1. Martine Hackett Antonio (Jay) Pastrana, Jr.Hofstra University John Jay College, CUNY ESS Annual Conference February 25, 2012

2. 1. From individual perspective: Health providers for LGBT populations need to understand the stories of LGBT youth of color to communicate effectively and to provide appropriate care.2. From a population perspective: Effective construction of prevention messages and health policies require accurate knowledge of LGBT youth of color health beliefs and attitudes.

3. What are the current health narratives for LGBT youth of color as constructed by public health authorities? What are the interactions and experiences of LGBT youth of color with their health and the health care system? How could new narratives inform healthcare communication for LGBT youth of color?

4. Mixed-method approach, which encompassed secondary data analysis of a nation-wide survey of LGBT people of color (N=4,953) and selected youth of color (ages 18-24) from that sample. Ultimately, 959 cases were selected for analysis. Purposeful sample of 4 health campaigns (2010- 2012) from local health departments, Centers for Disease Control and Prevention and GHMC were analyzed for how LGBT youth of color health narratives were constructed in the media.

5. HIV main focus: emphasis on testing and education Focus on individual responsibility for health: what happens after you get tested? Though more campaigns are using strength-based approaches, a fear-centered deficit model and images pack a bigger punch Little to no representation of health issues for lesbians and transgender Health issues that LGBT youth of color at greater risk for not addressed: chronic disease, mental health, homelessness

6. Self-Reported General HealthLGBT Youth of Color (N = 959) Poor 2% Fair 9% Excellent 22% Good 33%Very Good 34%

7. Self-Reported Mental Health "Felt just as good as others" LGBT Youth of Color (N = 959)Most of the Time 39.5A Lot of the Time 29.5 Sometimes 23.7 Never 7.3

8. Self-Reported Mental Health "Felt hopeful about the future" LGBT Youth of Color (N = 959)Most of the Time 44.4A Lot of the Time 28.3 Sometimes 22.8 Never 4.5

9. Perceived comfort level of medical provider at last visit LGBT Youth of Color (N = 959) Did not know 36.7 Ignored 12.7 Uncomfortable 6.6Seemed comfortable 44.1

10. Source of Health Information LGBT Youth of Color (N = 959) Other 4.8 Friends 6.4 Family 20 Online 22.1A Medical Professional 36.3 0 5 10 15 20 25 30 35 40

11. Healthcare provider comfort level with LGBT youth of color needs to improve Health information is heard from different places, not just from medical professionals Most LGBT youth of color have positive perceptions of their own health, have a positive sense of self and are hopeful about the future

12. Would allow LGBT youth of color to own their stories about health andwellness from where they are, not where they should be.Would use narratives of their experiences to frame health messagesusing friends, family and online sources.Would reflect a contemporary, holistic image of LGBT youth of color inhealth communication materials.Where LGBT youth of color bring their authoritative selves and havean active role in patient-provider communication.Addresses other pressing health issues beyond HIV at community andpolicy levels.