Gay male health concerns reach beyond HIV
The Gay & Lesbian Medical Association recently released the results of a survey listing the 10 leading health care concerns men who have sex with men should discuss with their medical providers. The survey included responses from more than 500 doctors and health care practitioners affiliated with GLMA, a spokesperson there said.

The 10 items, ranked in order of importance, were: HIV/AIDS and safe sex; substance use; depression/anxiety; hepatitis immunization; sexually transmitted diseases; prostate, testicular and colon cancer; alcohol; tobacco; fitness (diet and exercise); and anal papilloma.

"We are concerned that physicians and other health care providers who do not understand the health risks in the gay community cannot provide competent care," said GLMA President Christopher E. Harris, a medical doctor.

"This is why we asked our members to help us define the health care concerns most relevant to men who have sex with men," he said. "Our purpose is to inform health providers and allow patients to be proactive in their relationship by knowing what questions to ask."

Ron Tierney, a spokesperson for the GLMA, said association leaders are not suggesting that these 10 health care concerns are the only ones that apply to men who have sex with men.

"These are things that should be taken into consideration, in addition to other factors," he said.

FOR MORE INFO:
Gay & Lesbian Medical Association
459 Fulton St., Suite 107
San Francisco, CA 94102
415-255-4547
www.glma.org

Harris said the provider and the patient should be aware of these concerns "and they should be addressed non-judgmentally as part of a patient's regular health care program."

Vincent B. Silenzio, a medical doctor and co-editor of the Journal of the Gay & Lesbian Medical Association, suggested that gay men discuss these 10 issues with their medical providers:

1. HIV/AIDS, safe sex: The effectiveness of safe sex in reducing the rate of HIV infection is one of the gay community's great success stories, Silenzio said. But the last few years have seen the return of unsafe sex practices. All health care professionals should be aware of how to counsel and support maintenance of safe-sex practices.

2. Substance use: Gay men use substances at a higher rate than the general population, and not just in larger cities, Silenzio said. These substances include amyl nitrate, or poppers, marijuana, Ecstasy, and amphetamines.

3. Depression/anxiety: These conditions appear to affect gay men at a higher rate than in the general population, GLMA officials said. The likelihood of depression or anxiety may be greater, and the problem may be more severe, 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.

4. Hepatitis immunization: Men who have sex with men are at an increased risk of sexually transmitted infection with the viruses that cause hepatitis, a liver condition. 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 in reducing the risk of viral hepatitis, and is currently the only means of prevention for the more serious hepatitis C virus.

5. Sexually transmitted diseases: STDs occur in sexually active gay men at a high rate, Silenzio said. These STDs include syphilis, gonorrhea, chlamydia, and public lice, as well as others for which no cure is available (including HIV, hepatitis, human papilloma virus).

6. Prostate, testicular, colon cancer: Gay men may be at risk for death by prostate, testicular or colon cancer. All gay men should undergo screenings routinely as recommended for the general population. Access to screening services may be limited by the unavailability of culturally sensitive care.

7. Alcohol: More recent studies have improved our understanding of alcohol use by gays, but it is still thought that gay men have higher rates of alcohol dependence and abuse than straight men. Alcohol-related illnesses can occur with low levels of consumption.

8. Tobacco: Recent studies suggest 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 other problems.

9. Fitness, diet, 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. The use of substances such as anabolic steroids and certain supplements can adversely affect health. At the opposite end of this spectrum, overweight and obesity are problems that also affect a large subset of gays, leading to health problems that include diabetes, high blood pressure, and heart disease.

10. Anal papilloma: Human papilloma virus, which causes anal and genital warts, 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 recurrence of the warts is very common, and the rate at which the infection can be spread between partners is very high.

Washington Blade - August 16, 2002
Rhonda Smith

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