The Northwest MHTTC is excited to collaborate with the Mountain West AIDS Education & Training Center Program (AETC) on an educational series for behavioral health providers on addressing sexual health in behavioral health care.
Sexual health refers to physical, mental, emotional, and social well-being in relation to a person’s sexuality. It is essential for well-being, general health, and overall quality of life. It is not solely the absence of an illness, dysfunction, or infirmity. Sexual health necessitates a respectful and positive approach to life toward sexuality and sexual relationships and the ability to make pleasant and safe sexual experiences that are free of coercion, discrimination, and violence.
Living with a mental disorder or substance use disorder can present additional challenges for a person’s sexual health. Behavioral health treatment provides opportunities to identify and address a client’s needs related to healthy relationships, gender identity and sexual orientation, reproduction, and prevention of sexually transmitted infections (STI). But behavioral health providers do not typically receive specific training in these topics, and many lack comfort and confidence in discussing sexual health with their clients.
This series is based on the belief that sexuality is a fundamental aspect of mental health and an essential part of behavioral health care. The series is a 4-session introduction to this large and important topic, and will highlight best practices for assessing sexual history, and provide up-to-date information on sexual risk and STI prevention services. These 90-minute sessions will include didactic presentations from experts followed by facilitated group discussion of strategies to integrate the information into current practice. This series aims to lay the foundation for understanding that sexual health is integral to overall health, and to empower the behavioral health workforce to confidently navigate this essential aspect of client care.
Sign up for any or all of the events by clicking registration links below.
Sexual Health: An Essential Part of Recovery
Our first session will provide an overview of the importance of integrating sexual health and behavioral health care. We will share research evidence of increased risk and poorer health outcomes among people living with mental illness, and the need for behavioral health providers to support clients to reduce risk. We'll also explore the discomfort some providers feel when discussing these topics.
Session 1 will lay the foundation for the series--providing the “why” sexual health should be integrated into behavioral health care—and preview the “what” and the “how” of the subsequent sessions.
Discussing & Documenting Sexual Orientation and Gender Identity (SOGI)
Sexual Orientation and Gender Identity (SOGI) are important dimensions of individual self-perception and behavior and have profound effects on health. SOGI data collection and documentation are a key component of enhancing meaningful dialogue during clinical encounters and promoting the provision of high-quality care. If clinicians do not know their client’s SOGI status and sexual behavior, important therapeutic and preventive services may be ignored, including referrals for medical or support services, and HIV and STI screening. Our second session will highlight best practices for obtaining and documenting SOGI data and help build provider skills and confidence in these activities.
PrEP Talk: Enabling Mental Health Professionals to Lead in Prevention
The prevalence of HIV among people who have serious mental illnesses is four times as high as that of the general population. Pre-exposure prophylaxis (PrEP) refers to medications for HIV-negative people to prevent them from getting HIV-infected. Current guidelines from the Centers for Disease Control and Prevention (CDC) recommend informing all sexually active adults and adolescents about PrEP, but in a large 2020 survey of outpatient mental health care programs, only 33% of programs offered HIV testing and only 20% prescribed PrEP.
Behavioral health treatment settings offer opportunities for identifying the need for PrEP and linking clients to services. Our third session will provide information about the effectiveness of PrEP for reducing risk of acquiring HIV and describe criteria for eligibility and best practices for initiating and monitoring persons receiving PrEP prescriptions.
The Syndemic of HIV, Sexually Transmitted Infections (STI) and Behavioral Health Disorders
In a January 30, 2024, letter to SAMHSA grantees, Dr. Miriam Delphin-Rittmon, Assistant Secretary for Mental Health and Substance Use and the leader of SAMHSA, made clear that screening, testing, and treating Sexually Transmitted Infections (STIs) is part of SAMHSA’s whole person approach to behavioral health treatment and substance use prevention. Syphilis and congenital syphilis along with substance use
disorder, mental illness, and other STIs such as HIV, gonorrhea, and chlamydia represent a syndemic. Syndemics happen when two or more health conditions cluster and interact within a population because of social and structural factors and inequities, leading to an excess burden of disease and continuing health disparities. Our final session will provide an update on syndemic conditions that disproportionately impact people living with serious mental illnesses and/ or substance use disorders and discuss the important role of behavioral health providers in screening and linkage to treatment.
Dr. Chwastiak is a psychiatrist, internist and health services researcher who is a Professor in the UW Department of Psychiatry and Behavioral Sciences. Over the past 22 years, her research has focused on improving care and outcomes for people with complex needs in low resource settings, such as low-barrier primary care clinics and community mental health centers in the US, and primary and secondary medical settings in India and Nepal. Dr. Chwastiak is co-directs the UW Behavioral Research in HIV (BIRCH) Center, an NIMH-funded AIDS Research Center, and is the PI and co-director of the Northwest Mental Health Technology Transfer Center (NW MHTTC).
Christina Clayton has been in the behavioral health field since 1993, primarily serving adults who live with severe mental health issues, substance use, experience chronic homelessness, suffer from poor physical health, trauma and any number of co-occurring issues. Christina has education and licenses/credentials in clinical social work, mental health and substance use, and highly values her direct service experience. Prior to joining the MHTTC in 2018, she spent 25 years working in and managing numerous clinical programs. She has provided licensure supervision, training and consultation, and has been a SW Field Instructor since 2000 She is Co-Director for the Northwest Mental Health Technology Transfer Center and Interim Assistant Dean & Director of Field Education for the UW School of Social Work.
Laurie Sylla has been involved with AIDS since the early 1980s, as an agency/program director, direct service provider, advocate, researcher, coalition leader, and educator. She is a co-founder of the AIDS Council of Northeastern New York and the Community Research Initiative of New England (CRI). She is currently the Director of the Mountain West AIDS Education & Training Center, based at the University of Washington.
Dr. Stekler began her career working to expand routine HIV antibody testing and access to pooled HIV nucleic acid amplification testing to diagnose acute HIV infection. She has led several studies investigating novel methods to diagnose acute and early HIV infection; comparisons of point-of-care HIV tests; and home, self-testing for HIV infection. Her current work is evaluating the feasibility of implementing point-of-care nucleic acid tests for HIV diagnosis and treatment monitoring in community and clinical sites in Seattle.
Her other interests include HIV pre-exposure prophylaxis (PrEP) and use of technology for HIV prevention. Dr. Stekler started the first community-based PrEP clinic in Seattle in 2013 and the first telePrEP clinic in 2015. Through collaborations with the Washington State Department of Health and Mountain West AIDS Education and Training Center, she has been working to expand access to PrEP to reduce healthcare disparities among populations disproportionately impacted by HIV.
Mountain West AETC, Washington State Training Coordinator
Mountain West AETC Local Partner University of Washington, Washington State Training Coordinator
Dayna K. Morrison, BA, MHP, brings over 20 years of experience working with people living with HIV/AIDS in Oregon and abroad. In her current role as Program Manager for the Oregon AETC and Lead Faculty for SOGI (sexual orientation/gender identity), Ms. Morrison has provided capacity building assistance to health care systems, federally qualified health centers, and clinicians in efforts to build more inclusive healthcare environments. Additionally, she has coordinated the LGBTQ+ Health Coalition of the Columbia-Willamette since 2010 representing LGBTQ+ voices in Health Equity Workgroups through the Oregon Health Authority. Previous professional positions include Director of HIV Services at Quest Center for Integrative Health, and Program Coordinator for the CDC Global AIDS Program.
Tim Menza, MD, PhD (he/they), is an infectious disease specialist with advanced training and expertise in HIV, STI, and viral hepatitis prevention and care. Tim has extensive experience in creating, implementing, and evaluating public health policy and advocating for communities through system-level change. As medical director of Oregon’s HIV/STD/TB program over the past 5 and a half years, Tim facilitated the implementation of a free statewide home HIV/STI testing program, public health accountability metrics for the prevention of congenital syphilis, partnerships with correctional facilities to increase HIV/STI/HCV testing and led Oregon’s response to mpox. Tim is currently an associate professor in the department of medicine at the University of Washington and a medical director of the Sexual Health Clinic with Public Health-Seattle & King County.
