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The 2009 National LGBT Health Summit

With President Obama’s efforts to reform health care dominating the headlines in recent weeks, it was with great anticipation that I attended the 2009 National LGBTI Health Summit in Chicago from August 14 18.

Over the course of the summit, dozens of workshops were held, as well as plenary panels and group discussions.  Presenters described cutting edge research on a variety of subjects that included HIV and safe sex, spirituality, activism, substance abuse, mental health, cancer, and the arts.  With so many activities being held simultaneously, I was unable to attend every workshop I was interested in, but here are some of the highlights that left a major impression on me as I returned to Nashville. 

One of the most controversial topics was the use of PrEP, Pre-Exposure Prophylaxis for HIV prevention.   This is an experimental strategy in which HIV-negative individuals  take antiretroviral drugs prior to engaging in unprotected sex.   Clinical trials are currently underway to gauge its effectiveness, but there is already a thriving underground market for gay men unwilling to wait for the government’s approval before procuring the drugs.

As you may expect, people had very emotional reactions to PrEP.  Some were concerned that the success of PrEP could hasten the end of safe sex education as we currently know it, as condoms would be rejected in favor of PrEP.   Others expressed doubts about the role of pharmaceutical companies in advancing PrEP, as its approval would create new markets (and profits) for existing drugs.

After hearing impassioned statements from supporters and detractors of PrEP, my fear is that it will exacerbate class tensions among gay and bisexual men, as condom users might be seen as “too poor for PrEP.”   Nonetheless, I believe PrEP is worth investigating, because the fact of the matter is that many bisexual and gay men are not using condoms, and anything that may reduce the rate of HIV transmission deserves serious consideration.  

I was very pleased to see a number of workshops dealing with the spiritual and emotional health of the LGBT community.  In my experience, many of the high risk and unhealthy  behaviors I’ve observed among LGBT people are rooted in a sense of feeling inferior to heterosexuals due to messages we receive from our cultural and ethnic communities about “proper” gender roles and religious upbringing.  A researcher from Arkansas, Karyl Lounsbery, produced a study that detailed the ways in which LGBTs experience prejudice within religious institutions, and the impact it has on our spiritual beliefs.  It was fascinating work and I am sure we will be hearing more about it in the future.  

Finally, we must begin addressing the health of older LGBTs.  As I have mentioned in previous columns, some of the fastest-growing rates of HIV infection are among gay men over the age of 50.  In addition to the concern over new infections, and the general health concerns facing older people like diabetes, heart disease, and hypertension, aging in the LGBT has unique features that deserve our attention.  

Gay life is generally portrayed as the domain of the young, but the Stonewall generation is approaching retirement, and we need to consider how we will support them in their later years.   Ensuring that long term care facilities are sensitive to the needs of LGBTs is critically important, as most of us do not have children we can rely on for care in our old age.  Some of the stories I have heard about older LGBTs forced to return to the closet once they were no longer able to live independently are heartbreaking.  Where was the support of the people who had benefitted from their trail-blazing paths? That kind of social exclusion is unacceptable for a group that prides itself on being a community.

The overall message I took away from the LGBTI Health Summit is how important it is that we assume responsibility for our collective health over the course of our lives.  As individuals, we need to make the healthiest choices for ourselves, but our health is a community-wide concern.  Not only do we need to be responsible for our elders, we must also offer a helping hand to rising  generations of LGBTs.  There was much discussion about the need for mentoring and providing role models for LGBT youth, many of whom are destined to repeat our mistakes if we fail to impart our knowledge and experience. 

As LGBTs, we face many challenges, but I am excited about the future of LGBT health! The next summit will be held in 2011.  Hopefully I will see you there.  

From “Blackout” for 8/24/09 by Anthony Rucker

 

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