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October 2009
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Welcome
to the October issue of Making Life Healthier, the quarterly newsletter of The
Fenway Institute. Since you last heard
from us in June, there has been news
out of Thailand that an HIV vaccine study has shown some promise in
preventing new infections in humans. As
exciting as this news has the potential to be, a working HIV vaccine is still
likely many years away. Because of that,
it is important that we continue research into other methods of preventing HIV
transmission. As you’ll read in this
newsletter, some progress is being made in research into microbicides that
would help prevent the spread of HIV and The Fenway Institute will be involved
in new research looking at the safety of potential microbicide candidates.
We are
also deeply involved in work to influence the federal government’s Healthy People 2020 document. Healthy
People is the nation’s program for health promotion and disease prevention
and is organized and facilitated through the Office of the Surgeon General.
Leading health indicators and priorities for public health initiatives are set
for each coming decade, with Healthy
People 2020 scheduled to be unveiled in early 2010. In conjunction with the National Coalition
for LGBT Health, representatives from The Fenway Institute have been working
hard over the last several years to make sure that data concerning the health
disparities that impact LGBT people are included in Healthy People 2020. Read more.
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 Ken Mayer, MD
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One of the first rectal safety studies of a microbicide set to launch at Fenway in early 2010
The news out of Thailand in September 2009 regarding progress in HIV vaccine development has provided a desperately needed boost to the field of HIV prevention. The news from Thailand arrives just as a recent success has been reported in the microbicide field.
In February 2009, it was reported that one of the leading vaginal microbicide candidates, Pro 2000, had a limited protective effect. When viewed in tandem, these two successes are poised to energize the entire field, which includes not only vaccines but also vaginal and rectal microbicides and oral prophylaxis (PEP and PrEP).
As microbicide research moves forward, additional data needs to be collected looking at safety, acceptability and efficacy. The Microbicide Trials Network (MTN) is leading this research with a series of studies. One of these studies, MTN-007, is set to launch at Fenway Health in the spring of 2010. Read more.
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Aimee Van Wagenen, PhD
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The Massachusetts LGBT Aging Needs Assessment (MLANA) Coalition
MLANA’s Mission: To assess the health, service, care and support needs of older LGBT people in Massachusetts and develop services that better meet the needs of this population.
All people face challenges to health and well-being as they age. As LGBT people, we will likely encounter challenges that are unique to our status as sexual or gender minorities, as ageism and heterosexism intersect to form a double burden in our lives. We will face stigmas related to our age and our sexual and gender identities; we are also likely to face unique challenges related to housing, physical and mental health, caregiving and receiving, and in our relationships with health care and social service providers. On the other hand, we are likely to draw on sources of strength and resilience that are distinctive to our personal and LGBT community histories of struggle. Read more.
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 Harvey Makadon, MD
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Ask the Experts About LGBT Health: A New Addition to Fenway’s Online Resources
Do you have questions that you’d like answered by a doctor with expertise in LGBT health and medicine? The Fenway Institute, through a donation from ExpertViewpoint LLC, and funding from Pfizer, Inc, has launched Ask the Experts About LGBT Health, an online Q&A that allows users to submit questions to Drs. Harvey Makadon and Patricia Raney from Fenway Health.
Launched in August 2009, the service provides detailed answers to questions on different topics in LGBT health, and maintains an archive of past questions and answers for easy browsing. Topics covered so far include Pap smears for men, breast cancer, and STD testing for bisexual women. For each topic there is an accompanying fact sheet that can be downloaded and distributed in hospitals, medical offices, and other healthcare settings. Ask the Experts is a logical extension of Fenway’s commitment to educating providers and consumers about health issues that impact the LGBT community. By offering a service like this on the Internet, we are able to reach people across the country and even the world. Read more.
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Jon Vincent
 Alex Solange
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Fenway Health’s T-Supper Club: Support and Understanding from Within
Within the broad palate of Boston’s inhabitants are a vibrant culture of “gender non-traditionalists.” This diverse group has a range of lifestyles, needs, and viewpoints. Some of them might call themselves transgender, transsexual or gender queer. Some might be cross-dressers, drag kings, drag queens, transvestites, trannys, pangender, bigender, ambigender, non-gendered, agender, gender fluid or intergender. Some of these people might be men who were classified as female at birth. Some might be women who were regarded as male when they were children. Some might have no gender, some might be intersex with the physical characteristics of both male and female. The individuals within this “metapopulation” have needs as varied as their gender identity and personalities. What these people have in common is that they are who they say they are, and that isn’t as simple as “I am a man and I was born a man,” or “I’m a woman and I was born a woman.” These folks work to be as who they are on the inside. Sometimes that means making the outside image match the inside identity. For some, this is called “transition.” Transition can happen through dress, cosmetics and mannerisms. It also may take medical interventions in the form of surgery and hormones. Sometimes, transitioning can simply mean staking claim to one’s gender identity and living as you identify. Some people in this population don’t transition at all. The simply are. Read more.
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Judy Bradford, PhD
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Healthy People 2020
Healthy People, the nation’s program for health promotion and disease prevention, is organized and facilitated through the Office of the Surgeon General. Leading health indicators and priorities for public health initiatives are set for each coming decade, with Healthy People 2020 (HP2020) scheduled to be unveiled in early 2010. Scientific experts, educators and advocates for lesbian, gay, bisexual and transgender health, including Fenway Health management and staff, were very active in the development of Healthy People 2010 (HP2010). This work resulted in the first-ever inclusion of “persons defined by sexual orientation” as a health disparities population in a Federal policy program for public health. Fenway convened meetings that supported dissemination of existing science to support these efforts, lead to the creation of the National Coalition for Lesbian, Gay, Bisexual and Transgender Health, and provided leadership for writing the Healthy People 2010 Companion Document for LGBT Health, sponsored by the Health Resources and Services Administration of the US Department of Health and Human Services. Read more.
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Reisner SL, Mimiaga MJ, Skeer M, Bright D, Cranston K, Isenberg D, Bland S, Barker TA, Mayer KH. Clinically Significant Depressive Symptoms as a Risk Factor for HIV Infection among Black MSM in Massachusetts. AIDS and Behavior published online 22 May 2009.
Mimiaga MJ, Helms DJ, Reisner SL, Grasso C, Bertrand T, Mosure DJ, Weinstock H, McLean C, Mayer KH. Gonococcal, Chlamydia, and Syphilis Infection Positivity among MSM Attending a Large Primary Care Clinic, Boston, 2003 to 2004. Sexually Transmitted Diseases 36(8):507-511, 2009.
Reisner SL, Mimiaga MJ, Bland S, Mayer KH. HIV Risk and Social Networks among Transgender Sex Workers. Journal of the Association of Nurses in AIDS Care 20(5):373-386, 2009.
Maynard E, Carballo-Diéguez A, Ventuneac A, Exner T, Mayer K. Women’s Experiences with Anal Sex: Motivations and Implications for STD Prevention. Perspectives on Sexual and Reproductive Health 41(3):142-149, 2009.

The Fenway Institute will be well represented at the American Public Health Association’s Annual Meeting, November 7 - 11 in Philadelphia, PA. Fenway staff will be making 5 oral presentations and 2 poster presentations. Fenway staff will make the following presentations:
Oral Presentations
- Johnson, CV, Mimiaga, MJ, VanDerwarker, RA, Mayer, KH. Routine HIV testing in Massachusetts community health centers: Perceived barriers and strategies to improve screening rates
- Mimiaga MJ, Noonan E, Donnell D, Safren SA, O’Cleirigh C, Chesney MA, Coates TJ, Koblin BA, Mayer KH. Mediators of the relationship between childhood sexual abuse and subsequent HIV infection among MSM in the EXPLORE study.
- Reisner SL, Mimiaga MJ, Bland S, Cranston K, Isenberg D, Mayer KH. HIV risk behavior among Black men who have sex with transgender partners, Boston, Massachusetts.
- Skeer M, Mimiaga MJ, Safren SA, O’Cleirigh C, Mayer KH. What substances are HIV-infected MSM using that are associated with transmission risk behavior?
- "Fostering the development of population-based LGBT research: The National Mentoring Program of The Center for Population Research in LGBT Health" Authors: Aimee, Judy and Ulrike Boehmer 3279.0, Current Topics in LGBT Public Health, scheduled for Monday, November 9, 2009 at 2:30 PM.
Poster Presentations
- Mimiaga MJ, Reisner SL, Bland S, Cranston K, Isenberg D, Mayer KH. Contextual and psychosocial factors surrounding HIV risk behavior among Black men who engage in transactional sex with other men, Boston, Massachusetts.
- Reisner SL, Mimiaga MJ, Mayer KH, Safren SA. Childhood sexual abuse and HIV risk among MSM sex workers in Boston, Massachusetts: Implications for HIV prevention interventions.

The following individuals contributed content to the October 2009 edition of Making Life Healthier:
Judy Bradford, PhD
Hilary Goldhammer, MPH
Kenneth Mayer, MD
William O’Brien
Alex Solange
Aimee Van Wagenen, PhD
Jonathan Vincent
Christopher Viveiros
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