Canadian Gay Men’s Health

Whose health is it anyway?
EDITORIAL / Understanding health risks in the gay community

story by Brian Gallant, Publisher and Editor-in-chief / Capital Xtra!
Sep 27 2002

It shouldn¡¯t be too difficult to convince you that gay men face
greater health risks than our heterosexual counterparts. And if
you¡¯re a sexually active gay man, there are health risks in our
culture or subculture that healthcare providers simply don¡¯t
understand, unless you¡¯re one of the more fortunate.

¡°Health providers need to be informed and patients need to be
more proactive in their relationship with their caregivers,¡±
according to a survey of members of the Gay and Lesbian Medical
Association (GLMA) released just weeks ago.

How I am reminded, on reading this survey, of hallways travelled at
the Ottawa General Hospital, those shuttling between the modules of
ostensibly caring health specialists and the pharmacists who
diligently dispense prescribed treatments that, you have to trust,
will work in favour of the patients¡¯ health. And of families and
friends whose loved ones are whisked from here to there in search of
answers ¨C perhaps that proverbial silver bullet.

The GLMA¡¯s most valid claim, however, is how patients and
providers may both not know what to ask.

¡°Clinicians providing health care to gay and bisexual men may
not be aware of all of the things that should be discussed during the
visit,¡± says GLMA president Christopher Harris. ¡°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.¡±

Consider, for the sake of your own health, dealing more proactively
with some of these highlights from the survey results.

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 and in 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, being overweight or even obese is
a problem that also affects a large subset of the gay community. This
can cause a number of health problems, including diabetes, high blood
pressure and heart disease.

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 adversely affect health, however,
alcohol-related illnesses can also occur with low levels of

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.

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 severe for those men who
remain in the closet or who do not have adequate social supports.

Gay men use substances at a higher rate than the general population.
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.

And we all know that men who have sex with men are at an increased
risk of HIV infection, and one of the gay community¡¯s great
success stories is the effectiveness of safer sex in reducing the rate
of HIV infections. 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.