Allying with Peru to Integrate LGBT-Affirming Practices

Kim-Monique Johnson
Diana Padilla
Edgar Vargas
Northeast and Caribbean ATTC

January 24, 2019

“This is the first time I have ever discussed LGBTQ health care with anyof my colleagues – it’s long overdue that we treat the LGTBQ community with dignity and respect. This is about humanity.”– Psychiatrist, SOGI Training Participant, Lima, Perú

Diana Padilla, Kim-Monique Johnson,
and Edgar Vargas, Lima, 2017

In May 2017, a meeting was held by the Colombo Plan in Santiago, Chile, bringing together a group of international experts to create a new curriculum on providing substance use disorder (SUD) treatment to LGBT individuals. Starting with the curriculum on Culturally Responsive Care for Lesbian, Gay, Bisexual and Transgender Individuals developed by the SAMHSA-funded YMSM + LGBT Center of Excellence, the experts worked to make the curriculum applicable to an international audience. 

This resulted in a pilot training in the fall of 2017, and then evolved into a training-of-trainers (ToT) in 2018, for providers in Lima, Peru. These events were in partnership with The Colombo Plan’s Drug Advisory Program, and funded by the US Department of State, Bureau for International Narcotics and Law Enforcement Affairs. On behalf of the Northeast & Caribbean ATTC, three trainers from NDRI-USA, Kim-Monique Johnson, Diana Padilla, and Edgar Vargas, delivered the pilot training and ToT, The Intersection between Substance Use and Sexual Orientation and Gender Identity (SOGI).

Groundbreaking Training Initiatives 

The five-day pilot, trained at the US Embassy in Lima, was groundbreaking, bringing together 48 participants representing LGBTQ activists, medical providers, counselors, and educators committed to inclusivity in clinical practice. The training goal was simple, yet profound – to increase awareness and improve provider SUD treatment in response to the needs of lesbian, gay, bisexual and transgender people. Participants created action plans for continuing the work, creating alliances between their respective agencies. One of the highlights was the emotional validation that a transgender woman activist shared when she and her new associate, a psychiatrist, announced their plan to have her visit his hospital and train his medical staff.

SOGI Training-of-Trainers, Lima, October 2018

Recently, we delivered a SOGI ToT to build on momentum and create sustainability at local levels. Forty-five mental health and SUD treatment providers from across the country, including returning participants, strengthened the collaborative process creating a supportive, interdisciplinary learning community, which was captured and posted by Proyecto GROW on their Facebook page.

While the curriculum was focused on the intersection of SUD treatment as it relates to SOGI, learning the difference between sexual orientation and gender identity resulted in robust conversations and professionals shared their challenges in treating LGBTQ people. We further discussed mental health and why some LGBTQ folks may be more at risk for substance use (i.e. research around microaggressions impacting health) along with the intersection of race, social determinants of health, Maslow's Hierarchy of Needs, and trauma-informed care to meet clients where they are.

SOGI Training-of-Training Participants, Lima, October 2018

Reflections 

Both trainings were conducted in Spanish and we learned that some things are universal – the language of compassion, laughter, and the desire to make a difference. We discovered that the little fidget items we brought, pipe cleaners or limpia pipas, facilitates learning in Perú just as in the USA! To our delight, we watched seasoned medical professionals playing with limpia pipas, making symbols welcoming and affirming for LGTBQ people. At the end of both SOGI deliveries, we found that professionals internalized and demonstrated their commitment to providing culturally informed and affirming care for LGBTQ people in Perú – making them pioneers in their country!

About the Guest Bloggers

Kim-Monique Johnson, MSW, has over 25 years of healthcare and non-profit experience. Kim-Monique uses her training, group facilitation, and organizational development expertise to help organizations manage change and foster professional development for program staff. She has delivered training and written curricula for CBOs, drug treatment programs, health care corporations, criminal justice entities, hospitals, and government agencies. Kim-Monique earned a BA degree in psychology from The Johns Hopkins University and a MSW from the State University of New York at Stony Brook where she completed her thesis: "Addressing the Black Identity Issues of African-American Women in Drug Treatment: A Model of Cultural Competence for HIV/AIDS Prevention and Treatment."

Edgar Vargas, LMSW, MPH works with CBOs to develop and adapt training to improve adoption of EBPs including MI and CBT, and provide TA to help improve implementation of these EBPs. Edgar’s work has focused on improving health outcomes for marginalized communities. Edgar has facilitated training on a range of topics, including harm reduction practices and LGBTQ inclusivity. He has experience providing direct clinical care to people with SUDs and has managed a number of client-facing programs, including HIV and HCV testing programs and public health research studies. Edgar holds an MPH and MSW from Columbia.

Diana Padilla brings 18 years of public health experience to her position as a Program Manager for NDRI-USA’s Training Institute. She has trained drug court practitioners and substance abuse professionals across the country on how to work effectively with diverse cultures and enhance the likelihood of successful program outcomes. She is also a senior trainer and curriculum developer for the Northeast & Caribbean Addiction Technology Transfer Center (NeC-ATTC). With her background in drug treatment and HIV/AIDS services, Diana trains behavioral health providers, prevention professionals, treatment specialists, and drug court practitioners on various topics effecting behavior change such as SBIRT, Substance Abuse, Cultural Proficiency, Hepatitis C, Trauma-Informed Care, and Developmental Issues with Adolescents.