You may know Howard Brown Health Center (HBHC) as a facility that tests for and treats sexually transmitted diseases. Ah, but
HBHC is so much more. The center covers a wide variety of services including elder care, nutritional counseling, neuropsychology
research, and domestic violence counseling.
The center also offers the Chicago Training Collaborative (CTC), a program that provides specialized training for mental health
professionals who work with GLBT clients and their families. The award-winning program is a joint project between the Chicago
Center for Family Health (CCFH), Horizons Community Services, and HBHC. Also, word about the program is certainly spreading; it's
even been the subject of a rant by your friend and mine, Dr. Laura.
In the CTC, students can take classes independently or combine them over the academic year. Trainees in the CCFH Advanced
Certificate Program may also enroll in the CTC in their second year.
The CTC curriculum serves different functions. Among other things, it:
— Expands the limited training many mental health workers receive regarding the GLBT community;
— Translates theory into practice through case consultation; and
— Helps develop more efficient approaches for clinical practice with GLBT individuals and their loved ones/families.
The classes in the current curriculum include such courses as Gender Issues and the GLBT Population as well as Clinical
Practice with GLBT Survivors of Childhood Trauma. There is also a seminar called Emerging Models of Clinical Practice with the
GLBT Population, which every student must take.
According to Braden Berkey, the director of behavioral sciences at HBHC, CTC came about 'because GLBT therapists
recognized that the training [regarding GLBT issues] was non-existent or inaccurate. GLBT therapists were not even equipped to
know what development is like for someone who is lesbian or transgendered or how certain issues may contribute to substance
abuse. So those folks got together and, over the past three years, constructed the program.'
Although Berkey said that he only expected about three people to sign up for this first certificate program, 15 did—and 13
graduated. Moreover, Berkey definitely sees the program expanding, thanks to the Internet. 'There are people in Topeka, Wichita,
and Des Moines who are isolated and need someone to help them. What we want to do is make this program Web-based so that a
therapist in Topeka who wants to serve the GLBT community better can go online, take courses, and become competent to work with
that gay person. We want to educate therapists. We're not here to make them all GLBT specialists, but this is something we'd like
therapists to have in their tool bags.
'The Illinois School of Professional Psychology at Argosy University has a well-developed distance-learning component. I'm
starting to talk to them about how to partner with them and develop courses online. We hope to get that going in two years. There is a
definite need for this type of program.'
The program will hopefully expand in more than one aspect. Berkey also envisions the curriculum containing more classes to
meet the myriad GLBT-related issues out there. According to Berkey, 'there are areas we aren't hitting yet, like substance abuse.
People underestimate how prevalent smoking and alcoholism are in the GLBT community. We've also floated stuff around on kink.
That's a whole area that therapists are unfamiliar with: things like bondage and role-playing with leather.' (Getting a jump on that
potential part of the curriculum, there were seminars on leather and kink during IML Weekend.) Other courses may cover topics like
heterophobia and gay parents,
When asked what he finds most rewarding about the program, Berkey replied without hesitation. 'The feedback I get from the
students—the fact that they're so appreciative—is wonderful.'
The certificate program is available to all post-master's degree professionals in the areas of social work, counseling, psychology,
medicine, nursing, family therapy, and allied professions. Trainees must be working with GLBT people or their families during
training.
If you wish to donate to the CTC (which has zero funding but administrative support), send contributions to the Chicago Center for
Family Health, 35 East Wacker, Suite 2700, Chicago, IL 60601. You may also donate online through eGrants.com .
Contact Berkey at (773) 388-8904 or at bradenb@howardbrown.org .
I'm at westelm406@yahoo.com .
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Resistant Staph (plus that old syphilis)
by Enid Vázquez
Doctors have long warned of powerful germs growing as a result of misused antibiotics, a practice that's common around the
world. Earlier this year came a report from Los Angeles about a drug-resistant Staphylococcus (Staph) infection in gay men. This
nasty infection was seen here in Chicago long before the L.A. doctors made their report.
Today we're looking at a new epidemic, especially in people with HIV, in Chicago, San Francisco, Los Angeles and other large
cities. Dr. Neel French of Klein, Slotten and French Medical Associates presented on both resistant Staph and syphilis earlier this
month at Test Positive Aware Network, as part of TPAN's Committed to Living series of educational forums.
'I saw patients with resistant Staph more than a year before it was reported in L.A.,' Dr. French said. Methicillin-resistant Staph
aureus (MRSA) is a Staph infection that doesn't go away with the usually prescribed antibiotics. This Staph is resistant to most
antibiotics, including augmentin, cephalosporms (Keflex, etc.) and quinolones (Cipro, Levaquin, etc.).
Dr. French explained that almost everyone has some Staph on their skin. However, the misuse of antibiotics has made it stronger
in some people. MRSA used to be found primarily in nursing homes and hospitals, where antibiotic use is high. People with HIV
infection, he pointed out, have usually taken lots of antibiotics for recurrent skin and respiratory infections.
'If you know people who have boils [inflammation with pus] or keep getting them, tell them to get tested for MRSA,' Dr. French
urged audience members. Other symptoms include skin infections that cause folliculitis (inflamed hair follicles), cellulitis (redness of
skin) and abscesses. An abscess can be drained in the doctor's office, but surgery may be necessary. If it gets into your blood and
invades internal organs, it can cause infections of the heart valves, lungs, bone, kidney or brain.
Dr. French saw one patient who almost had to have his leg amputated after surgery for a broken leg. The man developed MRSA
infection of the surgical wound. A different patient who required leg abscess surgery knew he had been exposed to another man with
MRSA two weeks before the operation.
Staph infections are normally easily treated with oral drugs, but Cipro and penicillins won't work for drug-resistant Staph. MRSA
may require hospitalization and use of Vancomycin, an IV (intravenous) antibiotic, often for weeks. The oral drugs Bactrim and
clindamycin may be effective. People who get antibiotics but don't finish their prescription are setting themselves up for resistant
Staph, which can then be transmitted to others. Doctors admit that they find it too easy to give in to patients wanting antibiotics for
conditions for which antibiotics aren't indicated and this can lead to resistant organisms. There's more than Staph to worry about.
The most common example of misuse is people who really feel that antibiotics help a flu or a cold (they don't), and demand them, for
their children as well as themselves. Medical organizations around the globe are working to fight the disaster of resistant bacteria.
('Resistant' means that the bacteria has managed to fight off medications one way or another. If resistance continues to grow, at
some point there may not be a stronger drug that will work.)
As for syphilis, there has been a 'huge' increase in Chicago, primarily among gay men. Drs. Klein, Slotten and French have seen
at least 150 cases in the last two years. For HIV-positive men, the disease progresses more rapidly. While neurosyphilis, which
attacks the brain and spinal cord, could develop after 10 years without treatment, people with HIV have developed it in as little as one
year. There have even been cases of neurosyphilis developing after only two weeks in people with HIV. Symptoms include severe
headaches, visual disturbances and difficulty walking.
Dr. French said he could not stress strongly enough the need for sexually active gay men to get tested for syphilis on a regular
basis. One gay man, who is HIV-negative, had developed an unusual eye disease before he tested positive for syphilis.
Another gay man, who's HIV-positive, was contacted by the health department because he had been exposed to syphilis (sources
are kept confidential). He tested right away and was negative, but was not treated after exposure, as recommended by the U.S.
Centers for Disease Control and Prevention (CDC). The recommendation is that anyone with reasonable risk of exposure to a person
with syphilis in the last 90 days be treated regardless of their test result. Treatment consists of a single shot of long-acting penicillin
(Bicillin) for an exposure. Treatment for syphilis in HIV-positive patients usually requires three shots of Bicillin, each one week apart.
It usually takes about two weeks for a test to come back positive after exposure, and he was afterwards found to have progressed to
the secondary stage of syphilis. People with HIV tend to have a 'blunted' response to testing, meaning that a test may come back
negative when they're actually positive. That's what makes monitoring so important. They shouldn't assume that they're truly negative
if they have symptoms that are characteristic of syphilis. As the disease progresses, it will eventually show up on a test.
Transmission occurs through wet, open sores, such as chancres or ulcers. These appear on the genitals and mouth. The
chancres are often with raised edges, and they're not painful.
Let's do it.
The Committed to Living series takes place the first Wednesday of each month at 7:30 p.m. Dinner is provided. Future CTL forums
include New Drugs (July), Understanding Lab Results (August), HIV Legal Issues (Sept.), HIV-Related Cancers (Oct.) and Reinfection
(Nov.). Contact Jeffrey Allen, jeffrey.allen@tpan.com, and ask to be placed on the TPAN e-mail list.
Enid Vázquez is associate editor of Positively Aware, the national HIV treatment magazine of Test Positive Aware Network.
