The annual examatn is a prehensive evaluatn of patients which all aspects of health and well-beg are nsired, cludg proper screeng, appropriate preventive re, and remendatns and rourc for healthy livg. Clicians monly avoid certa topics wh lbian, gay, bi …
Contents:
- THE ANNUAL EXAMATN FOR LBIAN, GAY, AND BISEXUAL PATIENTS
- “A GAY MAN AND A DOCTOR ARE JT LIKE, A RECIPE FOR STCTN”: HOW RACISM AND HOMONEGATIVY HEALTHRE SETTGS FLUENCE PREP UPTAKE AMONG YOUNG BLACK MSM
- A GUI TO THE GAY MAN'S PHYSIL EXAM
- THE DOCTOR'S BOY TOY (FIRST TIME GAY MEDIL EXAM AND MMM MENAGE APHRODISIAC EROTI)
- DOCTOR'S ATTENTNS (A FIRST TIME GAY MEDIL EXAM DOMANCE EROTIC BUNDLE)
- THE DOCTOR'S STRAIGHT PATIENT (FIRST TIME GAY MEDIL EXAM DOMANCE EROTI)
THE ANNUAL EXAMATN FOR LBIAN, GAY, AND BISEXUAL PATIENTS
* medical examination and gay *
Clicians monly avoid certa topics wh lbian, gay, bisexual, transgenr, and queer (LGBTQ) patients bee they may be unprepared to addrs their health needs. This article foc on both the general and unique health needs of lbian, gay, bisexual, and queer patients; re for transgenr and genr-diverse patients is nsired elsewhere. Associatn of Affirmg Care wh Chronic Disease and Preventive Care Out among Lbian, Gay, Bisexual, Transgenr, and Queer Olr Adults.
Published fal eded form as:PMCID: PMC6571052NIHMSID: NIHMS1516922AbstractYoung, Black, gay bisexual or other MSM are signifintly ls likely to e PrEP than their Whe unterparts.
“A GAY MAN AND A DOCTOR ARE JT LIKE, A RECIPE FOR STCTN”: HOW RACISM AND HOMONEGATIVY HEALTHRE SETTGS FLUENCE PREP UPTAKE AMONG YOUNG BLACK MSM
The annual physil exam is tght as a universal modaly medil schools. Sce there are certa risk factors that perta specifilly to the gay muny, this discsn will foc on aspects of the physil exam that are cril for gay men. * medical examination and gay *
We ed a team-based approach to thematic ntent analysis to unrstand how racism and homonegativy affected healthre accs and experienc. Keywords: Medil mistst, racial dispari, PrEP dispari, young adults, qualative, racism, homonegativyHIV pre-exposure prophylaxis (PrEP) is a promisg ponent of HIV preventn, particularly for gay, bisexual, and other men who have sex wh men (MSM), monstratg high efficy among adherent ers1, 2.
Incln creria required that participants intify as Black or Ain Amerin, were assigned male genr at birth, intified as gay, bisexual, or other men who have sex wh men, were between the ag of 16 and 25, and reported an HIV-negative or unknown serostat. We explicly asked about experienc of discrimatn, racism, and homonegativy om health re provirs and sought to unrstand how the factors may affect PrEP uptake among young Black analysisFoc groups were d-rerd, transcribed verbatim, and d g MAXQDA qualative analysis software. The fal book clud barriers to PrEP (cludg stigma, lack of support, and perceptn of need), benefs of PrEP, medil mistst, discrimatn healthre settgs, PrEP stigma, homonegativy (cludg ‘down low’, homonegativy wh the Black muny, ternalized homonegativy, and anticipated homonegativy), and racism (cludg differenc healthre treatment by race and racial discrimatn).
Seventy-five percent (n=33) intified as gay; others intified as bisexual (n=8), pansexual (n=1), no label (n=1), and straight (n=1).
A GUI TO THE GAY MAN'S PHYSIL EXAM
CDC remends a variety of laboratory ttg and STD screengs to ensure the health of gay and bisexual men. * medical examination and gay *
Analys revealed the ntued effects of racial and enomic disadvantage on health re accs and the ways which racism and homonegativy fluenced young men’s fort discsg sexual behavr wh physicians. [Foc group six]Although this excerpt they were discsg healthre more generally, the perceptn of receivg ferr medil treatment n ntribute to dividuals’ reluctance to start discsg perceived substandard re for Black gay men, foc group three participants scribed how racism, homonegativy, discrimatn, and poor medil re had bee expected and accepted as part of their health re. Precedg the followg excerpt om foc group three, several participants had jt shared personal stori of discrimatn and poor treatment:Facilator: Why do we, as a gay Black muny, why do we allow suatns like that to bee a mon thg?
Through their own experienc and those of their fay, iends, and muny members, participants uld rell so many experienc of stigma and mistreatment that they had e to expect and accept homonegativy, racism, and discrimatn.
THE DOCTOR'S BOY TOY (FIRST TIME GAY MEDIL EXAM AND MMM MENAGE APHRODISIAC EROTI)
This is not to say they did not intify the jtice this or sire better re, but such experienc had bee so monplace that they were no longer shockg or Black MSM rced to their sexualy by doctorsThe perceived racism participants faced was plited by the tersectn of homonegativy. While the lack of a tsted, regular provir was one factor this, this disfort was also rooted anticipated homonegativy and poor treatment om physicians.
P1: I don’t want to say ’s all Whe doctors, ‘e I’ve had some good on, but ’s jt that they treat gay men like we nasty… I even asked, “If you don’t wanna do , you n brg a woman nurse here if you want to. The fear of both race- and sexualy-based discrimatn and prejudice om Whe physicians ntributed to the notn that a gay man and doctor is a “recipe for stctn.
Mistst of physician motiv for wantg to know about sexual behavrs often stemmed om past experienc of discrimatn and homonegativy.
DOCTOR'S ATTENTNS (A FIRST TIME GAY MEDIL EXAM DOMANCE EROTIC BUNDLE)
He jt assumed bee I was Black and I was gay, that this is what happened… I really, to be hont, I don’t know I’ve been to the doctor sce then. Participants noted that, upon revealg sexual behavrs, physicians only looked at them as young gay men at risk for HIV, rather than treatg them as a whole person, wh other healthre needs. Among those who felt PrEP was beg phed on the Black gay muny, there was skepticism about the effectivens and tentns of PrEP.
Specifilly, several men raised ncerns about the ‘ttg’ of meditns on Black and gay people and exprsed skepticism about the targetg of PrEP toward Black MSM. This skepticism about physician tentns was amplified for the young men who were ntendg wh racism and homonegativy healthre settgs, which rerced medil mistst. The majory, however, did not have an tablished provir and reported more disfort wh and greater perceived homonegativy om physicians.
Seeg a new physician at every vis meant that, if they were to disclose their sexual orientatn, they would be ‘g out’ over and over aga and face the strs and risks associated wh disclosure at every vis, as they anticipated homonegativy and mistreatment. Although genr was not as notable a factor as race, there were several participants who exprsed preference for female provirs, whom they perceived to be more motherly and ls homophobic.
THE DOCTOR'S STRAIGHT PATIENT (FIRST TIME GAY MEDIL EXAM DOMANCE EROTI)
Participants believed physician-iated nversatns about PrEP revealed physicians’ stereotyp about gay men, particularly Black gay men, as ‘risky’. Racism and homonegativy have alienated young Black MSM om the health re system and created signifint systematic barriers to health re and has been documented prev rearch35, 36, generatns of medil mistreatment and historil disadvantage have ntributed to stctural and cultural barriers that ma difficult for the young men to tablish re wh a tsted physician.
Addnally, young men expected substandard treatment medil facili, cg racism and homonegativy, ferr clics ‘the hood’, and beg geographilly and socially exclud om higher qualy health re. Further fuelg mistst, perceived homonegativy om health re provirs was a persistent barrier to sexual healthre and PrEP e.
53 Addnally, tnal efforts and medil school pipele programs are need to enhance the racial and sexual inty makp of the healthre workforce, creasg the number of Black provirs, particularly those who are also gay and bisexual. Participants overwhelmgly exprsed a preference for Ain Amerin and/or gay provirs, who they believed they uld better relate to and receive better servic om.