Creating a LGBTQ-friendly Environment

 

• Provide comprehensive training for all clinic staff in the care and rights of HIV positive patients . Make sure to include “frontline” staff; those that the patients will interact with when they first walk in the door ."
• Make sure someone is there to greet young people when they walk into the clinic so they feel welcome. Have posters and flyers with same-sex couples and transgendered youth.
• Provide information about safe sex, HIV prevention, and/or pregnancy prevention that is appropriate (e.g., resources that only talk about heterosexual couples may not be received well).
• Provide appropriate resources and referrals for LGBTQ-friendly services such as mental health, substance use and peer support.
• Discuss racism, sexism, homophobia and other forms of cultural oppression in your program. Generate discussions on   ways to solve, limit or minimize the problems caused by cultural oppression.

 

Address Institutional Stigma

 

•  LGBTQ patients often face difficulties in accessing quality health services due to stigma, both real and perceived, within the medical community.
•  Lack of education and training for health professionals surrounding the specific needs of LGBTQ patients, and communication shortfalls during clinical visits, can have an enormous impact on a patient’s health-seeking behavior and adherence to health recommendations.
• People return to environments where they know people care for them so be empathetic, non-judgmental and kind. Remember that most HIV positive patients young and old have experienced a tremendous amount of trauma in their lives and have faced incredible adversity.
• Shifting your model of care from a “deficit” approach to an “asset,” or resiliency model, will help them focus on a continuum of life rather than just a continuum of care.

 

Building a positive relationship with your patients

 

• Spend extra time with new patients, helping them understand the significance of learning and understanding their lab results, adherence and building relationships with providers.
• Get to know the patient as a person (e .g ., partners, jobs, interests) . Ask open-ended questions, like “What do you like to do for fun?
• Assist youth with their autonomy and self-acceptance, concerning both their sexual orientation/gender identity and their HIV status.
• Encourage patients to keep a list of questions for you, perhaps in their phones, so that they feel prepared and confident when they attend appointments .
• Create open and honest dialogue, particularly around sensitive issues . Remind them that what they say is confidential and that they can trust you.
• Ask non-judgmental questions about sex, sexuality and sexual identity . Ask questions in a way that does not assume sexuality. For instance, instead of “Do you have a boyfriend/girlfriend?” ask, “Are you in a relationship?”"
• Respect and address confidentiality proactively – do not assume whom the patient has told about his/ her sexual identity or HIV status, including other providers .
• Be prepared to make appropriate referrals and recommendations, particularly for case management, mental health, housing, substance use and peer support.