title: Health care screening for men who have sex with men.
abstract: Men who have sex with men often do not reveal their sexual practices or sexual orientation to their physician. Lack of disclosure from the patient, discomfort or inadequate training of the physician, perceived or real hostility from medical staff, and insufficient screening guidelines limit preventive care. Because of greater societal stresses, lack of emotional support, and practice of unsafe sex, men who have sex with men are at increased risk for sexually transmitted diseases (including human immunodeficiency virus infection), anal cancer, psychologic and behavioral disorders, drug abuse, and eating disorders. Recent trends indicate an increasing rate of sexual risk-taking among these men, particularly if they are young. Periodic screening should include a yearly health risk and physical assessment as well as a thorough sexual and psychologic history. The physician should ask questions about sexual orientation in a nonjudgmental manner; furthermore, confidentiality should be addressed and maintained. Office practices and staff should be similarly nonjudgmental, with confidentiality maintained. Targeted screening for sexually transmitted diseases, depression, substance abuse, and other disorders should be performed routinely. Screening guidelines, while inconsistent and subject to change, offer some useful suggestions for the care of men who have sex with men.
authors.affiliation: University of Arkansas for Medical Sciences, Department of Family and Preventive Medicine, Little Rock, Arkansas 72205, USA. daknight@uams.edu
authors.forename: Daniel
authors.initials: D
authors.lastname: Knight
mesh_terms: D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008487:Medical History Taking; D010808:Physical Examination; D010817:Physician-Patient Relations; D011322:Primary Prevention; D018570:Risk Assessment; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis