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Publications

Textbook

 

The Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health

American College of Physicians (ACP), 2008 Editors: Harvey Makadon, MD, Jennifer Potter, MD, Kenneth Mayer, MD and Hilary Goldhammer, MS of the Fenway Institute, Fenway Health

The first American medical textbook dedicated to LGBT health. Written by leading clinicians and researchers in the field of LGBT health, this one-of-a kind comprehensive resource is intended for health care professionals, public health officials, researchers, and policy makers working towards eliminating disparities in health care. The Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health is an invaluable reference for healthcare professionals seeking further knowledge and guidance on sexual minority health care.

For more information and to order copies: Amazon.com | Kindle

 


 

Briefs, Tools and Guidelines

 

Emerging Clinical Issue: Hepatitis C Infection in HIV-Infected Men Who Have Sex with Men

 

Hep C CoverView/Download the Brief [PDF]

Approximately 3.2 million individuals in the United States are infected with chronic hepatitis C (HCV) infection. While injection drug use is the most common mode of transmission, growing evidence indicates that the virus is also being spread through sexual contact, particularly among HIV-infected men who have sex with men (MSM). In this clinical brief, we review what is known about the epidemiology of HCV among HIV-infected MSM, as well as current screening, treatment, and prevention recommendations for HCV.

 

 

 

 


 

 

 

Best Practices in HIV Prevention: Translating Innovation into Action

View the course and download the white paper

Best Practices in HIV Prevention CoverOn September 27, 2013, the National LGBT Health Education Center hosted a summit of 15 experts to discuss the most innovative and evidence-based HIV prevention strategies and how to implement these strategies into clinical practice. The summit brought together leaders in HIV prevention research, education, policy, and community engagement to share interventions, professional experiences, and research findings, and to debate next best steps to ending the epidemic among the vulnerable populations of gay and bisexual men and transgender women.

 

Based on the findings from this summit, we have developed a multi-media educational course that includes the White Paper: Best Practices in HIV Prevention: Translating Innovation into Action, with accompanying videos and slides from the summit. All materials can be viewed for free and can be viewed separately or together.

 

 


 

 

 

Emergency Preparedness and Lesbian, Gay, Bisexual & Transgender (LGBT) People: What Health Centers Need to Know

View/Download (PDF)

Pages from LGBT_Emergency_Prep 4 10 14

 

Health centers often serve as a key resource during a natural disaster or other public health emergency. Before an emergency strikes, it is important for health centers to consider the unique needs and circumstances of vulnerable populations, including LGBT individuals and families in the community.

 

 

 


 

 

 

Optimizing LGBT Health Under the Affordable Care Act: Strategies for Health Centers

Center for American Progress and the National LGBT Health Education Center, The Fenway Institute, Fenway Health, 2013 

View/Download the BriefCover Image

LGBT people are among those most in need of access to affordable health insurance and high-quality health services. The launch of the Affordable Care Act is providing an unprecedented opportunity to improve the health of many LGBT Americans. This brief explains how the Affordable Care Act will benefit LGBT Americans, particularly through better data collection, stronger nondiscrimination policies, a new essential health benefits standard and other insurance reforms, and coverage expansions. Part 1 provides an overview of the issues, while Part 2 discusses how America’s health centers, which are integral to efforts to enroll uninsured people, can deploy effective strategies for reaching LGBT people.

 

 

 

Infographic

Click here to download the companion infographic- great to post in your office or as a reference!

 

 

 

 

 

 

 

 

 

 


 

 

Taking Routine Histories of Sexual Health: A System-Wide Approach for Health Centers

The National Association of Community Health Centers and the National LGBT Health Education Center, The Fenway Institute, Fenway Health, 2013  View/Download the Toolkit

Cover Image

For patients and the health centers that serve them, sexual health care and prevention interventions mean routine screening of physical, behavioral, and social health factors and subsequent care management and coordination with public health through strong partnerships.  Skilled at patient engagement and proactive planned care, health centers can integrate a routine sexual health history as part of the overall health assessment, as well as routine screenings for HIV and hepatitis C based on the most current CDC recommendations. To support health centers as they endeavor to better integrate sexual health into patient-centered care, we collaborated with the National Association of Community Health Centers (NACHC) to create Taking Routine Histories of Sexual Health: A System-Wide Approach for Health Centers (Toolkit).

In addition to the toolkit, NACHC developed a companion video series entitled, HIV and Related Issues:  Engaging Patients and Communities.  This series of 4 short videos highlights health centers as an integral part of our nation’s response to the critical issues of HIV, hepatitis C, and sexual health.  Addressing these issues, often through active partnerships, is essential in a true Patient Centered Medical Home and in fully engaging our patients, families, and communities.

Education Center Director Harvey Makadon’s video Importance of Sexual Health in Primary Care can be seen below.  Click here to view the rest of the video series from NACHC.

 

 


 

 

Affirmative Care for Transgender and Gender Non-Conforming People: Best Practices for Front-line Health Care Staff

Affirmative Care for Transgender and Gender Non-Conforming People

The National LGBT Health Education Center, The Fenway Institute, Fenway Health, 2013  Download PDF

In collaboration with transgender health care providers, researchers and front-line staff, we created a helpful tool of best practices for front-line health care staff to provide affirmative care for transgender and gender non-conforming individuals. Our needs assessments and review of available research reveal a great need for front-line staff to learn how to appropriately and sensitively communicate with transgender patients. With increased need for health centers and other health care organizations to become more culturally competent in providing affirmative services for transgender clients, this tool addresses the often overlooked best practices for training front-line staff.

 

Spanish Trans CoverAhora en español! “Atención afirmativa para personas transgénero y de género no conformista: Mejores prácticas para el personal de atención médica de primera línea”

Click here to download the Spanish version!

 

 

 

 

 

 

 


 

Promoting Cervical Cancer Screening Among Lesbians and Bisexual Women

The Fenway Institute, Fenway Health, 2013Cahill_PolicyFocus_cervicalcancer_cover image  Download PDF

By Sarah Peitzmeier, MSPH

This Fenway Institute analysis examines the heightened risk profile of lesbians and bisexual women, such as lower rates of health insurance coverage and less access to preventive health care, including routine pelvic exams. It also describes efforts in the UK and Australia to promote Pap tests among lesbians, and why it is important to offer Pap tests to some transgender men, many of whom retain a cervix and may be at risk for cervical cancer. Providers should also be trained in broader LGBT health issues, so that they are equipped to provide clinically competent care to lesbian and bisexual women and transgender men in ways that are sensitive and culturally competent.

 

 

 


 

Addressing the Needs of LGBT People in Community Health Centers: What the Governing Board Needs to Know

The National Association of Community Health Centers and the National LGBT Health Education Center, The Fenway Institute, Fenway Health, 2012  Download PDF

This two-page brochure offers a brief overview of LGBT people and their health needs written specifically for governing board members of community health centers. Action steps for change are also included.

 

 

 

This brochure is also available in Spanish! (Updated September 2014)

 

 

 

 

 

 

 

 

 


 

 

Promoting Human Papilloma Virus Vaccine To Prevent Genital Warts and Cancers

The Fenway Institute, 2012  Download PDF

By John Trinidad, MPH

Human papilloma virus (HPV), one of the most common sexually transmitted infections, is preventable through a vaccine now recommended for all females and males age 11 to 26. However, vaccination rates remain low in the U.S., in part because only one-third of doctors prescribe the vaccine to eligible patients. HPV infection can lead to genital warts and certain types of cancer. This brief provides an analysis of the current state of HPV vaccination rates in the U.S., finding them lagging well behind other countries, where vaccination campaigns have been more successful.  The brief also describes barriers to vaccine uptake, and examines insurance coverage of HPV vaccine, including what vaccine guidelines mean for insurance coverage under the Affordable Care Act. The brief concludes with policy recommendations, including encouraging or mandating HPV vaccination through social institutions such as the military and publicly-funded universities; increasing vaccine delivery by providers and at STI clinics; reducing vaccine costs; and researching why there are gaps in HPV vaccine awareness and rates.

 

 


 

 

 

Improving the Health Care of Lesbian, Gay, Bisexual and Transgender (LGBT) People: Understanding and Eliminating Health Disparities

The National LGBT Health Education Center, The Fenway Institute, Fenway Health, 2012 Download PDF

By Kevin L Ard, MD, MPH, Brigham and Women’s Hospital, and Harvey J Makadon, MD, Director of the National LGBT Health Education Center, The Fenway Institute.

This document offers a brief but comprehensive overview of the major issues relevant to the health and health care of lesbian, gay, bisexual and transgender people. The authors discuss LGBT demographics, terminology, and concepts; they also review LGBT health disparities across the life span. Clinicians and health care organizations will learn steps they can take to improve access to patient-centered care for their LGBT patients, including collecting data on sexual orientation and gender identity, creating a welcoming environment and providing interventions that respond to LGBT disparities.

 


 

 

Why Gather Data on... (PDF Download)Why gather data on sexual orientation and gender identity in clinical settings

The Fenway Institute, Fenway Health, 2012 Download PDF

 

By Sean Cahill, PhD, Director of Health Policy Research, Judith Bradford, PhD, Co-chair and Director of the Center for Population Research in LGBT Health; Chris Grasso, Associate Director for Health Informatics and Data Services; and Harvey Makadon, MD, Director of the National LGBT Health Education Center.

This document explains why gathering data on sexual orientation and transgender identity will help health care providers and population researchers better understand LGBT people and their health needs. Collecting this data in medical records, particularly in electronic health records (EHRs), is consistent with key recommendations in Healthy People 2020, the 2011 Institute of Medicine report on LGBT health issues and research gaps, and the Affordable Care Act.

 

How to gather data... (Download PDF)How to gather data on sexual orientation and gender identity in clinical settings

Fenway Institute, Fenway Health, 2012 Download PDF

By Sean Cahill, PhD, Director of Health Policy Research, Judith Bradford, PhD, Co-chair and Director of the Center for Population Research in LGBT Health; Chris Grasso, Associate Director for Health Informatics and Data Services; and Harvey Makadon, MD, Director of the National LGBT Health Education Center.

This companion brief provides guidance on how to ask questions on patient registration forms and how clinicians can ask questions during medical visits. It addresses concerns about confidentiality with EHRs and other potential barriers to collecting data on LGBT identity.

 


 

 

MPOWERED: Best and Promising Practices for LGBT Tobacco Prevention and Control

The Network for LGBT Health Equity, Fenway Health, 2012  Download PDF

By Scout, PhD, Director, Network for LGBT Health Equity 

Every disparity population struggles with the lack of precedent for their work, the lack of scientific testing of tailored strategies, and the lack of acknowledgement for the undeniable wisdom built by years of work in a field. The resources needed to build a portfolio of evidence-based tobacco interventions are rarely available for disparity populations, creating a catch-22 whereby existing strategies that could perhaps become evidence-based tobacco interventions are not tested. The Network for LGBT Health Equity has reviewed the science to date and engaged in a yearlong process to build a document where existing strategies were subjected to rigorous review, and the best collected for dissemination resulting in a portfolio of evidence-based tobacco interventions for the Lesbian, Gay, Bisexual, and Transgender communities.

 

 

Patient Handouts

 

Do Ask, Do Tell: Talking to your provider about being LGBT

Do Ask, Do Tell Brochure Cover

June, 2013 Download PDF

Lesbian, Gay, Bisexual and Transgender (LGBT) people routinely face stigma and barriers to health care. Do Ask, Do Tell: Talking to your health care provider about being LGBT was developed to empower LGBT patients to “come out” to health care providers.  Being open and honest about sexuality and gender identity is important for improving individual health and allowing providers to deliver culturally responsive, cost-effective, patient-centered care.  There is space on the brochure to add your organization’s logo.  For information about obtaining copies for your organization, email lgbthealtheducation@fenwayhealth.org

 

 

 Spanish CoverAhora en Español! “Pregunte y dígalo: Hable con su proveedor deatención médica sobre ser LGBT”

Click here to download the Spanish version! 

 

 

 

 

 

 

In response to multiple requests, we have developed a poster to display in your health center that helps create a welcoming climate. This poster encourages patients to talk to their provider about being LGBT, and lets patients know that providers will welcome the conversation. The poster is available in English and Spanish!

 

DADT Poster

 

 

 

 

 

 

 

 

 

 

 

Protecting Yourself from HIV through Pre-Exposure Prophylaxis (PrEP): What You Need to Know

October, 2012 Download PDF

The Food & Drug Administration (FDA) recently approved the use of an HIV treatment medication for HIV-negative people at high risk of getting HIV through sexual exposure.  Known as “pre-exposure prophylaxis”—or PrEP—this medication is a once-a-day pill to be used in combination with condoms and other safer sex behavioral strategies to reduce risk.  Protecting Yourself from HIV through PrEP informs consumers about PrEP and how it works, as well as other ways they can work with their health care providers to protect themselves against HIV.

 

 

Breast Cancer Risk and Screening

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Managing Your Meds

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STDs and Men Who Have Sex with Men

Download PDF

 

Take Charge of Your Health!: Early Pregnancy

Download PDF

 

Take Charge of Your Health!: Exercise

Download PDF

 

Take Charge of Your Health!: Nutrition

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Take Charge of Your Health!: Sexual Health

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Take Charge of Your Health!: Smoking

Download PDF

 


 

Journal Articles

Ard, KL and Makadon HJ. Addressing intimate partner violence in lesbian, gay, bisexual and transgender patients. J Gen Intern Med. 2011 Aug;26(8):930-3. Epub 2011 Mar 30.

Bedoya CA, Mimiaga MJ, Beauchamp G, Donnell D, Mayer KH, Safren, SA. Predictors of HIV Transmission Risk Behavior and Seroconversion Among Latino Men Who have Sex with Men in Project EXPLORE. AIDS Behav. 2012 Apr;16(3):608-17.

Bradford J. The Promise of Outreach for Engaging and Retaining Out-of-Care Persons in HIV Medical Care. AIDS Patient Care and STDs. 2007;21(S1): s85-s91.

Cahill S, and Valadéz R. Growing older with HIV/AIDS: new public health challenges. Am J Public Health. 2013 Mar;103(3):e7-e15. Epub 2013 Jan 17.

Cahill S, Valadéz R, and Ibarrola S. Community-based HIV prevention interventions that combat anti-gay stigma for men who have sex with men and for transgender women. J Public Health Policy. 2013 Jan;34(1):69-81. Epub 2012 Nov 15.

Coleman S, Boehmer U, Kanaya F, Grasso C, Tan J, Bradford J. Retention Challenges for a Community-Based HIV Primary Care Clinic and Implications for Intervention. AIDS Patient Care and STDs. 2007 Sep;21(9):691-701.

Donnell D, Mimiaga MJ, Mayer K, Chesney M, Koblin B, Coates T. Use of non-occupational post-exposure prophylaxis does not lead to an increase in high risk sex behaviors in men who have sex with men participating in the EXPLORE trial. AIDS Behav 2010 Oct;14(5):1182-9.

Fessler, D, Makadon HJ, Mitty, J, Mayer, K. The 2010 Health Care Act and barriers to effective health promotion among men who have sex with men. Sexually Transmitted Diseases. 2012 Jun; 39(6):449-52.

Gamarel K, Reisner SL, Parsons J, Golub S. Perceived discrimination due to socioeconomic status is associated with psychological distress among a community-based sample of urban men who have sex with men (MSM) in New York City: Implications for mental health. APHA. 2011.

Hatzenbuehler ML, O’Cleirigh C, Grasso C, Mayer K, Safren S, Bradford J. Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment. Am.J Public Health. 2012 Feb;102(2):285-91.

Hatzenbuehler ML, O’Cleirigh C, Mayer KH, Mimiaga MJ, Safren SA. Prospective associations between HIV-related stigma, transmission risk behaviors, and adverse mental health outcomes in men who have sex with men. Ann Behav Med. 2011 Oct;42(2):227-34.

Herrick AL, Stall R, Goldhammer H, Egan JE, and Mayer KH. Resilience as a Research Framework and as a Cornerstone of Prevention Research for Gay and Bisexual Men: Theory and Evidence.  AIDS Behav. 2013 Jan 16. [Epub ahead of print]

Johnson CV, Mimiaga MJ, Bradford J. Health care issues among lesbian, gay, bisexual, transgender and intersex (LGBTI) populations in the United States: Introduction. 2008. J Homosex. 54(3):213-24.

Johnson CV, Mimiaga MJ, Reisner SL, VanDerwarker R, Mayer KH. Barriers and facilitators to routine HIV testing: perceptions from Massachusetts Community Health Center personnel. AIDS Patient Care STDS. 2011 Nov;25(11):647-55.

Kumta, S, Lurie M, Weitzen S, Jerajani H, Gogate, A, Row-kavi A, Anand, V, Makadon H, Mayer K. Bisexuality, sexual risk taking and HIV prevalence among men who have sex with men accessing voluntary counseling and testing services in Mumbai, India. J Acquir Immune Defic Syndr. 2010 Feb;53(2):227-33.

Makadon H. Primary care of gay men. Up to Date 2009, Version 14.2.

Makadon HJ, Bharucha F, Gavin M, Oliveira J, Wietecha. Value management: optimizing quality, service and cost. JHCQ. 2010;32:29-34.

Makadon HJ, Mayer KH, Garofalo R. Optimizing primary care for men who have sex with men. JAMA. 2006;296:2362-2365.

Makadon HJ. Ending LGBT invisibility in health care: the first step in ensuring equitable care. Cleve Clin J Med. 2011 Apr;78(4):220-4. Review.

Makadon HJ. Improving health care for the lesbian and gay communities. N Engl J Med. 2006;354:895-897.

Mayer KH, Goldhammer H, eds. Focusing on Sexual Health Promotion to Enhance Preventive Behaviors among Gay Men and other Men Who Have Sex with Men. AIDS Behav. 2011 Apr;15:S1-S8.

Mayer KH, Mimiaga M, VanDerwarker R, Goldhammer H, Bradford J. Fenway Community Health’s model of integrated community based LGBT care, education and research in Meyer I and Northridge M, eds. The Health Of Sexual Minorities – Public Health Perspectives On Lesbian, Gay, Bisexual And Transgender Populations. 2007. Springer. 693-715.

Mayer KH, Mimiaga MJ, Gelman M, Grasso C. Raltegravir, Tenofovir DF, and Emtricitabine for Postexposure Prophylaxis to Prevent the Sexual Transmission of HIV: Safety, Tolerability, and Adherence. J Acquir Immune Defic Syndr. 2012 Apr;59(4):354-9.

Mayer KH, Mimiaga MJ, Safren SA. Out of the Closet and Into Public Health Focus: HIV and STDs in Men Who Have Sex With Men in Middle Income and Resource-Limited Countries. Sex Transm Dis. 2010 Feb;37(4):205-7.

Mayer KH, Mimiaga MJ. Resurgent syphilis in the United States: urgent need to address an evolving epidemic. Ann Intern Med. 2011. Aug;155(3):192-3.

Mayer KH. Sexually transmitted diseases in men who have sex with men. Clin Infect Dis. 2011 Dec;53 Suppl 3:S79-83.

Mayer KM, Bradford JB, Makadon HJ, Stall R, Goldhammer H, Landers S. Sexual and gender minority health: what do we know and what needs to be done? AJPH. 2008;98:989-995.

McCauley H, Reisner SL,Falb K. Developmental differences in depression by sexual orientation in a sample of 2,555 high school students: Results from the 2007 Massachusetts Youth Risk Behavior Survey (MYRBS). APHA. 2011.

Mimiaga MJ, Goldhammer H, Belanoff C, Tetu AM, Mayer KH. Men who have sex with men: perceptions about sexual risk, HIV and sexually transmitted disease testing, and provider communication. Sex Transm Dis. 2007 Feb;34(2):113-9.

Mimiaga MJ, Johnson CV, Reisner SL, VanDerwarker R, Mayer KH. Barriers to routine HIV testing among Massachusetts community health center personnel. Public Health Rep. 2011 Sep-Oct;126(5):643-52.

Mimiaga MJ, Reisner SL, Goldhammer H, Tetu AM, Belanoff C, Mayer KH. Sources of human immunodeficiency virus and sexually transmitted disease information and responses to prevention messages among Massachusetts men who have sex with men. Am J Health Promot. 2010 Jan-Feb;24(3):170-7.

Patel, V, Mayer, K, Makadon, H. Men who have sex with men in India: A diverse population in need of medical attention. Indian Journal of Medical Research 2012 Oct; 136: 563-570.

Reisner S, Mimiaga M, Bland SE, Driscoll MA, Cranston K, Mayer KH. Pathways to Embodiment of HIV Risk: Black Men Who Have Sex with Transgender Partners, Boston, Massachusetts. AIDS Educ Prev 2012 Feb;24(1):15-26.

Reisner SL, Mimiaga MJ, Bland S, Skeer M, Cranston K, Isenberg D, Driscoll M, Mayer KH. Problematic alcohol use and HIV risk among Black men who have sex with men in Massachusetts. AIDS Care. 2010 May;22(5):577-87.

Reisner SL, Mimiaga MJ, Case P, Grasso C, O’Brien CT, Harigopal P, Skeer M, Mayer KH. Sexually transmitted disease (STD) diagnoses and mental health disparities among women who have sex with women screened at an urban community health center. 2007. Sex Transm Dis. 2010 Jan;37(1):5-12.

Reisner SL, Perkovich B, Mimiaga MJ. A mixed methods study of the sexual health needs of New England transmen who have sex with nontransgender men. AIDS Patient Care STDS. 2010 Aug;24(8):501-13.

Rosario M, Reisner SL, Carliss H, Wypij D, Frazier A, Austin S. Explaining disparities in depressive distress by sexual orientation among a cohort study of US emerging adults. 2011.

Rumptz M, Tobias C, Rajabiun S, Bradford J, Cabral H, Young R, Cunningham W. Factors Associated with Engaging Socially Marginalized HIV- Positive Persons in Primary Care. AIDS Patient Care and STDs. 2007;21 Suppl 1:s30-s39.

Safren SA, O’Cleirigh C, Skeer MR, Driskell J, Goshe BM, Covahey C, Mayer KH. Demonstration and evaluation of a peer-delivered, individually-tailored, HIV prevention intervention for HIV-infected MSM in the primary care setting. AIDS Behav. 2010 Jul;15(5):949-58.


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