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Ten Things Gay Men Should Discuss
With Their Health Care Provider
Following are the health issues that the Gay
and Lesbian Medical Association (GLMA) healthcare providers
have identified as most commonly of concern for gay men. While
not all of these items apply to everyone, it's wise to be
aware of these issues.
- HIV/AIDS
- Substance
Use
- Depression/Anxiety
- Hepatitis
- STDs
- Cancers
- Alcohol
- Tobacco
- Fitness
- Anal
Papilloma
1.
HIV/AIDS,
Safe Sex
That men who have sex with men are at an increased risk of
HIV infection is well known, but the effectiveness of safe
sex in reducing the rate of HIV infection is one of the
gay community's greatest success stories. However, the last
few years have seen the return of many unsafe sex practices.
While effective HIV
treatments may be on the horizon, there is no substitute
for preventing infection. Safe sex is proven to reduce the
risk of receiving or transmitting HIV. All health care professionals
should be aware of how to counsel and support maintenance
of sexual practices.
TOP
2.
Substance Use
Gay men use substances at a higher rate than the general population,
and not just in larger communities such as New York, San Francisco,
and Los Angeles. These include a number of substances ranging
from amyl
nitrate ("poppers"), to marijuana,
Ecstasy,
and amphetamines.
The long-term effects of many of these substances are unknown;
however current wisdom suggests potentially serious consequences
as we age.
TOP
3.
Depression/Anxiety
Depression and anxiety appear to affect gay men at a higher
rate than in the general population. The likelihood of depression
or anxiety may be greater, and the problem may be more sever
for those men who remain in the closet or who do not have
adequate social supports. Adolescents and young adults may
be at particularly high risk of suicide because of these concerns.
Culturally sensitive mental
health services targeted specifically at gay men may be
more effective in the prevention, early detection, and treatment
of these conditions.
TOP
4.
Hepatitis Immunication
Men who have sex with men are at an increased risk of sexually
tranmitted infection withthe viruses that case the serious
condition of the liver known as hepatitis.
These infections can be potentially fatal, and can lead to
very serious long-term issues such as cirrhosis and liver
cancer. Fortunately, immunizations are available to prevent
two of the three most serious viruses. Universal immunization
for Hepatitis A Virus and Hepatitis B Virus is recommended
for all men who have sex with men. Safe sex is effective at
reducing the risk of viral hepatitis, and is currently the
only means of prevention for the very serious Hepatitis C
Virus.
TOP
5.
STDs
Sexually tranmitted diseases (STDs) occur in sexually active
gay men at a high rate. This includes STD infections for which
effective treatment is available (syphilis,
gonorrhea,
chlamydia,
pubic
lice, and others),
and for which no cure is available (HIV,
Hepatitis
A, B, or C virus, Human
Papilloma Virus, etc.). There is absolutely no doubt that
safe sex reduces the risk of sexually transmitted diseases,
and prevention
of these infections through safe sex is key.
TOP
6.
Prostate, Testicular, and Colon Cancer
Gay men may be at risk for death by prostate, testicular,
or colon cancer. Screening for these cancers occurs at different
times across the life cycle, and access to screening services
may be negatively impacted because of issues and challenges
in receiving culturally sensitive care for gay men. All gay
men should undergo these screenings routinely as recommended
for the general population.
TOP
7.
Alcohol
Although more recent studies have improved our understanding
of alcohol
use in the gay community, it is still thought that gay
men have higher rates of alcohol dependence and abuse than
straight men. One drink daily may not aversely affect health,
however alcohol-related illnesses can occur with low levels
of consumption. Culturally sensitive services targeted to
gay men are important in successful prevention and treatment
programs.
TOP
8.
Tobacco
Recent studies seem to support the notion that gay men use
tobacco at much higher rates than straight men, reaching
nearly 50 percent in several studies. Tobacco-related health
problems include lung disease and lung cancer, heart disease,
high blood pressure, and a whole host of other serious problems.
All gay men should be screened for and offered culturally
sensitive prevention and cessation programs for tobacco use.
TOP
9.
Fitness (Diet and Exercise)
Problems with body image are more common among gay men than
their straight counterparts, and gay men are much more likely
to experience an eating disorder such as bulimia or anorexia
nervosa. While regular exercise is very good for cardiovascular
health an din other areas, too much of a good thing can be
harmful. The use of substances such as anabolic steroids and
certain supplements can adversely affect health. At the opposite
end of the spectrum, overweight and obesity are problems that
also affect a large subset of the gay community. This can
cause a number of health problems, including diabetes, high
blood pressure, and hear disease.
TOP
10.
Anal Papilloma
Of all the sexually transmitted infections gay men are at
risk for, human
papilloma virus - which cause anal and genital warts -
is often thought to be little more than an unsightly inconvenience.
However, these infections may play a role in the increased
rates of anal cancers in gay men. Some health professionals
now recommend routine screening with anal Pap Smears, similar
to the test done for women to detect early cancers. Safe sex
should be emphasized. Treatments for HPV do exist, but recurrences
of the warts are very common, and the rate at which the infection
can spread between partners is very high.
TOP
Author:
Vincent M. B. Silenzio, MD, MPH, former Member Board of Directors,
GLMA and Former Co-Editor, Journal of the Gay and Lesbian
Medical Association
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