, trans women to get Monkeypox vaccination

Majority of local cases are men who have sex with men

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D.C. Mayor Muriel Bowser on Monday urged gay and bi men and trans women to get vaccinated for Monkeypox. (Blade file photo by Michael Key)

D.C. Mayor Muriel Bowser and the city’s Department of Health announced that beginning on Monday, June 27, a limited number of appointments can be made for monkeypox vaccinations and that gay and bisexual men and transgender women who have sex with men are urged to get vaccinated.

In a statement released on Monday, the mayor and health department said Monkeypox vaccinations offered by the city are free and available Tuesdays, Thursdays, and Sundays between 1-8 p.m. at the city’s health department facility at 7500 Georgia Ave., N.W. It says the appointments are for eligible D.C. residents and can be made at PreventMonkeypox.dc.gov.

“Monkeypox is a rare, but potentially serious viral illness that can be transmitted from person to person through direct contact with bodily fluids or monkeypox lesions/rash,” the statement from the mayor and DOH says, “Monkeypox can spread during intimate contact between people, including respiratory secretions during prolonged face-to-face contact, during intimate physical contact like sex, kissing, or hugging, as well as touching fabrics and objects during sex that were used by a person with monkeypox, such as bedding and towels,” the statement says.

According to the statement, the initial symptoms of monkeypox often include flu-like symptoms such as fever, headache, muscle aches and swollen lymph nodes, followed by a rash and skin lesions.

“Although the majority of cases do not require hospitalization, monkeypox is dangerous, highly contagious, and uncomfortable,” the statement says. “While monkeypox can spread to anyone, the majority of current cases in the District are in men who have sex with men,” it says.

The DOH and mayoral statement says that to be considered eligible for the monkeypox vaccination provided by the city, persons must be a D.C. resident, 18 years of age or older and must fall within these categories:

• Gay, bisexual, and other men 18 and older who have sex with men and have had multiple (more than one) sexual partners or any anonymous sexual partners in the last 14 days

• Transgender women or nonbinary persons assigned male at birth who have sex with men

• Sex workers (of any sexual orientation/gender)

• Staff (of any sexual orientation/gender) at establishments where sexual activity occurs (e.g., bathhouses, saunas, sex clubs).

The statement says upon arrival at the vaccination site, proof of D.C. residency will be required and could include an identification card with a D.C. address, a utility bill or other mail with the person’s name on it and a D.C. address, or a current D.C. lease or mortgage with the person’s name on it.

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Gay doctor elected AMA president-elect

Dr. Jesse Ehrenfeld joined organization 22 years ago

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Dr. Jesse M. Ehrenfeld has been named president-elect of the American Medical Association (Photo courtesy of the American Medical Association)

Physicians and medical students have elected Wisconsin-based anesthesiologist Dr. Jesse Ehrenfeld as the first openly gay president-elect of the American Medical Association (AMA). 

Ehrenfeld was elected June 14 at the AMA House of Delegates’ annual meeting.

“Well, it’s certainly just an amazing feeling to know that you’ve got the confidence of your colleagues from such a broad array of practice types of modalities and perspectives,” Ehrenfeld told the Washington Blade during a telephone interview. “The association is a very diverse and increasingly diverse organization, and that’s a good thing. It’s more representative of the country and to see such broad support for a vision to move forward was really sort of heartening for me.”

The anesthesiologist and LGBTQ health expert will also serve as the first openly gay AMA president when he steps into the position later this month.

“When I joined the AMA 22 years ago, roughly, I didn’t think it was possible that a gay person could be the AMA president. And certainly 175 years ago, when the AMA was founded, that felt like something that wouldn’t have been possible,” Ehrenfeld said. “And so, to look at how the association, how medicine, health professional organizations have evolved, it’s pretty remarkable when you look at what that has looked like, and that’s a reflection of society in general. But certainly, you know, another pink ceiling has been shattered.”

Ehrenfeld previously served on the AMA’s Board of Trustee’s Executive Committee. He also worked on the AMA Recovery Plan for America’s Physicians; a long-term project that was unveiled at the annual meeting.

“A big component of that is helping physicians prepare the health system so that we can make sure that we can renew our commitment to achieving optimal health for all,” Ehrenfeld said. “To do that, we have to make sure that we prioritize the needs of physicians to improve patient care.”

Ehrenfeld is an associate dean and tenured professor of anesthesiology at the Medical College of Wisconsin and has advocated for issues affecting multiple marginalized communities, such as transgender representation in the military. He emphasized the importance of diversifying the medical field to ensure better service for patients.

“We need folks from every community but particularly marginalized communities to step forward and enter the profession. That’s how patients get better care,” Ehrenfeld said “There’s data that when we have a more diverse healthcare workforce, and when we’re a more diverse community, that those health disparities inequities, actually start to go away.”

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Take Pride in Your Health: Tips from a Primary Care Physician

Navigating health care can be daunting, especially for those who identify as LGBTQ+. Historically, the LGBTQ+ community has been marginalized and discriminated against, which has led to mistrust and unease for many who seek medical care. 

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Navigating health care can be daunting, especially for those who identify as LGBTQ+. Historically, the LGBTQ+ community has been marginalized and discriminated against, which has led to mistrust and unease for many who seek medical care. 

In Washington, DC, individuals identifying as LGBTQ+ comprise 9.8% of the population, a greater percentage than in any state. Individuals from this community are almost three times more likely to report poor quality of care and discrimination by healthcare providers. Nearly three in 10 of those who identify as transgender reported being refused healthcare because of their gender identity. Patients who identify as LGBTQ+ are less likely to seek preventive services such as cancer screenings and treatment for chronic conditions. And are more than two times more likely to delay getting care.

As we recognize Pride Month, I want to offer a few suggestions for finding healthcare providers committed to care equity and navigating the healthcare system so you can get the support you need to be healthy. Below are three tips to guide your care.

Find a doctor who’s an ally: The first important step is to find a doctor with whom you can speak honestly about your sexual health, gender identity, and health concerns. Look for a caring practitioner with special expertise in treating the LGBTQ+ population. Review the physician’s profile, looking for their level of interest and experience in treating the LGBTQ+ community. To get started with a new provider, I suggest scheduling a meet-and-greet appointment with a primary care provider to review your personal medical history, family history, specific concerns and health goals.  From there, you and your doctor can establish a health regimen that includes any necessary lab work, screenings, and office visits to best support your total health. Gender-affirming healthcare, if desired, should be discussed. 

Kaiser Permanente offers Pride Medical at Capitol Hill Medical Center, a welcoming, judgment-free, compassionate, and supportive medical practice devoted to meeting the unique health care needs of adult patients who identify as LGBTQ+. Kaiser Permanente’s gender-affirming care program, Gender Pathways, takes an innovative approach to providing care to transgender, nonbinary, and gender-expansive patients. Their services include behavioral health care, hormone replacement therapy, and gender-affirming surgeries. 

Know your risk factors: Understanding the unique health needs within the LBGTQ+ community is key to staying healthy. As people within the LGBTQ+ population face daily discrimination, some cope with these challenges by using tobacco and substances. In fact, there are higher rates of substance abuse for individuals who identify as LGBTQ+ than among heterosexual adults.Some populations within the LGBTQ+ community have a higher risk of sexually transmitted diseases, including HIV. The LGBTQ+ population also has a higher risk of developing certain cancers.To address your specific health risks and goals, your doctor can develop an individualized care plan that will include preventative screenings and routine appointments designed to identify and address problems early, leading to better health outcomes.Kaiser Permanente’s electronic medical record system proactively identifies the need for general health screenings and sends personalized reminders.

Manage your mental health: At Kaiser Permanente, we encourage preventive health measures to avoid developing health conditions like heart disease or cancer – and the same goes for mental health. Members of the LGBTQ+ group are more than twice as likely as cisgender heterosexual adults to have a mental health condition, such as depression or anxiety disorders. And, adults who identify as transgender are nearly four times as likely as cisgender adults to have a mental health condition. You can manage stress through exercise and using self-care digital apps, such as Calm or myStrength, free to Kaiser Permanente members. These tools can guide meditation and find support for building resilience, setting goals, and making minor changes to improve sleep, mood, and relationships. Prioritize frequent exercise, talking to someone you trust, journaling, and making time for self-care. As always, talk to your doctor if your mood or behavior changes affect your ability to participate in everyday activities.

You can become a self-advocate and receive the healthcare you need by establishing a rapport with a doctor you trust, knowing your specific health risks, and managing your mental health. Live a joyful, healthier life by seeking support from a primary care doctor and maintaining your routine screenings. Learn more about Pride Medical and LGBTQ+ care at Kaiser Permanente here. 

Dr. Keith Egan, a primary care physician at Kaiser Permanente and assistant medical director of Pride Medical at Capitol Hill.

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