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INNOVATORS Q&A

The vision behind Rhode Island’s first LGBTQ health clinic

Open Door Health in Providence aims to overcome discrimination and stigma

Dr. Amy Nunn, executive director of the Rhode Island Public Health Institute.Jesse Burke

The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Edward Fitzpatrick at edward.fitzpatrick@globe.com.

This week’s Ocean State Innovators conversation is with Dr. Amy Nunn, executive director of the Rhode Island Public Health Institute.

Question: What is the Open Door Health clinic and when did it open?

Answer: Open Door Health just opened on March 2. It is Rhode Island’s first LGBTQ health center. We offer primary care and sexual health services for Rhode Island’s diverse population. The Rhode Island Public Health Institute’s vision for Open Door Health is to improve the health and quality of life for members of the state’s LGBTQ population, which faces disparities in access to care and health outcomes. The work is driven by our approach to integrating efforts to advance community health, reduce health disparities, develop innovative programs, and train the public-health workforce.

Q: Has there been a clinic like this before in Rhode Island, and what is the need it is meeting?

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A: LGBTQ populations disproportionately experience poor health outcomes for many chronic and infectious diseases, and mental health. Until now, Rhode Island was one of 13 states without an LGBTQ health center. This is the first LGBTQ-focused health center, and we aim to fill that gap.

Q: What are some of the problems that LGBTQ Rhode Islanders have faced in accessing health care?

A: Discrimination and stigma cause many LGBTQ individuals not to seek care or to receive inadequate care. Moreover, many members of this population travel out of Rhode Island to seek health care tailored to their needs. While Rhode Island has among the highest rates of health insurance coverage in the nation, there is still a disparity in access to care and health-care utilization for the Rhode Island LGBTQ population. We are filling a need for primary care and sexual health services for Rhode Islanders.

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Q: How many people could this facility serve?

A: We hope to serve about 3,000 to 5,000 by year’s end. According to a Williams Institute study, Rhode Island has among the highest percentage of LGBTQ residents in the country.

Q: What are the latest trends and statistics on HIV and AIDS in Rhode Island and what difference has Pre-Exposure Prophylaxis (PrEP) made in preventing HIV?

A: Rhode Island reported 73 new cases of HIV in 2019. That is down from 81 in 2017 and 115 in 2010. We are one of few states in the country with a real possibility of eradicating HIV. Rhode Island has one of the highest rates of PrEP use in the country. We believe that one reason new HIV infections may be declining is because of widespread PrEP use. Additionally, most HIV patients in Rhode Island are in care and take their medications. People who are HIV positive who take their medications have almost zero chance of transmitting HIV. Taken together, our high rates of PrEP use and our high rates of people in HIV treatment have likely caused the observed decreases in HIV infection.

Q: Where is Open Door Health located and what services does it offer?

A: The center is located at 7-9 Central St. in Providence, Rhode Island. It offers primary care services. It also offers express HIV, sexually transmitted disease and hepatitis C screening. In the express screening model, patients with no symptoms can quickly receive preventive screenings without having to see a provider. Patients who require follow-up will receive priority appointment slots, as do members of priority populations with greater disease burden.

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Given the disproportionate burden of HIV, sexually transmitted diseases and hepatitis C among this population, we believe this rapid screening center will be an important gateway into primary care services and substance-use treatment for LGBTQ populations. In addition, drawing on our core competencies of conducting research, providing culturally competent care and training the public health workforce, Open Door Health will offer educational training for medical and other health professions students and serve as a hub for research focused on improving LGBTQ health.


Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him on Twitter @FitzProv.