“Being dealt with as a whole person.” Care seeking and adherence: the benefits of culturally competent care

Schilder, Arn J.; Kennedy, Cornelis; Goldstone, Irene; Ogden, Rüssel D.; Hogg, Robert S.; O’Shaughnessy, Michael V.

doi:10.1016/s0277-9536(00)00274-4

Cited by 102 publications

(78 citation statements)

References 20 publications

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“…Such programs may provide social role models who may be older and may have endured similar discrimination. Several qualitative studies have emphasized the importance of addressing discrimination within service delivery protocols (Bockting et al, 1998;Clements et al, 1999;Green, 1994;Lombardi and van Servellen, 2000;Nemoto et al, in press;Schilder et al, 2001). HIV prevention programs could also benefit from research involving transgendered youth participants and assessing the impact of exposure to transphobia during adolescence on HIV risk and health outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Exposure to Transphobia on HIV Risk Behavior in a Sample of Transgendered Women of Color in San Francisco

Sugano

Nemoto

Operario³

2005

AIDS Behav

151

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This study examined the relationship between exposure to transphobia--societal discrimination and stigma of individuals who do not conform to traditional notions of gender--and risk for engaging in unprotected receptive anal intercourse (URAI) among 327 transgendered women of color. Overall, 24% of participants had engaged in URAI at least once in the past 30 days. Individuals who self-identified as pre-operative transsexual/transgendered women were significantly more likely than self-identified females to have engaged in URAI. Although exposure to transphobia was not independently related to URAI, an interaction between age and experiencing discrimination was observed. Among transgendered women 18-25 years old, those reporting higher levels of exposure to transphobia had a 3.2 times higher risk for engaging in URAI compared to those reporting lower levels. Findings from this study corroborate the importance of exposure to transphobia on HIV risk, particularly among transgendered young adults.

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Section: Discussionmentioning

confidence: 99%

The Impact of Exposure to Transphobia on HIV Risk Behavior in a Sample of Transgendered Women of Color in San Francisco

Sugano

Nemoto

Operario³

2005

AIDS Behav

151

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“…10 LGB-specifi c services have been developed to overcome these defi ciencies 11 ; however, there is a pressing need for mainstream services to become culturally competent in this area. 12,13 We assert that such cultural competence should be LGB-specifi c rather than generic to overcome a tendency to disregard minority sexual orientation in clinical care. Many family physicians prefer to avoid stereotyping and remain neutral by ignoring numerous specifi c cultural attributes; as a result, crucial differences that infl uence health are missed.…”

Section: Pr Im a Ry C A R E O F Lgb Peopl Ementioning

confidence: 99%

Guidelines for the Primary Care of Lesbian, Gay, and Bisexual People: A Systematic Review

McNair¹,

Hegarty²

2010

The Annals of Family Medicine

113

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PURPOSEWe assessed whether existing guidelines for the primary care of lesbian, gay, and bisexual (LGB) people meet appropriate standards of developmental rigor, and whether they provide consistent recommendations useful for primary care clinicians. METHODSWe performed a systematic review of such guidelines using the Cochrane Collaboration method. The countries searched were Australia, Canada, Ireland, New Zealand, the United Kingdom, and the United States. For sources, we used electronic databases, guidelines databases, primary care professional organizations, government departments of public health, LGB health care textbooks, and national LGB organizations. We assessed the quality of existing guidelines using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) instrument and compared the recommendations from all fully appraised guidelines. RESULTSOur search did not identify any previous systematic reviews on primary care of LGB people. Of 2,421 documents identifi ed, we initially reviewed 30 and fully appraised 11, none of which completely satisfi ed the AGREE criteria for quality and only 2 of which were specifi cally designed for primary care. Developmental rigor was poor. Particular gaps were a lack of explicit inclusion criteria, independent reviewers, and updating procedures. Nonetheless, we did identify several consistent recommendations pertinent to primary care settings: guidance on inclusive clinical environments, standards for clinician-patient communication, sensitive documentation of sexual orientation, knowledge for cultural awareness, staff training, and addressing population health issues.CONCLUSIONS Currently available guidelines for LGB care are philosophically and practically consistent, and provide a degree of evidence-based clinical and systems support to primary care clinicians. There is a need, however, for evidencebased LGB guidelines that are more rigorously developed, disseminated, and evaluated specifi cally for the primary care setting.

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“…[1][2][3] Federal clinical guidelines recommend that all people living with HIV/AIDS (PLWHA) see an HIV health care provider to monitor their clin-ical status at least once every 3-6 months, and more frequently depending on medication regimen and disease progression. 4 However, many PLWHA do not receive this level of care and thus cannot benefit from current advances in treatment.…”

Section: Introduction Rmentioning

confidence: 99%

“Getting Me Back on Track”: The Role of Outreach Interventions in Engaging and Retaining People Living with HIV/AIDS in Medical Care

Rajabiun

Mallinson

McCoy

et al. 2007

AIDS Patient Care and STDs

100

108

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This qualitative study investigated the process of engagement in HIV medical care from the perspective of people living with HIV/AIDS (PLWHA). In-depth interviews were conducted with 76 participants in six cities. All participants were considered underserved because of histories of substance use, mental illness, incarceration, homelessness, or cultural barriers to the traditional health care system. A semistructured interview guide elicited narratives related to health care and the role of program interventions in facilitating access to care. Data analysis revealed that participants cycled in and out of care, a process that was influenced by (1) their level of acceptance of being diagnosed with HIV, (2) their ability to cope with substance use, mental illness, and stigma, (3) their health care provider relationships, (4) the presence of external support systems, and (5) their ability to overcome practical barriers to care. Outreach interventions played a role in connecting participants to care by dispelling myths and improving knowledge about HIV, facilitating access to HIV care and treatment, providing support, and reducing the barriers to care. The findings suggest that outreach programs can interrupt this cyclical process and foster sustained, regular HIV care for underserved PLWHA by conducting client-centered risk assessments to identify and reduce sources of instability and improve the quality of provider relationships; implementing strategies that promote healthy practices; creating a network of support services in the community; and supporting adherence through frequent follow-ups for medication and appointment keeping.

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“Being dealt with as a whole person.” Care seeking and adherence: the benefits of culturally competent care

Cited by 102 publications

References 20 publications

The Impact of Exposure to Transphobia on HIV Risk Behavior in a Sample of Transgendered Women of Color in San Francisco

The Impact of Exposure to Transphobia on HIV Risk Behavior in a Sample of Transgendered Women of Color in San Francisco

Guidelines for the Primary Care of Lesbian, Gay, and Bisexual People: A Systematic Review

“Getting Me Back on Track”: The Role of Outreach Interventions in Engaging and Retaining People Living with HIV/AIDS in Medical Care

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