Keith Green knows that physicians read books and take classes on how to provide the best health care for members of the lesbian, gay, bisexual and transgender community.
But Green, chairman of the Chicago Black Gay Men's Caucus, also knows that too many black gay men don't even go to the doctor. When they do, they're reluctant about being open and honest about their sexual orientation and practices.
And, if they are open about their sexuality, Green said too often that's all doctors see. The concern is that a patient may have had repeated HIV/AIDS tests but no screenings for obesity, diabetes, high blood pressure and high cholesterol.
"On the South Side, it's challenging to connect people to culturally sensitive and competent care," he said.
The caucus is on a mission to make that connection.
Earlier this year, the caucus decided to align its health mission with that of the city's Healthy Chicago action plan for the LGBT community. The plan's goal is to identify ways to address such things as the high rates of smoking, violence, obesity and HIV in the LGBT community as well as improve access to quality health care.
Certainly there are many benefits to a more holistic and sensitive approach to health care, but a significant one is that when the focus isn't so heavily on sexual health, participants may feel less of a stigma about going to the doctor.
Why is this so important?
Dr. John Schneider, a University of Chicago Medical Center physician who has an HIV/AIDS practice, began working with Green and the caucus in 2010 in an effort to reach some of his most noncompliant patients — young men who repeatedly engaged in risky sex.
On the South Side, there are about 5,500 black men ages 16 to 29 who have sex with men, he said. About 1 in 4 are HIV-infected. That's seven to 10 times the rate for the white population.
"The reason for this is the limited partner pool," Schneider said. "If you have a smaller partner pool in a segregated area, the chances you come into contact with someone who's infected are greater. Black men who have sex with men typically have sex with other black men."
Last month, the caucus held its eighth annual LoveFest, a daylong festival of health and wellness, entertainment and music in Jackson Park. The caucus collaborated with the University of Chicago, the University of Illinois at Chicago, the AIDS Foundation of Chicago, the Howard Brown Health Center and Almighty Home Health Care to provide an array of health services, including mental health screenings with referrals to mental health centers.
In the past, only screenings for HIV/AIDS and other sexually transmitted infections were offered, along with hepatitis A and B vaccinations. Green said that, to a degree, had stigmatized the festival.
"We want to start helping people build relationships, and we want people to know that they can go, for example, to the University of Chicago and there are people who are sensitive to who they are," he said.
After last month's LoveFest, researchers gathered data from the more than 350 participants, Schneider said. Although a day of rain may have decreased turnout, two things were surprising, he said. First, of the 57 people tested for HIV, none of them was positive. Last year, 25 percent of the participants were infected.
Second, many of the participants were overweight, and several reported having been previously diagnosed with chronic ailments such as hypertension, high cholesterol, asthma, cardiovascular disease or diabetes. Some had more than one of the conditions.
"In the African-American community, in general, there are high rates of obesity," Schneider said. "But we tend to think of young gay guys as being healthy and fit and going to the gym a lot, and that's a stereotype."
In November, the caucus will participate in the University of Chicago's STI and HIV Intervention Network conference.
But Green said that because some of the hardest-to-reach members of the LGBT community don't attend conferences, the caucus has had to come up with creative ways to get to them.
In December, the caucus will collaborate with the University of Chicago for the second annual World AIDS Day house ball party.
The party is for the House and Ball Community, a little-known underground group of LGBT folks who compete in lavish fashion shows. This group was given special attention because participants tend to be young black men who engage in risky sex with men and have disproportionately high rates of HIV-infections.
Since last year's event, the university and the caucus have met with leaders in that group and developed an initiative that gives incentives such as cash prizes at the ball to members who are vigilant about safe sex practices and seeking comprehensive health care.
"These young men are dying, and we can't seem to get a handle on HIV, particularly (among) black gay and bisexual men," Green said. "We're just trying to open doors so they don't feel they're alone in this journey."