Background: Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) communities experience significant health disparities related to sexual health, including sexually transmitted infections (STIs). Improved access to culturally congruent primary care and sexual health services, including HIV/STI prevention and care, are needed. We describe how we developed a new community-based LGBTQ+ primary care clinic and implemented safety-net sexual health and STI screening and care services in Providence, Rhode Island.
Methods: Open Door Health in Providence, Rhode Island, was started in 2020 to improve access to HIV/STI care and prevention services, primary care, and gender- affirming care for the LGBTQ+ community. We reviewed demographics and behaviors of patients presenting for STI screening services from February 2021 to October 2023 at the clinic. Bivariate and multivariate analyses were used to evaluate demographics and behaviors among patients testing positive for HIV and other STIs.
Results: A total of N=1,633 people presented for STI screening. Of these, 56% were 30 years or younger, 65% identified as male, 24% as female, and 9% as non-binary or gender diverse. Forty-three percent were MSM, 19% were Black/African American (B/AA), and 22% were Hispanic/Latino (H/L). Seventy-one percent reported two or more partners in the last three months. The prevalence of STIs was 22.3% (4.4% syphilis, 7.5% gonorrhea, and 9.7% chlamydia). Those who tested positive for an STI were more likely to be B/AA (23.3% of B/AA individuals versus 15.9% of White, p<0.05), H/L (23.1% versus 17.4%, p<0.05), and MSM (25% versus 16.9%, p<0.05).
Conclusion: Open Door Health provides important safety-net STI services for the LGBTQ+ community. Individuals presenting for services had a high prevalence of HIV/STIs. Improved approaches are needed for HIV/STI care and prevention in this group, including among B/AA and H/L communities.