Stigma and discrimination negatively impact access to HIV prevention for lesbian, gay, bisexual and transgender populations in the Caribbean
A. Radix1,2, J. Didier2,3, V. Cenac2,3
1Columbia University, Mailman School of Public Health, New York, United States, 2Caribbean Vulnerable Communities, Kingston, Jamaica, 3AIDS Action Foundation, Castries, Saint Lucia
Issues: Few Caribbean-based HIV prevention programs have targeted the LGBT community, due to high levels of societal stigma and legislation that criminalizes same-gender sexual activity. The health care experiences of the lesbian, gay, bisexual and transgender community in the Caribbean are not well understood. Understanding the interplay of sexual minorities with health care systems and medical professionals is essential to designing targeted prevention programs.
Description: Members of the LGBT community in St. Lucia were interviewed to gain insight into their experiences of homophobia within the medical profession, ability to access sensitive and knowledgeable medical providers and to truthfully disclose issues related to sexual orientation and sexual behaviors. In addition they were questioned about issues related to personal safety and victimization within the community.
Lessons learned: 31% of LGBT persons had not disclosed their sexual orientation to their primary care provider. Only 6% had been able to access providers who were sensitive to the needs of LGBT persons. 44% were not able to discuss health related needs in an open and honest manner and only one-third knew of the existence of an LGBT-sensitive medical provider. 88% had experience physical or verbal abuse due to their sexual orientation or gender identity. When questioned about access to LGBT specific HIV prevention materials, only 57% had access to materials. < 15% of MSM were aware of the availability of post-exposure prophylaxis.
Next steps: Implementation of LGBT sensitivy training to improve cultural competency of health care providers and decrease stigma in health care environments is essential and will be included in furture HIV prevention, treatment and care programs.