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Group Interview Project

The Center: Lesbian Gay Bisexual and Transgender + Health

Jorge Beltran, Jason Do, Schyler Sullivan, Kate Vang, Audrey Vo

Health Science 435 Section 03, Professor A. Johnson

California State University, Long Beach — Fall 2018

15 November 2018
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The Center: Lesbian Gay Bisexual and Transgender + Health

Improving Lesbian, Gay, Bisexual and Transgender (LGBT+) health is one of the

newest objectives added to the Healthy People 2020 topics, which regards all communities

that celebrate diversity in sexuality and identity (U.S. Department of Health and Human

Services, 2014). Allied movements in the past have narrowed disparities, shortening the gap

for exercising basic human rights between the LGBT+ community and the general

population. A new disparity has emerged in health. The LGBT+ population collectively has

a lower health status in comparison to heterosexuals caused by social exclusion, oppression

and prejudice (CDC, 2016). In an effort to close the gap of health disparities between the

LGBT+ population and other groups, The Center located in Long Beach arranges health

promotion programs in order to provide a long healthy life for every LGBT+ person they can

reach (I. Salamanca, personal communication, November 5, 2018).

Background and Description

Our group had the privilege of interviewing the Director of Health Services, Ismael

Salamanca to gather information on the organization. The Center’s mission is to engage,

empower, and advocate to achieve a more equitable society and foster an ever-improving

quality of life for the LGBT+ community. Salamanca described the organization’s main goal

is to provide a long healthy life for every LGBT+ person in the Long Beach community. The

organization officially started in 1980 by the name of “One.” In 1997, the name was then

changed to “The Gay and Lesbian Center of Greater Long Beach.” The last name change

occured in 2014 to present day name: The Center. The LGBT+ community is hesitant to seek

health care because of historic tendencies for health care settings to be hostile towards them;

discriminatory behaviors from homophobic doctors and transphobic nurses. The Center was

created to provide a safe place for individuals of this community (I. Salamanca, personal

communication, November 5, 2018)

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Health Problems

It is clear that the LGBT+ community faces higher prevalence of certain diseases and

health problems than other populations. The hostility that they face in health care settings as

well as the discrimination throughout their daily lives contribute to higher rates of psychiatric

disorders, substance abuse, and suicide (U. S. Department of Health and Human Services,

2014). Individuals of this community are also more likely to experience violence and

victimization, which has long-lasting effects on the individual and the community. The

LGBT+ community has higher rates of HIV and other STIs, and higher rates of smoking,

depression, and anxiety. Compared to their heterosexual counterparts, individuals of the

LGBT+ community are more than twice as likely to smoke, experience more depression and

anxiety, and more likely to commit suicide (National LGBT Health Education Center, 2016).

Problems that Salamanca identified that The Center specifically faced were chlamydia and

gonorrhea, which they helped alleviate with the treatment sessions they provide on Tuesdays

and Thursdays along with additional screening resources.

Funding Source

The LGBT+ Center of Long Beach’s main source of funding are donations from

different organizations that support their cause as well as personal donations from individuals

looking to support the LGBT+ community. This organization does not receive any state or

federal funding. The Center provides different organization campaign events in order to

increase support and raise money. The most recent event was the “Aids Walk Long Beach,”

which is a community event that raised millions of dollars to support individuals struggling

with HIV (I. Salamanca, personal communication, November 5, 2018). The funds raised help

support different prevention services like free condoms, HIV and STI testing, food and

medication support, case management and social support groups. Sponsors also provide
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funds that have helped The Center grow in the past few years. These organizations include:

HereTV, California Institute of Contemporary Arts, and Mark Schneider Fine Jewelry.

Health Promotion Methods

The Center provides free rapid-HIV and STI screenings and forms of preventative

care with Post-Exposure Prophylaxis (PEP) and Pre-Exposure Prophylaxis (PrEP), which

lower the risk of contracting HIV. Other prevention methods include providing free

vaccinations for meningitis and Hepatitis-B. The Center also provides mental health

counseling for trauma, domestic violence, anxiety and depression. The stress of legal

pursuits can have detrimental effects on overall health and in order to lower the stress, The

Center provides free consultations for legal advice. Social support group meetings for

LGBT+ parents, intimate partner violence survivors, coming out and transgender support,

alcoholics anonymous meetings, living with HIV AIDS, and grief and loss support are also

hosted by The Center (I. Salamanca, personal communication, November 5, 2018).

Barriers and Challenges

Various barriers can arise for members of the LGBT+ community when accessing

health care, including misbelief regarding costs, physician’s maltreatment, and funding

services. According to Pinkerton, Bogart, Howerton, Snyder, Becker & Asch (2010), the

average cost of rapid-HIV testing and counseling for HIV-negative patients is a little over

$48, and $64 for HIV-positive patients. Although The Center provides free rapid-HIV testing

and counseling, members of the community hold false belief on medical costs leading to the

refusal of attendance. Furthermore, physician maltreatment has occurred in the past resulting

in long-term fear of discriminatory behavior for future patients (Albuquerque et al., 2016). In

addition to the possible discrimination, The Center experiences difficulty with younger

members regarding their HIV status. Because the younger members of the LGBT+

community are less inclined to visit, determining accurate HIV rates becomes difficult. This
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can grow into a larger issue for those unaware of the immediate and long-term dangers for

HIV.

Evaluation Methods

To evaluate if their health promotion methods are effective, The Center records data

on local individuals who receive services. This is done by assigning individuals with a

unique identification number that is used to track the who, what, when, and how often

services are used. Salamanca also emphasized that proper LGBT+ cultural competence

training is essential to making sure individuals return for more services. Cultural competence

is difficult to evaluate because it measures the way staff and volunteers interact with the

community but every individual who comes in to receive services gets an opportunity to fill

out a short questionnaire. Questions measure how likely they are to recommend the

organization, if they are likely to return, if they felt comfortable with the staff, identity

questions about age and ethnicity and if they needed further information or had any

questions.

Recommendations

Parents, Friends and Families of Lesbians and Gays (PFLAG) is another organization

dedicated to providing health promotion methods to the LGBT+ community. A unique

distinction from The Center however, is the form of evaluation that PFLAG uses. PFLAG

contacts clinics and schools in their area after implementing an intervention to record data on

services used or data regarding rates of sexually transmitted infections (PFLAG, 2018). The

Center may benefit from this health evaluation. Regarding HIV testing, The Center may be

able to attract more walk-ins and increase the chances of someone donating into their

donations jar at the front desk if they would advertise their rapid HIV tests. History has

shown that individuals prefer rapid HIV tests as opposed to tests that require a waiting period

before receiving the results (CDC, 2018). The CDC also recommends making an
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appointment for a new check-up before leaving for individuals who are sexually active and at

high risk in order for them to continue seeking services and be aware of their status (2015).

This would increase possible revenue and foot traffic. The Center can also partner with local

schools such as California State University, Long Beach and provide internships or volunteer

opportunities that will meet graduating criteria. Considering that The Center is run mostly on

volunteers and interns, this would involve more community members and more opportunities

for The Center to reach a wider community (Hopkins, Meyer, McLennan, Sharp & Sheffield,

2012). A recommendation for other organizations that are dedicated to diminishing the

health disparities in the LGBT+ community should follow in the footsteps of The Center in

ensuring all staff and volunteers receive appropriate cultural competence training. The

Center should continue leading the way for clinics and facilities that provide services to the

LGBT+ community in providing LGBT+ cultural competence to their staff and volunteers in

order for patients to return and continue receiving health services (I. Salamanca, personal

communication, November 5, 2018).

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References

Albuquerque, G. A., Garcia, C. D. L., Quirino, G. D. S., Alves, M. J. H., Belém, J. M.,

Figueiredo, F. W. D. S., Paiva, L. D. S., … & Adami, F. (2016). Access to health

services by lesbian, gay, bisexual, and transgender persons: Systematic literature

review. BMC International Health and Human Rights, 16(2). doi: 10.1186/s12914-

015-0072-9.

Centers for Disease Control and Prevention. (2016). Gay and bisexual men’s health.

Retrieved from https://www.cdc.gov/msmhealth/stigma-and-discrimination.htm.

Centers for Disease Control and Prevention. (2015). HIV infection: Detection, counseling and

referral. Retrieved from https://www.cdc.gov/std/tg2015/hiv.htm.

Centers for Disease Control and Prevention. (2018). HIV testing in clinical settings.

Retrieved from https://www.cdc.gov/hiv/testing/clinical/index.html.

Hopkins, K., Meyer, M., McLennan, W., Sharp, J. & Sheffield, K. (2012). Increasing both

organizational and client capacities during tough economic times: An examination of

the consumer and incentive-based ambassador volunteer program. Journal of

Community Practice, 20(3), 317-335.

http://dx.doi.org/10.1080/10705422.2012.700183

National LGBT Health Education Center. (2016). Understanding the health needs of LGBT

people. Retrieved from https://www.lgbthealtheducation.org/wp-content/uploads/LGB

THealthDisparitiesMar2016.pdf.

Parents, Families and Friends of Lesbians and Gays. (2018). Cultivating respect: Safe

schools. Retrieved from

http://www.pflag.org/publication/toptenwaystomakeschoolssafe
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Pinkerton, S., Bogart, L., Howerton, D., Snyder, S., Becker, K., & Asch, S. (2010). Cost of

rapid HIV testing at 45 U.S. hospitals. AIDS Patient Care and STDs, 24(7), 409-13.

doi: 10.1089/apc.2009.0348.

U. S. Department of Health and Human Services. (2014). Lesbian, gay, bisexual, and

transgender health. Healthy People 2020. Retrieved from

https://www.healthypeople.gov/2020/topics-objectives/topic/lesbian-gay-bisexual-

and-transgender-health.