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Putting the focus on women’s health

byNurit Shein
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Last weekend, Mazzoni Center marked our third annual Elixir celebration and fundraiser — an opportunity to join with friends of the organization to mark our accomplishments and raise money for the goals we have set for ourselves in the coming year. This year, we had a very specific goal, and we wanted to communicate that through our choice of honorees. We chose to honor three extraordinary women: Marla Gold, M.D., dean of the Drexel University School of Public Health; Christina Kallas-Saritsoglou, Philly AIDS Thrift co-founder; and Jaci Adams, a longtime LGBT activist and educator.

Most importantly, we chose to dedicate the funds from this event to the expansion of women’s health services at Mazzoni Center Family and Community Medicine, 809 Locust St., and to bring on new medical staff.

Our goal with the women’s health initiative is to increase access to and affordability of key health screenings and services for women, particularly for uninsured and/or underinsured LBT women.

Many people who are familiar with Mazzoni Center’s work in the field of HIV/AIDS prevention, testing and care services may perceive us as only serving men. They may not realize the diversity of the patients and clients we serve every day. Currently our primary-health practice, MCFCM, has an active patient roster of more than 7,000 individuals, of which 1,954 (29.8 percent) are women and 1,118 (17.0 percent) are transgender individuals.

This year, we felt we had an opportunity to generate more awareness of and expand upon the services we provide women so we can reach more — particularly the under- and uninsured LBT ones — with the preventive care they need and the compassion and understanding they deserve.

One of the cornerstones of our plan relates to cervical cancer screenings. In the past 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly. The CDC credits the decline largely to women getting regular Pap tests, which can find cervical pre-cancer before it turns into cancer. While this is great news, we know that under-/non-insured women are less likely to have access to, or the ability to afford, regular pre-cancer testing. This impacts women in the lesbian and bisexual communities disproportionately. It is also relevant for trans-identified men who have not had their cervix removed; they are advised to follow the same screening guidelines as cisgender females.

The Fenway Institute in Boston last month released a study showing that lesbians and bisexual women are as likely as heterosexual women to get cervical cancer, but are up to 10 times less likely to be regularly screened for it. We know lesbians are less likely to access preventive care compared to other women, and both lesbians and bisexual women are less likely to be insured. This is attributable to various factors: Many employers no longer provide comprehensive insurance plans, and many more do not offer coverage for the same-sex partners of employees. Also, many lesbian and bisexual women, and trans-identified men and women, have had unpleasant experiences with health professionals, making them less likely to pursue regular preventive care, which is important to maintaining optimal health. Lower rates of regular screening put lesbian and bisexual women at greater risk of late diagnosis, when cervical cancer is less treatable.

When a woman or trans-identified man receives an abnormal result on a Pap smear, the next step is generally to receive a “colposcopy” to determine the cause. Up until now at our primary-care practice, we would have to refer women and transgender men who have not had their cervix removed to see a specialist for this procedure. This presents a barrier for many — either because of lack of insurance and/or trans phobia.

That’s why we plan to acquire a colposcope — the machine used to perform a follow-up screening — for our primary-care practice. Having a colposcope on site will allow our providers to perform a follow-up screening directly in our offices, without having to refer patients to outside providers. We are also adding two part-time providers to our staff, both of whom have a special focus on women’s health care. So whether the concern is a cervical cancer screening, a mammogram or simply a well-woman visit, women and trans-identified individuals in our communities will find a welcoming and knowledgeable staff to address the questions they have in an atmosphere where their unique health needs are respected and understood. All of these are important steps to ensure that our patients can access the health information and the specific care they need, regardless of their insurance status or income level.

We’ve done some calculating and determined that through the funds raised at Elixir on Saturday night, Mazzoni Center will be able to provide pre-cancer screenings to 1,000 women in the Philadelphia area. That’s a strong start. But there’s much more work to be done to ensure that all women in our communities have access to affordable, quality health care, and we’re excited to take these steps in 2013. We look forward to sharing more about this project as it evolves and grows.

Nurit Shein is executive director of Mazzoni Center. For more information,

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