Taking PRIDE in LGBTQ+ Health: A Profile of Dr. Viraj Patel

Viraj Patel, M.D., M.P.H., associate professor in the department of medicine’s division of general internal medicine, has been very busy (and successful!) during his 16 years at Einstein and Montefiore. He is a clinician, a teacher, and a researcher. Starting as a Firm 3 resident in the Primary Care/Social Internal Medicine Residency Program, Dr. Patel went on to complete a research fellowship and M.P.H. (now incorporated into Einstein’s Clinical Research Training Program). He joined the Einstein faculty in general internal medicine in 2012 with a focus on LGBTQ+ care and research.

Viral Patel, M.D., M.P.H.

Viraj Patel, M.D., M.P.H.

Dr. Patel has received several grants, including a five-year, $4.2 million grant from the National Institutes of Health (NIH) to compare two strategies for improving PrEP access and use in the Bronx (with co-PI and Einstein colleague Uriel Felsen, M.D.) Another five-year NIH grant provided $2.8 million to conduct a randomized clinical trial involving digital-messaging strategies with more than 1,000 residents of Mumbai, India, who are at high priority for HIV prevention by using mobile dating apps, WhatsApp, and other social media platforms.

He is set to receive the Mid-Career Excellence Award from the department of medicine at its annual Physician Celebration on June 6, recognizing his commitment, dedication, experience, expertise, and contributions to clinical medicine and education. According to the Division of General Internal Medicine Division Chief, Julia Arnsten, M.D., M.P.H., who nominated him, “Dr. Patel has made invaluable contributions to global and HIV health programs, provided direct primary care for patients at Montefiore’s Comprehensive Health Care Center, led Montefiore-wide clinical and educational initiatives, and successfully taught and mentored trainees at all levels."

We recently spoke with Dr. Patel about his life’s work.

Who and/or what inspired you to pursue a career in medicine?
I think some of the inspirations included my high school biology teacher (Dr. Glenda George), family members who were physicians (which allowed me to “see” myself being a physician), and undergraduate experiences that nurtured my interests in human biology and disease and its intersections with social sciences.

What made you want to focus on LGBTQ+ care?
My experiences (before residency) were formed through volunteering with an LGBTQ+ community organization in India and observing the lack of clinical competency to provide care for this population and the dearth of research to guide care as well as my own experiences as someone who identifies as a South Asian gay man and growing up in an immigrant community in the U.S.

How has LGBTQ+ care changed since you started practicing medicine?
I think some of the ways include more LGBTQ+ specific health education being integrated into medical school and residency curricula across the country – though we have just scratched the surface. There has also been increasing institutional support, such as changes in EPIC, that allow clinicians to track sexual orientation and gender identity, and collect information such as patients’ preferred pronouns and preferred names.

Additionally, there is sensitization and cultural competency training around LGBTQ+ health for clinical staff onboarding at Montefiore Einstein.

What do you hope to see in the future for LGBTQ+ care?
I hope that we are able to rid healthcare and society of the stigma and marginalization that impacts the health of LGBTQ+ individuals everywhere, including other forms of oppression – racism, sexism, xenophobia, etc. – as we can’t really address LGBTQ+ inequities without addressing the whole person. As healthcare providers and institutions are members and products of the society in which we live, improving the health and well-being of all LGBTQ+ people will require us to truly address these intersecting identities and forms of marginalization.

What are you most proud of in your career?
I am most proud of my 16+ year partnership with the Humsafar Trust – an amazing LGBTQ+ community organization in India in which we have conducted community prioritized research that has led to the scale-up across India of virtual/mHealth strategies for reaching and engaging gay, bisexual, and other same-gender-loving men (SGLM) for healthcare. It was a big deal when the Humsafar Trust was established in Mumbai in 1994, 24 years before the Supreme Court of India legalized homosexuality.

Tell us about your research.
My research focuses on community-engaged approaches to address inequities in sexual and gender minority health, with a focus on HIV prevention and treatment. These include:

  • ED2PrEP – a five-year, implementation science study supported by the NIH through a $4.2 million grant to test telehealth strategies to improve HIV prevention uptake (including PrEP) and longer-term sexual health among patients seeking care in Montefiore emergency departments.
  • mHealth –a five-year, $2.8 million, NIH-supported comparative-effectiveness trial that is rigorously testing a multi-level behavioral and structural intervention leveraging mobile phones and social media to increase HIV testing and prevention in a cohort of more than 1,000 high-risk residents of Mumbai, India.
  • A three-year, $420,000, NIH-supported longitudinal cohort study elucidating mechanisms by which intersectional stigma impacts HIV treatment engagement for transgender women and gay and bisexual men (GBM) living with HIV in India and identifies targets for support interventions.

Tell us about your teaching role.
I facilitate resident scholarly projects for the Primary Care/Social Internal Medicine residents providing mentorship. I also advise and teach LGBTQ+ healthcare topics to Einstein medical students and residents, and attend on the inpatient internal medicine service.

What are your experiences being a physician of South Asian heritage?
From a young age I have had many physician role models of South Asian heritage. Immigration policies that started in the 1960s resulted in a large proportion of South Asian immigrants being physicians, so there were a lot of role models to choose from. However, there has historically been a lack of visibility of South Asian and other Asian physicians in the U.S. identifying as LGBTQ+ and those doing work in this space. So, I had to create my own path (with amazing support from mentors and teachers at Montefiore Einstein).

How, if at all, has it informed your work in LGBTQ+ health?
The lack of representation or visibility of physicians identifying as LGBTQ+ – especially those who are South Asian – as well as those doing work that address the health of South Asian LGBTQ+ people globally, has motivated me to help address this gap. Additionally, it has informed my work in the Bronx focusing on LGBTQ+ health research among the Bronx LGBTQ+ population that has not been included historically in health research efforts.