LGBT+ History Month: Q&A with Professor Chloe Orkin
Professor Chloe Orkin is Professor of Infection and Inequities at the Queen Mary University of London and has been a Consultant HIV Physician at Barts Health NHS Trust since 2003. Chloe directs the SHARE research collaborative for health equity and she is the outgoing Academic Lead for Equality Diversity and Inclusion in the Faculty of Medicine at QMUL.
Her specialist area is viral therapeutics and her clinical trials unit has contributed to the licensing of more than 20 therapies for viruses such as HIV, viral hepatitis, and SARS-CoV-2. She is Chief Investigator on the first long-acting injectable therapy trial in the UK. Chloe was an expert advisor to WHO Europe on monkeypox (mpox) and COVID-19. During the multi-country mpox outbreaks she established and led an international collaborative clinical network (SHARE-net) resulting in three global case series that have changed international guidelines.
Chloe was the 80th President of the Medical Women's Federation, past Chair of the British HIV Association. She is a member of the governing council for the International AIDS Society and a scientific advisor to the Medicines Patent Pool.
Please could you tell us a bit about your career working in HIV?
I was inspired to choose HIV Medicine because of my training in South Africa where HIV was very prevalent and because of my close friendships with gay men living with HIV in South Africa. After moving to the UK, I trained at Chelsea and Westminster Hospital and started a consultant career in inpatient and outpatient HIV care at Barts Health NHS Trust in 2003.
I established and led a clinical trials unit to deliver novel therapies to people living with HIV which has contributed to the licensing of more than 20 therapies. I also conducted HIV and blood-borne virus (BBV) testing research, specifically the Going Viral Campaign in 2014 which was a world first in opt-out testing for BBVs. A full ten years later this has become standard practice and it is referenced in BHIVA and EU guidelines. As BHIVA Chair, we were the first medical organisation to say the words ‘zero risk’ and this language is something I have spearheaded consistently.
Why do you think it’s important for people and organisations to observe LGBT+ History Month?
Knowing our history allows us to endeavour not to repeat it, and education is a bridge to empathy. Homophobia is an important cause of marginalisation and should not be forgotten. Stigma is still a huge problem for many people living with HIV and many people living with HIV are men who have sex with men (MSM).
The theme for LGBT+ History Month this year is Medicine: #UnderTheScope, to celebrate LGBT+ peoples’ contribution to the field of Medicine and Healthcare both historically and today. Is there anything you would particularly want to highlight about the impact of LGBT+ people in medicine?
I would like to highlight that LGBTQ+ medics have historically experienced discrimination from the regulator the General Medical Council (GMC). At least 40 doctors were erased from the medical register for being gay while sex between men was still criminalised. That is an ignominious history and something for which the GMC has recently apologised. Transgender medics go through significantly onerous and ardous processes to ensure their names can be changed on the medical register.
What are the key things you think need to happen to address the health inequalities that LGBT+ people face still today, particularly in medicine?
There is a LGBTQ+ action plan in place since the 2017 National LGBT survey, that had over 108,000 responses and evidenced the discrimination that LGBTQ+ people were facing - including failure to meet their needs, problems with access and poorer experiences when accessing healthcare.
It is very clear that LGBTQ+ health outcomes are worse across a number of measures - this has to change. Disparities in mental health outcomes were particularly notable as an area of concern just as it was in the Positive Voices survey in people living with HIV.