{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:34:52Z","timestamp":1792971292147,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Florida Department of Health through the CDC Ending the HIV Epidemic initiative, the 340B Drug Pricing Program, TransSocial, and ReadySetPrep","id":[{"id":"https:\/\/ror.org\/03e1xkn26","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Prim Care Community Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The LGBTQIA+ community faces substantial barriers to healthcare access, contributing to disproportionate rates of HIV and sexually transmitted infections, limited uptake of pre-exposure prophylaxis (PrEP), and inadequate access to gender-affirming hormone therapy (GAHT). A root cause is the lack of LGBTQIA+-focused training in US medical curricula, with a median of only five hours dedicated across four years of medical school. From January through December 2024, a student-run gender-affirming care and infectious disease clinic was piloted at an academic medical institution in South Florida. The objective of this implementation study is to report on clinic implementation, patient outcomes, and stakeholder feedback.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The clinic provided GAHT, HIV and sexually transmitted infections prevention and testing, including PrEP, nPEP, and DoxyPEP to an LGBTQIA+ patient population at no cost. Five medical student officers led operations alongside 38 student volunteers, 6 attending physicians, and 4 residents. Qualitative interviews informed by the Consolidated Framework for Implementation Research (CFIR) were conducted with four key stakeholders following the pilot.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The clinic served 42 patients. Among 36 patients receiving GAHT, 63.9% also received PrEP. Patient retention was high: 85.4% returned for follow-up within 90 days, 97.6% picked up medications after the first visit, and 82.9% continued regular medication pickup. Qualitative stakeholder perspectives centered on responsiveness to the political climate and local need, effective clinical care with high patient satisfaction, a supportive learner culture, and potential for program expansion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This pilot demonstrates the feasibility and impact of student-led, gender-affirming sexual health clinics and provides a replicable framework for other institutions. Grant funding is being pursued to re-establish and expand services with an integrated psychiatric component tailored to LGBTQIA+ populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501319261496826","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:54:57Z","timestamp":1792785297000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Creation and Pilot of a Student-Led, Gender-Affirming and LGBTQIA+-Focused Sexual Health Care Clinic in Miami, FL"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9423-8823","authenticated-orcid":false,"given":"Nicholas","family":"DiStefano","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4310-8799","authenticated-orcid":false,"given":"Hunter","family":"Kessous","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5300-4078","authenticated-orcid":false,"given":"Brendan","family":"Driscoll","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Fuentes","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7208-3035","authenticated-orcid":false,"given":"Karan","family":"Prasad","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiana","family":"Magee","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Rocabado","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Doblecki-Lewis","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Beauchamps","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"e_1_3_9_2_2","volume-title":"The state of the LGBTQ community in 2020","author":"Gruberg Sharita","unstructured":"Gruberg Sharita, Mahowald Lindsay, Halpin John, et al. The state of the LGBTQ community in 2020. Center for American Progress. Published October 6, 2020. https:\/\/www.americanprogress.org\/article\/state-lgbtq-community-2020\/. Accessed March 6, 2023."},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-020-02409-6"},{"key":"e_1_3_9_4_2","unstructured":"Centers for Disease Control and Prevention. Fast Facts: HIV and Gay and Bisexual Men. Published May 8 2024. https:\/\/www.cdc.gov\/hiv\/data-research\/facts-stats\/gay-bisexual-men.html"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2019.0050"},{"key":"e_1_3_9_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-12761-5"},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2020.0141"},{"key":"e_1_3_9_8_2","unstructured":"Williams Institute. Only 3% of sexually active transgender people use PrEP. Published July 7 2020. https:\/\/williamsinstitute.law.ucla.edu\/press\/trans-prep-use-press-release\/"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.7448\/ias.19.7.21105"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/trgh.2021.0074"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.36425"},{"key":"e_1_3_9_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(25)00004-9"},{"key":"e_1_3_9_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-025-01814-x"},{"key":"e_1_3_9_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10597-022-00943-9"},{"key":"e_1_3_9_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-025-01450-7"},{"key":"e_1_3_9_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6795"},{"key":"e_1_3_9_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000004542"},{"key":"e_1_3_9_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.20808"}],"container-title":["Journal of Primary Care &amp; Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261496826","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/21501319261496826","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/21501319261496826","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T23:16:19Z","timestamp":1792970179000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/21501319261496826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":17,"alternative-id":["10.1177\/21501319261496826"],"URL":"https:\/\/doi.org\/10.1177\/21501319261496826","relation":{},"ISSN":["2150-1319","2150-1327"],"issn-type":[{"value":"2150-1319","type":"print"},{"value":"2150-1327","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"article-number":"21501319261496826"}}