This report--describing the first national quality improvement collaborative focused on providing culturally affirming care for LGBT people--finds that making primary care practices more LGBT-friendly and inclusive may improve STD and HIV screening rates among this vulnerable population. The goal of the Transforming LGBT Care program was to help highly motivated community health centers implement LGBT-affirming care by providing infrastructure for training, collaboration, knowledge sharing, leadership buy-in and practice change. Ten federally qualified health centers were selected to participate in the year-long program. Small care teams were formed at each site, and those teams received coaching, training and facilitation from the program's staff, much of which was conducted virtually. By the end of the program, estimated HIV screening of LGBT patients at eight of the reporting sites rose from 14.8 percent to 30.5 percent, with increases in STD screenings as well. Most participating centers had improved their electronic health record system to allow for sexual orientation and gender identity documentation, but very few reported improvements in documenting the sexual histories of LGBT patients. The authors of the program's quality improvement study note, "Ultimately, federally qualified health centers and other primary care organizations have an opportunity and a responsibility to provide equitable care to people of all sexual orientations and gender identities. Even small changes to health care practices may make a large difference for people burdened by health disparities and discrimination."
Transforming Primary Care for Lesbian, Gay, Bisexual, and Transgender People: A Collaborative Quality Improvement Initiative
Bruce W. Furness, MD, MPH, et al
Centers for Disease Control and Prevention, Atlanta, Georgia