Gay Health

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  • Health disparities exist among sexual minority groups (gay or lesbian and bisexual) and between sexual minority groups and heterosexuals; disparities are far reaching and include differences in health conditions, health behaviors, health care access, and health care utilization. Sexual minority groups tend to fare worse across all realms.
  • LGBT individuals may hide their orientation out of fear of stigma and discrimination, so it is important to ask all patients about sexual identity and behavior in a nonjudgmental environment.
  • Structural barriers of a heterosexist and unwelcoming healthcare system and the minority stress (fear, stigma, internalized homophobia) experienced by LGBT people likely contribute to the development of health disparities. These disparities do not arise from innate characteristics of LGBT people.
  • This chapter focuses on the diverse group of gay, bisexual, and other men who have sex with men (MSM). Although lesbian and transgender health are discussed separately under their respective topic headings, please note that many of the disparities and risks discussed here affect transgender women at similar or higher levels than men. Men who have sex with transgender women may need many of the same screenings and prevention strategies as MSM.
  • Although this chapter reviews the important topics that disproportionally effect this population, primary care of MSM is foremost about delivering the same care delivered to all patients.

General Prevention

  • All MSM should receive hepatitis A and B immunizations (1)[A].
  • Young MSM <26 years old should be vaccinated against HPV (1)[C].
  • Centers for Disease Control and Prevention (CDC) recommends at least annual screening for HIV, syphilis, gonorrhea, and chlamydia as detailed below.
  • CDC recommends testing for hepatitis B (2)[A].
  • Annual screening for hepatitis C is only recommended in MSM with HIV (2)[A].
  • Screening for hepatitis A is not recommended.

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