Enhancing Two Spirit and LGBTQ+ Health Equity Through HIV-related Data Improvement and Related Initiatives

Content From: Victoria Warren-Mears, PhD, RDN, FAND, Director, Northwest Portland Area Indian Health Board, and Morgan Thomas, Two Spirit and LGBTQ+ Outreach Coordinator, Northwest Portland Area Indian Health BoardPublished: December 09, 20202 min read


The Northwest Portland Area Indian Health Board (NPAIHB)
Credit:  Northwest Portland Area Indian Health Board

The Northwest Portland Area Indian Health Board (NPAIHB) has been working since September 2019 to enhance American Indian and Alaska Native (AI/AN) HIV-related data in the Northwest and improve Two Spirit and LGBTQ+ health equity. These activities are supported by funding from the Minority HIV/AIDS Fund awarded through the Indian Health Service.

Established in 1972, NPAIHB is a nonprofit tribal advisory organization serving the 43 federally-recognized tribes of Oregon, Washington, and Idaho. It houses a tribal epidemiology center, research programs, and health promotion disease prevention projects. Through a contract with the Washington Department of Health, NPAIHB addresses unmet foundational public health services for the 29 federally-recognized tribes in Washington, focusing on infectious diseases impacting AI/AN communities within the state, including HIV. 

In collaboration with its Improving Data and Enhancing Access-Northwest (IDEA-NW) ProjectExit Disclaimer, NPAIHB is using race-corrected HIV data from the Washington Department of Health to better understand the HIV disease burden within these tribal communities. Complemented by virtual and in-person training on prevention, control, and outbreak investigation, the data will be used to assist tribes in adopting HIV prevention and control methods that are de-stigmatizing and culturally appropriate.

In addition, NPAIHB has been working to improve Two Spirit and LGBTQ+ health equity by developing a set of educational text messages for providers and offering a 6-month Trans & Gender-Affirming Care ECHO—a collaborative educational model in which health care professionals participate in guided practice with clinical specialty experts via video conferencing to acquire new skills. This distance-learning initiative trained ten providers to offer gender-affirming care. In addition, the organization’s research initiatives have included completing a systematic review of the existing literature on Two Spirit and Native LGBTQ+ health, and conducting a small quantitative survey focused on Two Spirit and Native LGBTQ+ health, connectedness, and healthcare access across Turtle Island. The organization’s community programming has included a Two Spirit and LGBTQ+ Text Campaign, educational campaigns for allies and individuals who are Two Spirit or LGBTQ+, and a Two Spirit Talks podcast (first episode forthcoming). The work at NPAIHB continues with a qualitative assessment of Two Spirit and LGBTQ+ health, connectedness, and access to healthcare; ongoing community programming; and a planned second phase of the Trans & Gender-Affirming Care ECHO for clinicians.