Gay men’s health
Huge difference in gay men’s health care
There is still a huge difference in the quality of the health-care and sexual health services that gay men and lesbian women receive, in comparison to their straight counterparts. Partly this is because of prejudice which still exists in some populations, and also in some areas of the health care profession.
This means that some gay/lesbian/bisexual people still do not feel comfortable in disclosing their sexuality to their doctor, or in fact find it difficult to be honest about issues affecting them, for fear of discrimination. This can cause problems in making a correct diagnosis, and thus affects the quality of their health-care.
A large part of the blame lies at the doctor’s doorstep, for not necessarily providing an open and free non-judgemental environment in which patients feel able to discuss these difficult issues. Health-care professionals are also to blame for not asking the right questions and or familiarising with the different issues affecting the gay population
In addition there are fears about disclosing sexuality or having evidence of sexually transmitted infection (STI’s), as they feel this might affect their chances of obtaining health or life insurance.
samedaydoctor health-care and sexual health services
At samedaydoctor Canary Wharf, our resident doctor Dr Cottrell, has many years’ experience of working in the gay community and he understands the different issues affecting gay men. We understand that the lifestyle and risks affecting gay men are different and that this translates into different medical needs. We can address any concerns as varied as:
- general health
- sexual health
- mental health
- sexual risk taking
- recreational drugs
- steroids use and more.
See our current price list.
There are certain health care concerns that are particularly relevant to gay men.
- HIV: We know that HIV is a still a big problem, and that it affects the gay community disproportionally. We also know that despite years of education and prevention strategies, large numbers of gay men are being infected with HIV every year. A survey conducted by the HIV charity THT, found that 1 in 7 gay men in London is HIV positive (Source: Gay Men’s Sexual Health Survey 2009). As part of a responsible attitude to sex we promote regular testing for HIV and other STI’s. A lot of people fear HIV testing because they understandably fear getting a positive test results and what that means for them. However, HIV is now a treatable condition and most people diagnosed with HIV in this day and age can go on to live normal active and healthy lives. The proviso here is that they are diagnosed early enough for effective treatment to be started and their health to be monitored.
- Hepatitis C. Until a few years ago no one even considered this to be a sexual risk. Now we are seeing many new diagnoses a year of acute Hepatitis C. We now know that Hepatitis C can be sexually transmitted, with the risk being higher in gay men, people co infected with HIV, or in the presence of other STI’s such as syphilis and LGV. The main risk factors are traumatic sex, fisting, unprotected anal sex or sex where there is blood exposure, as well as injecting drug use. The sharing of drug equipment such as bullets and straws are also considered a risk factor. The risk for sexual transmission in heterosexual couples is extremely low. I now recommend routine Hepatitis C screening for all my gay/bisexual/msm patients.
- Hepatitis B. The modes of transmission are similar to that of Hepatitis C but it seems to be much easier to pass on sexually. We offer vaccination against Hepatitis B and I would recommend that all our sexually active gay/bisexual/msm patients be routinely vaccinated against this potentially lethal disease. The vaccination consist of three injections over a period of 6 months and should protect you against this potentially life threatening disease
- LGV: Lymphogranuloma venereum is a systemic disease caused by a type of Chlamydia infection. It is mostly seen in gay men who have unprotected anal sex (bareback), multiple sexual partners especially in saunas, sex clubs and fisting without gloves. Symptoms can take from a week to several weeks to appear. The initial symptoms are usually blood or pus coming from the rectum, painful inflammation of the rectum (proctitis), a feeling that you have to go to the toilet (tenesmus), and eventually it can lead to ulceration and or abscesses. It can enter the bloodstream and cause a systemic illness with fever. It is easily treated with a course of antibiotics, especially early on. Left untreated it becomes much more serious and can cause lasting damage to the rectum. It is possible to get LGV in the penis too.
- Human Papilloma Virus (HPV) infection in the HIV positive community. For most people infection with HPV is a minor irritation leading to genital warts. However for our HIV positive patients due to an impaired immune system, it is much harder to clear the virus. The problem with a persistent HPV infection is that eventually this could lead to anal dysplasia, pre-cancerous changes in the anus. At the moment there are very few NHS clinics that will offer the testing for HPV and even fewer that will do an anal smear to see if there are any pre-cancerous changes. This is unacceptable and we offer both HPV swab testing as well as anal smears with referral for treatment if necessary. We also offer the Gardasil vaccination off licence to patients who feel they might be at risk from picking up HPV.
- Alcohol and drug abuse in the gay community is also often a hidden problem, with very little in the way of support. We can offer a sympathetic ear and referrals to the appropriate gay friendly specialists if required.