title: Don't ask, sometimes tell. A survey of men who have sex with men sexual orientation disclosure in general practice.
abstract: Despite advances in lesbian, gay, bisexual and transgender equality in recent years, some men who have sex with men remain at increased risk of ill-health. Positive interventions in primary care include psychological support and strategies for risk reduction. It is important that men who have sex with men can disclose sexual orientation in primary care. To quantify disclosure of sexual orientation by men who have sex with men attending general practice and identify barriers to disclosure we surveyed a group of Scottish men. A questionnaire was distributed by voluntary organisations and the National Health Service in the West of Scotland, to rural and urban populations. Two hundred and four gave evaluable responses, with all ages represented. A total of 199 (98%) were registered with a General Practitioner and 167 (83%) attended in the previous year. A total of 81 (40%) stated staff were aware of their sexual orientation. A total of 93/121 (75%) men who have sex with men whose GP was unaware stated this was because they had never been asked. A total of 36/81(44%) men who have sex with men rated support from practices since disclosure as 'excellent' and qualitative responses were positive. It is reassuring that almost all respondents were registered with GPs and attending primary care services. However, only 40% had disclosed sexual orientation. This was not because of fear of negative impact on care but because men who have sex with men felt it was irrelevant to their attendance. GPs appear to be reluctant to raise the issue of sexual orientation without prompting.
authors.affiliation: Sandyford Sexual Health Services, NHS Greater Glasgow & Clyde, Glasgow, UK rebeccametcalfe@nhs.net.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Metcalfe
authors.affiliation: West of Scotland Sexual Health Services Managed Clinical Network (MCN), Glasgow, UK.
authors.forename: George
authors.initials: G
authors.lastname: Laird
authors.affiliation: Sandyford Sexual Health Services, NHS Greater Glasgow & Clyde, Glasgow, UK West of Scotland Sexual Health Services Managed Clinical Network (MCN), Glasgow, UK.
authors.forename: Rak
authors.initials: R
authors.lastname: Nandwani
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001727:Bisexuality / Q000523:psychology; D005194:Family Practice; D058006:General Practice; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012424:Rural Population; D012606:Scotland; D012650:Self Disclosure; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014505:Urban Population; D044465:White People / Q000523:psychology; D055815:Young Adult
keywords: Homosexuality; MSM; bisexuality; disclosure; general practice; men who have sex with men; primary health care; sexuality