Mazzoni Center Puts the Focus on Women’s Health

Back in May, Mazzoni Center hosted their third annual Elixir event. The theme of the event was ‘Leading Ladies’ and the goal was to raise funds to support what Mazzoni is calling their Women’s Health Initiative –  a project aimed at increasing access to and affordability of key health screenings and services for women, particularly for uninsured and/or underinsured women from the lesbian, bisexual, and transgender communities.

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We sat down with Mazzoni Executive Director Nurit Shein to learn a bit more about what the Women’s Health Initiative is all about, and what women can expect to see over the next few months and beyond.

Q: What prompted this initiative?

A: 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, or primarily, serving men.  They may not realize the diversity of the patients and clients we serve every day.  Currently our primary health practice, Mazzoni Center Family and Community Medicine, has an active patient roster of over 7,000 individuals, of which 1,954 (29.8%) are women and 1,118 (17.0%) are transgender individuals.

Since we opened the practice in 2003, the growth has been impressive. As we looked at our demographics we agreed that we would like to see the number of female-identified patients that we serve increase, since we know there is a need among that population.

The Mazzoni Center medical practice, 809 Locust St.

So this initiative is partly an effort to raise awareness about the services we currently provide for women, which include primary care, GYN exams, family planning services (which include fertility counseling and referrals), breast health screening and education, and a range of mental health services – which encompass everything from one-on-one counseling to support groups for individuals in recovery.

We also felt we had an opportunity to expand on those services by adding a couple of key pieces of equipment, which will allow us to perform certain screenings that are important to women right here at our practice, and not have to refer our patients elsewhere for those procedures.  We’d like to be more of a ‘one-stop shop’ where women can have all their basic health needs addressed in an environment that is friendly and accessible to all women, but especially for under and uninsured lesbian, bisexual and transgender women.

Q: What are some of the key screenings you’re talking about?

A: 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 have the ability to afford, pre-cancer testing on a regular basis.  This impacts lesbian and bisexual women disproportionately.   (It’s also relevant for trans-identified men who have not had their cervix removed; it’s recommended that they follow the same screening guidelines as cisgender females).

Our peer organization in Boston, the Fenway Institute, published a study earlier this year that points to just how serious the issue is.  Among other things, their study showed 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 that lesbians are less likely to access preventive care compared to other women, and both lesbians and bisexual women are less likely to be insured compared to other women.  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 their employees.

In addition, many lesbian and bisexual women, as well as transgender-identified men and women, have had unpleasant or discriminatory experiences with the health profession, which makes them less likely to pursue regular preventive care.  Lower rates of regular screening put lesbian and bisexual women at greater risk of late diagnosis, when cervical cancer is less treatable.  That’s the kind of scenario we are trying to avoid, through education and access to care.

On the technological front, we’re investing in new equipment that will allow us to directly address this issue.   As you may know, when a female (or trans-male) patient 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’ve had to refer these patients out to see a specialist in order to have this procedure. This presents a barrier for many – either because of lack of insurance, or reluctance to see another provider for fear of homo or trans-phobia and/or trans phobia.

That’s why we’ve purchased a colposcope (the machine used to perform a follow-up screening), as well as an ultrasound machine, for our primary care practice. Having this equipment available to our medical providers will allow them to perform a follow-up screening directly in our offices, without having to refer patients elsewhere.  It makes things much easier for our patients, and avoids the risk that they don’t follow up.

And of course, we will continue to emphasize the importance of breast health screenings for women, as their individual circumstances dictate.  We’re fortunate to have an excellent, longstanding relationship with the Komen Foundation Philadelphia Affiliate, which helps us provide mammograms for the women we serve.

We’re really working to address the full spectrum of women’s health issues within a primary care setting.  Because we have seen that the fundamental driver of someone’s overall health and well-being is having a strong relationship, and consistent relationship, with their primary care provider. That seems to be the key, and it really can impact all kinds of health outcomes.

Q: What’s your ‘takeaway’ message to all the women reading this?

A: If you don’t already have a health care provider, give us a call! And if you have one you are happy with, be sure you are following up and really taking ownership of your own health care.

With regard to the Women’s Health Initiative, we know already that with the funds raised through the Elixir event alone, Mazzoni will be able to provide pre-cancer screenings to 1,000 women in the Philadelphia area – so that’s a strong start. I would say that there’s much more work to be done to ensure that all women in our communities have access to affordable, quality health care, but we are excited to take these steps in 2013.

As we move forward, we are looking to women in the community to help us guide out efforts.  We’d like to know what services you’re looking for, and how we can best meet your needs.  To that end we’ve developed an online survey, and we’ve been reaching out to women at the Dyke March, at Pride, and other events.

It just takes a few minutes to fill out, but it will be a big help to us in identifying priorities.  Please take a minute to fill it out, if you haven’t already: http://mazzonicenter.org/content/2013-womens-health-initiative-survey

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