East Bay HIV/STI Case Management Manual

Author: Maurice Tobin

The LGBTQ community requires special consideration due to unique health disparities, discrimination, and social stigmas that can affect their access to and quality of care. Understanding and addressing these specific needs is essential for providing effective and compassionate case management.

Case managers should keep in mind several key factors when providing inclusive services and care for the LGBTQ community. Many individuals in this community face significant challenges, including discrimination, isolation, housing and food insecurities, and struggles with substance use. Some may also experience mental and/or physical abuse and trauma. That’s why it’s essential to be aware of the services available to support them and ensure they are approached in a gender-neutral and affirming way. 

Gender-affirming care is crucial to making clients feel understood and respected. It’s important to understand how someone identifies, as men who have sex with men (MSM) and trans-identifying individuals are among those most disproportionately affected by HIV. By providing compassionate, inclusive care, case managers can play a critical role in helping to reduce these disparities and create a safer, more supportive environment for LGBTQ clients.

When working with the LGBTQ community, it’s so important for case managers to approach things with cultural understanding. Take the time to really know your target population and the resources available to them—it makes all the difference. Take the time to explore and address any personal biases or judgments. The last thing you want is for someone to feel like they can’t open up to you or share what they’re going through because they’re afraid of being judged. 

Everyone’s journey is different, and it’s important to recognize that. It can also be incredibly helpful to have people in case manager roles who either identify with or truly understand the experiences of the LGBTQ community. By being compassionate and open, you can help create a space where clients feel safe, understood, and supported.

Examples/practical applications

1. Cultural competency and training: Staff and volunteers should undergo regular training on LGBTQ issues, including the use of correct pronouns, understanding gender identity, and recognizing the specific health and social needs of LGBTQ clients.

Example: Implementing a mandatory cultural competency training program for all case managers, with modules on LGBTQ-specific issues, updated regularly to reflect current best practices.

2. Creating safe spaces: Establishing safe, inclusive environments where LGBTQ individuals feel respected and supported. This includes ensuring clinics, shelters, and other service centers have clear anti-discrimination policies.

Example: Partnering with local LGBTQ organizations to designate specific shelters as LGBTQ-friendly and ensuring these shelters have staff trained in LGBTQ cultural competency.

3. Gender-affirming care: Providing access to healthcare services that affirm the gender identity of the client. This includes hormone therapy, mental health support, and other gender-affirming treatments.

Example: Collaborating with healthcare providers to create a referral network for gender-affirming care and ensuring clients are aware of these resources.

4. Comprehensive sexual health services: Offering comprehensive sexual health services, including PrEP and PEP for HIV prevention, STI testing and treatment, and sexual health education.

Example: Hosting regular sexual health clinics in collaboration with local health departments and LGBTQ health organizations.

5. Addressing mental health needs: Providing access to mental health services that are sensitive to the unique experiences of LGBTQ individuals, including trauma-informed care.

Example: Establishing partnerships with mental health professionals who specialize in LGBTQ issues and offering on-site counseling services at your site.

Key Takeaways

• Pronouns matter: Always use the client’s pronouns and preferred names. This simple act of respect can significantly impact their comfort and trust in the service provider.
• Cultural competency: Ongoing education and training on LGBTQ issues are essential for providing empathetic and effective care.
• Gender-affirming approach: Ensure that all healthcare and support services affirm the client’s gender identity.
• Bias awareness: Be aware of and actively work to mitigate personal biases. Approach every client with an open, non-judgmental mindset.
• Holistic care: Address the comprehensive needs of LGBTQ clients, including mental health, sexual health, and social support.

Important Links/Resources

• GLAAD Media Reference Guide: GLAAD Guide
• The Trevor Project
• Human Rights Campaign (HRC): HRC Resources
• National LGBT Health Education Center: LGBT Health Education
• Trans Lifeline
• National Center for Transgender Equality

Acknowledgements

I would like to extend my heartfelt thanks to the following individuals and groups for their invaluable assistance with information: The staff at the Oakland LGBTQ Center, Quinn Fowler, Benjamin Jackson, Angel Arellano, Dante Washington, Sam Carmel, Andy Cabrera, and Anita Thomas.