# data[].attributes.body
HIV prevalence is higher among the LGBTQ+ population

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Beliefs or values

Limited access to community resources

Social isolation

Health illiteracy

Fear of Healthcare discrimination

Stigmatization

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Sexual Identity

Substance Usage

Barrier Usage

Communication Efforts

Number of sexual partners

Fear of seeking queer focused sexual education

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Gay Men/Men Who have Sexual Relations with other Men

Men who have sexual relations with other men have a greater biological risk of HIV because of anal sex.

A person is more likely to get HIV from anal sex than vaginal.

The risk may be as much as 18 times greater than that of vaginal sex.

Possible Reasoning:

The makeup of rectal tissues

The fragility of rectal tissues

The immune response (Boskey, 2022)

Lesbian Women/Bisexual Women

Can be transferred through sexual activities such as fingering, fisting, oral sex, and sharing sex toys.

Not all women are assigned female at birth-- trans women who have penises have a higher risk of transmission when having unprotected contact with semen or presemen. (Wittke, 2020)

Many lesbian women live with HIV.

Although lesbians may not transmit HIV to a female sex partner, many lesbians may have a higher risk for HIV due to:

Injection drug use.

Sex with men, including bisexual men.

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Belle JA, Gamedze NN. Behavioral factors contributing to the transmission of HIV and AIDS amongst young women of Mbabane in Swaziland. Afr Health Sci. 2019 Sep;19(3):2302-2311. doi: 10.4314/ahs.v19i3.2. PMID: 32127799; PMCID: PMC7040258.

Boskey, E. (2022, December). Why gay men have a high risk of HIV. Verywell Health. https://www.verywellhealth.com/why-do-gay-men-have-an-increased-risk-of-hiv-3132782#:~:text=MSM%20with%20internalized%20stigma%20are,strategies%2C%20particularly%20among%20Black%2
0MSM.

Centers for Disease Control and Prevention. (2013). HIV and youth. Retrieved May 17, 2021, from http://www.cdc.gov/hiv/risk/age/youth/index.html

Institute of Medicine (US) Committee on Prevention and Control of Sexually Transmitted Diseases; Eng TR, Butler WT, editors. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington (DC): National Academies Press (US); 1997. 3, Factors that Contribute to the Hidden Epidemic. Available from: https://www.ncbi.nlm.nih.gov/books/NBK232936/

Levy, M.E., Wilton, L., Phillips, G. et al. Understanding Structural Barriers to Accessing HIV Testing and Prevention Services Among Black Men Who Have Sex with Men (BMSM) in the United States. AIDS Behav 18, 972–996 (2014). https://doi.org/10.1007/s10461-014-0719-x

Mary-Ann Shafer, Cherrie B. Boyer,
Psychosocial and behavioral factors associated with risk of sexually transmitted diseases, including human immunodeficiency virus infection, among urban high school students,
The Journal of Pediatrics,
Volume 119, Issue 5,
1991,
Pages 826-833,
ISSN 0022-3476,
https://doi.org/10.1016/S0022-3476(05)80312-9.
(https://www.sciencedirect.com/science/article/pii/S0022347605803129)

Shafer MA, Boyer CB. Psychosocial and behavioral factors associated with risk of sexually transmitted diseases, including human immunodeficiency virus infection, among urban high school students. J Pediatr. 1991 Nov;119(5):826-33. doi: 10.1016/s0022-3476(05)80312-9. PMID: 1941394.

Goldsmith, L., & Bell, M. L. (2021, December 22). Queering Environmental Justice: Unequal environmental health burden on ... https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2021.306406

President, Julia Cusick   Vice, et al. “HIV/AIDS Inequality: Structural Barriers to Prevention, Treatment, and Care in Communities of Color.” Center for American Progress, 5 Oct. 2023, www.americanprogress.org/article/hivaids-inequality-structural-barriers-to-prevention-treatment-and-care-in-communities-of-color/.

Talman, A., Bolton, S., & Walson, J. L. (2013, February). Interactions between HIV/AIDS and the environment: Toward a syndemic framework. American journal of public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3558758/#:~:text=Environmental%20changes%20may%20foster%20conditions,an%20increase%20in%20diarrheal%20pathogens.

Wittke, Evan. “What You Need to Know About HIV in Gay, Lesbian, Bisexual, and Transgender People in the U.S.” The Body, 18 June 2020, www.thebody.com/health/hiv-aids-lgbtq.

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Particular Environmental changes or factors may "foster conditions that are favorable to disease transmission." (Talman et al., 2013) This includes:

Housing location due to discrimination

Community violence

Ecological degradation

The effect of heat stress and/or pollution on the immune system

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Socio-economic and Cultural Contexts

Stigma

Poverty

Racism (if POC)

Barriers to healthcare

Incarceration (Levy, 2014)

Social Determinants of Health

Residential segregation and housing discrimination

Education

Criminal justice (including HIV exposure laws)

Immigration (Robinson, Moodie-Mills, 2012)

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With Amie Pesek, RN, BSN

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Interviewee

Name: Ragi Patel

Pronouns: She/Her

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Interviewee

Name: Savanah Low

Pronouns: They/Them

Position: UofL Sexual Health Coordinator

Why is the health outcome a problem, or how does the burden play out for the community?

Low: HIV is Human Immunodeficiency Virus.

A virus that attacks cells that help the body fight infection, making a person more vulnerable to other infections and diseases.

There are 7,000+ people diagnosed and living with HIV in Kentucky as of 2019. 20% of new cases are diagnosed among people ages 13-24. 66% of HIV is transmitted by HIV positive people who are not retained in medical care. 23% of HIV is transmitted by people infected with HIV but undiagnosed and unaware.

No effective cure exists for HIV--but, by taking HIV medicine (called antiretroviral therapy or ART), people with HIV can live long and healthy lives and prevent transmitting HIV to their sexual partners.

What does this person's field/discipline do to address the problem?

Low: I am a sexual health coordinator on campus. I provide a lot of different programs and services;

Sexuality Coaching

Personal Sexual Health Resource Kits (SHK)

Free HIV Screening

Sexual Health and Relationships Program Requests

STI Testing and Treatment

HIV Testing and Referrals For HIV Treatment

PrEP & PEP Resources

Contraceptive Care

Well Person Exams

How does this person's field/discipline interact with public health in their work?

Low works hard managing a team of sexual health advocate leaders on campus. They educate students across campus in personal and group sessions, provide a plethora of resources, and advocate for students who need help. Low’s goal is to help as many students as they can learn more comprehensive sexual education and give students the best possible chance they can of having a healthy sex life. Low works closely with students and interacts with them one on one.