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Background Previous studies have established that sex workers experience discrimination and stigma within healthcare settings, limiting their access and receipt of culturally safe care. These barriers impact sex workers’ ability and desire to routinely engage with the healthcare system. Community empowerment interventions that are culturally safe offer an effective strategy to improve access to services and health outcomes for sex workers. Objectives This project was designed to inform the development of community empowerment interventions for sex workers by understanding their self-management, health promotion, and harm reduction needs. Methods In-depth interviews (N = 21) were conducted with sex workers in Chicago. Transcripts of individual interviews were analyzed in Dedoose using rapid content analysis. Results Participants had a mean age of 32.7 years; 45% identified as White, 20% as Black, 15% as Latinx, and 20% as multiple races; 80% identified as Queer. A total of 52% of participants identified as cisgender women, 33% as transgender or gender fluid, 10% as cisgender men, and 5% declined to answer. Themes of self-management practices, stigmatizing and culturally unsafe experiences with healthcare providers, and the prohibitive cost of healthcare emerged as consistent barriers to routinely accessing healthcare. Despite identifying patient-centered care as a desired healthcare model, many participants did not report receiving care that was respectful or culturally responsive. Themes also included developing strategies to identify sex worker-safe care providers, creating false self-narratives and health histories in order to safely access care, and creating self-care routines that serve as alternatives to primary care. Conclusion Our findings demonstrate how patient-centered care for sex-workers in Chicago might include holistic wellness exercises, accessible pay scales for services, and destigmatizing healthcare praxis. Focus on culturally safe healthcare provision presents needs beyond individualized, or even community-level, interventions. Ongoing provider training and inbuilt, systemic responsivity to patient needs and contexts is crucial to patient-centered care.

Background: This study explores the impact of gender and sexuality awareness training on perinatal health care providers' (HCPs') knowledge, attitudes, and intended behavior toward childbearing individuals identifying as lesbian, gay, bisexual, transgender, and/or queer (LGBTQ). Method: A nonrandom convenience sample of HCPs ( n = 187) comprised an experimental group ( n = 99) who attended grand rounds trainings covering gender and sexuality topics and a control group ( n = 88) who attended sessions on other unrelated topics. All participants completed a pre–posttraining questionnaire to assess changes in knowledge, attitudes, and intended behavior toward LGBTQ patients. Results: Participants in the experimental group demonstrated significant improvement in knowledge, misconception, prejudice, sensitive language, and normativity regarding LGBTQ pregnant patients from pretest to posttest. Conclusion: These findings suggest that a 40-minute gender and sexuality training can immediately improve HCPs' knowledge, attitudes, and intended behavior toward LGBTQ childbearing patients. [ J Contin Educ Nurs. 2019;50(7):303–312.]

Black females experience significant sexual health disparities. Intersectionality theory offers nurses a framework to address health disparities. Intersectionality theory examines how categorical identities of difference confer power or oppression, affect social interactions, and influence individuals' engagement with institutional structures. This secondary analysis of qualitative data details the damaging effects that power, oppression, and disadvantaged identities have on the sexual health of Black women. Twenty participants explained how the intersection of race, gender, age, education, and sexuality influences sexual health risk. Our expanded model of intersectionality theory emphasizes historical context with implications for research, practice, and education to promote health equity.

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