Primary care health issues among men who have sex with men.
OBJECTIVE
The purpose of the article is to examine "appropriate" health care for men who have sex with men (MSM), which is not to suggest "special" health care. As a group, MSM are at increased risk for sexually transmitted infections, anal cancer, and mental health disorders. Focus areas in this article will address health issues that the primary care nurse practitioner (NP) may encounter in clinical practice: anal carcinoma, sexually transmitted diseases (STDs), high-risk sexual practices, depression, and substance abuse were topics chosen for inclusion in this article. These topics were among those highlighted in the Healthy People 2010 Companion Document for LGBT Health, which served to examine the healthcare disparities and lack of access to needed services related to sexual orientation.


METHODS
Extensive literature review of research articles, journals, clinical practice guidelines, books, and public health department Internet Web sites.


CONCLUSIONS
There are unique health disparities that exist for MSM related to social, emotional, and mental health factors, in addition to physical issues such as STDs. There is an increasing need for primary care providers to be aware of these disparities, as well as the factors that influence these disparities, in order to provide multidimensional care and health counseling that is unique to NP practice.


CONCLUSIONS
Both the primary care NP and the patient should be aware of the unique healthcare issues among MSM that should be incorporated into the patient's routine health maintenance program. As primary care providers, it is within the standards of practice for NPs to provide culturally competent care, along with health promotion and disease prevention for MSM.
Sacramento Family Medical Clinic, Sacramento, California, USA. rgee@sacfamily.com
Royal
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Gee
D000465:Algorithms; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D003663:Decision Trees; D003863:Depression / Q000175:diagnosis* / Q000517:prevention & control; D006293:Health Promotion / Q000379:methods; D006301:Health Services Needs and Demand; D040361:Healthy People Programs; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008603:Mental Health; D009722:Nurse Practitioners; D024802:Nurse's Role; D011320:Primary Health Care / Q000379:methods*; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000517:prevention & control / Q000635:transmission; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000517:prevention & control