Filed under: News
From the Pittsburgh Post Gazette…
African-American men who have sex with other men typically are more conservative in sexual behavior than gay men in general. So why are they far more likely to contract HIV/AIDS?
“Generally, they take far fewer risks than white guys. They are much more conservative than gay men in general. But it’s a 30-year-long epidemiological puzzle,” said Ron Stall, in the department of behavioral and community health sciences at the University of Pittsburgh Graduate School of Public Health. “Where’s all the virus coming from? If you can’t answer that question, you can’t do HIV prevention.”
The graduate school and the Center for Black Equity in Washington, D.C., now hope to answer that question. They’ve landed a $3.2 million grant through the National Institute of Nursing Research at the National Institutes of Health to answer the question and help put the brakes on the national epidemic of human immunodeficiency virus and the deadly disease that HIV causes — acquired immune deficiency syndrome, known as AIDS. The research team plans to survey nearly 6,000 African-American men who attend annual Black Gay Pride events in Atlanta, Chicago, Los Angeles, Philadelphia and Washington, D.C., which draw about 300,000 participants annually.
“We will bring the community, and Pitt will bring the science,” said Earl Fowlkes, president and CEO of CBE. “We hope to get answers to help both institutions and all of society. This is the most important thing we’ve done in the history of our organization.” The study will create the largest sample of HIV-related data ever collected from African-American MSM, “and that will yield important data about the health and well-being of our community,” Mr. Fowlkes said.
Read more: http://www.post-gazette.com/
February 13, 2014
Only one-half of 1 percent of studies funded by the National Institutes of Health (NIH) between 1989 and 2011 concerned the health of lesbian, gay, bisexual and transgender (LGBT) people, contributing to the perpetuation of health inequities, according to a University of Pittsburgh Graduate School of Public Health-led analysis.
The findings, which grew from the Fenway Institute’s Summer Institute in LGBT Population Health in Boston and continued at Pitt Public Health’s Center for LGBT Health Research, are in the February issue of the American Journal of Public Health, published today. The researchers make several recommendations for how to stimulate LGBT-related research.
“The NIH is the world’s largest source of health research funding and has placed a low priority on LGBT health research,” said Robert W.S. Coulter, M.P.H., a doctoral student in Pitt Public Health’s Department of Behavioral and Community Health Sciences. “In general, LGBT people experience stigma associated with their sexual and gender minority status, disproportionate behavioral risks and psychosocial health problems, and higher chronic disease risk factors than their non-LGBT counterparts. Increased NIH funding for research on these topics, particularly focusing on evidence-based interventions to reduce health inequities, could help alleviate these negative health outcomes.”
About 3.5 percent of the U.S. adult population is estimated to be gay, lesbian or bisexual, according to recent research based on national- and state-level population surveys.
Mr. Coulter and his colleagues found 628 NIH-funded studies concerning LGBT health between 1989 and 2011, accounting for 0.5 percent of all NIH-funded studies. The majority of those studies focused on HIV/AIDS and other sexual health matters. When those studies were excluded, there were only 113 LGBT-related studies remaining, or 0.1 percent of NIH-funded studies during this time period.
After analyzing those studies, Mr. Coulter’s research team found further gaps within the 628 LGBT-related studies, with 86.1 percent concerning the health of sexual minority men, only 13.5 percent focused on sexual minority women and 6.8 percent focused on transgender populations, with some of the projects studying more than one subgroup.
The authors also found that there were 202 projects on the development, implementation or evaluation of interventions. When intervention studies concerning HIV and other sexual health matters were removed, the number of projects dropped to 21.
“Studies have shown that specific subgroups of LGBT populations experience health problems like tobacco use, violence and obesity at higher rates than their non-LGBT counterparts. Thus, the lack of intervention studies aimed at reducing these health disparities contributes to the perpetuation of health inequities among LGBT populations,” said Mr. Coulter.
He added that, “The political climate has had a chilling effect within the NIH that constrains LGBT health research and appears to be responsible, at least in part, for the marginalization of LGBT research at the NIH.”
Mr. Coulter and his colleagues noted that a 2003 request by some Republican members of Congress for the NIH to justify the benefits of nearly 200 projects, most of which investigated LGBT or other marginalized populations, was followed by more than half of the researchers leading those studies removing words from their study proposals that might be deemed controversial, such as “gay,” “lesbian,” “bisexual” and “AIDS.” A smaller proportion of researchers completely dropped their LGBT-related studies, with some even changing careers. The research by Mr. Coulter and colleagues showed a substantial drop in LGBT-related projects at NIH during these years as well.
Mr. Coulter and his colleagues believe that NIH is on the path toward lessening the dearth of LGBT-related research. In 2012, NIH supported a workshop about sexual orientation and gender identity in electronic health records and encouraged professional development activities related to LGBT health.
To more efficiently stimulate research projects on LGBT health, the researchers recommend the NIH engage in the following practices to comprehensively address the problem:
- Establish policies that designate LGBT people as priority populations for research that goes beyond HIV/AIDS and sexual health issues.
- Increase evidence-based intervention research to improve LGBT and reduce health inequities.
- Explore new strategies to increase the amount of LGBT health research, including support for diversity among researchers.
- Support efforts to expand the pool of trained researchers prepared to propose LGBT research projects through training grants, fellowships, career awards and the establishment of LGBT Centers of Excellence.
January 15, 2014
From Pittsburgh’s NPR radio station:
According to Dr. Ron Stall, director of the Center for LGBT Health Research at the University of Pittsburgh’s Graduate School of Public Health, the dearth of investment in sexual health research, especially for the LGBT community, is something of an American tradition. Primarily due to the hot-button nature of conversations about sexuality and sexual practices, “the US has been slow to invest in sexual health in general.”
This additional roadblock makes the advances that have been made in the treatment of sexually transmitted diseases such as HIV all the more impressive. According to Stall, thanks to breakthrough drug research, HIV “has now become a chronic manageable disease much like diabetes,” for those who are aware of their illness and have access to drugs.
“When historians write about this epidemic, they’ll be impressed.” Stall says. Still, members of the LGBT community are disproportionately affected by the disease and the complications that come with it. According to Dr. Stall, the center for LGBT health research seeks to go deeper than treatment, and is focused on understanding why the health disparities exist. Stall notes that mental health, substance abuse issues, and the health of the individuals relationships all have a serious impact on the risk of contracting HIV. And determining how these issues factor in can help prevent transmission of the disease going forward. One of the biggest challenges facing the center is, as it has always been, chronic under-funding. “There’s no question that the funding is not commensurate with the proportion of Americans that are LGBT.” Stall states. “There needs to be a structural change in how this work is funded.”
Listen to the radio interview here.
July 23, 2013
Dr. Howie Lim has been an esteemed student and valued colleague at the Center for LGBT Health Research for several years now. Howie took his doctorate from the Graduate School of Public Health at Pitt in 2008; his dissertation focused on patterns of health and illness among aging MSM in the MACS. After leaving Pitt, Howie took positions in Singapore and his home country of Malaysia where he has continued research in health issues among MSM. Everyone at the Center is delighted by the recognition of Dr. Lim’s work through his receipt of this prestigious joint award from the International AIDS Society and the (US) National Institute on Drug Abuse. We look forward to continued collaborations with Dr. Lim as he continues to develop his research agenda!
July 11, 2013
From Pittsburgh’s City Paper:
In the world of LGBT health, Dr. Ron Stall has identified what he calls “the knee and the navel problem.”
For years, studies and subsequent funding for studies revolved around HIV transmission and sexually-transmitted diseases. “Everything in LGBT health, the whole scientific agenda, is to study the area between the knee and the navel,” says Stall, director of the Center for LGBT Health Research at the University of Pittsburgh’s Graduate School of Public Health. “There are multiple health conditions that affect LGBT populations. We sort of know the prevalence rates — how common they are — but that’s about it. And we certainly don’t know how to stop them.”
Therein lays the focus of Pitt’s Center for LGBT Health Research. Among the work of researchers involved with the center include studying the higher rates of substance use, depression, experience of stigma and discrimination among the bisexual and transgender, to studying young men who have sex with men and how some overcome adversity and achieve positive health outcomes.
The Center started about a year ago and is a rebirth of sorts of Pitt’s Center for Research on Health and Sexual Orientation, which started in the 1990s.
Read the full article on City Paper’s Website.
July 11, 2013
From Scout, Ph.D.
Director, The Fenway Institute’s Network for LGBT Health Equity
I’ve had the pleasure for the last few days to be brainstorming with a bunch of other LGBT scientists at the very top of a crazy beautiful building at University of Pittsburgh, their Cathedral of Learning. Our host is Dr. Ron Stall and all the other members of the Center for LGBT Health Research at Pitt. I always love hanging out with a herd of pointy-headed folk, and this group is as pointy as it gets. The ideas are challenging, interesting, and always thought provoking. As the headline gave away, we’re brainstorming on what we’re fondly calling: “A love letter to future generations of LGBT health researchers” aka a textbook on how to do LGBT health research. Thanks to Ron & everyone at Pitt for convening us and shepherding this idea, because I feel like the longer we talk about what we really want the next generation to know, the more we realize how much there is to tell them. How to get LGBT measures added to surveillance instruments. How to make sure studies funding for one topic (say, oh HIV) create findings on other health priorities (like oh say, smoking!). How to disseminate research findings not just to elite academic journals, but also to communities.
To read more, go to Dr. Scout’s LGBT Health Equality Network blog.
Summer Institute brainstorms atop the Cathedral of Learning
June 25, 2013
From The Atlantic online:
University of Pittsburgh medical anthropologist Ron Stall and his colleagues have identified four interconnected “epidemics” of psychosocial health conditions among urban gay and bisexual men, each magnifying the others: childhood sexual abuse, partner violence, depression, and drug use. Together, their insidious effects are called “syndemics.”
“Something horrible is happening during adolescence to young gay men,” Stall told me in a 2010 interview for my book Victory Deferred. “These young men don’t understand what’s happening to themselves. There’s no community. Sometimes if the ‘sissy boy’ goes to dad to tell about getting beat up on the playground, he risks being beaten up by his dad. That kind of experience has got to be searing, and leaves scars on gay men.”
Read more on The Atlantic Website.
February 21, 2013
In March 2011, the Institute of Medicine issued its report of the NIH commissioned study on The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding . At that time, I asked the NIH institutes, centers, and offices (ICOs) to form the NIH LGBT Research Coordinating Committee (RCC). I charged this committee to consider carefully the report’s recommendations and to suggest strategies for how the ICOs can support research to increase the knowledge base for promoting the health of the LGBT community. I am pleased to say that the RCC has fulfilled their charge. I thank them for their thoughtful analysis of the NIH portfolio on LGBT research and for identifying several important opportunities for promoting research and knowledge in LGBT health. The NIH is now developing a multi-pronged plan to implement a number of these opportunities to extend and advance the knowledge base for promoting LGBT health.
Francis S. Collins, M.D., Ph.D. Director, National Institutes of Health
January 7, 2013
From the Gay and Lesbian Medical Association news:
Health and Human Services Secretary Kathleen Sebelius announced the Department’s 2012 objectives aimed at improving the health and well-being of LGBT Americans. Included in the nine objectives, detailed in a report by the HHS LGBT Issues Coordinating Committee, are initiatives aimed at reducing obesity in lesbian and bisexual women and preventing tobacco use among LGBT youth and young adults. Additionally, the Health Services and Resources Administration (HRSA) will award up to eight grants to organizations to connect transgender women of color with HIV prevention and care services, National Institutes of Health will release a report that identifies the gaps and opportunities in its research portfolios in light of the recommendations from the 2011 Institute of Medicine report and Substance Abuse and Mental Health Services Administration and HRSA will develop a plan to disseminate existing tools to behavioral health and primary care practitioners to help them assess, treat and refer LGBT clients in a culturally competent manner. To read more about the objectives, please click here.
June 25, 2012