About 40% Of MSM In New York City Do Not Disclose Sexual Orientation To Physicians, Survey Finds

Main Category: Men's health
Also Included In: Primary Care / General Practice;  Sexual Health / STDs;  HIV / AIDS
Article Date: 28 Jul 2008 - 1:00 PST

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Thirty-nine percent of men who have sex with men surveyed in New York City during the past year had not disclosed their sexual orientation to their physicians, according to data from the city's Department of Health and Mental Hygiene that was published in the Archives of Internal Medicine, the New York Times' "City Room" reports. According to health officials, the study's findings have implications for HIV prevention efforts because the survey found that MSM who disclosed their sexual behavior were twice as likely as MSM who did not to be tested for the virus.

The survey examined data from the National HIV Behavioral Survey conducted in 2004 and 2005 by CDC. The New York City portion of the data involved 452 men who were interviewed anonymously at gay bars and clubs, tested for HIV, and offered medical and social services if needed. According to the survey, 63% of MSM who disclosed their sexual behavior to their physicians were tested for HIV, compared with 36% of MSM who did not. The survey also found that although 78% of MSM who identified themselves as homosexual said they had discussed their sexual orientation with their physicians, none of the MSM who identified themselves as bisexual had.

The survey also found racial and ethnic differences in disclosure rates, with 60% of black MSM saying they had not discussed their sexuality with their doctors. This compared with 48% of Hispanic MSM, 47% of Asian MSM and 19% of white MSM. In addition, about three-quarters of MSM who identified themselves as bisexual were black and Hispanic. According to Monica Sweeney, assistant health commissioner for HIV prevention and control, the survey's findings reflect the stigma against MSM behavior in some minority populations. "There is a frequent phenomenon in the black community in which a man who is gay, by the conventional ways that we all know to identify somebody as gay, identifies himself as bisexual," Sweeney said (Chan, "City Room," New York Times, 7/23). Elizabeth Begier, the city's director of HIV epidemiology, said, "It's a combination of people being less comfortable with the term 'gay' or 'homosexual,' and discrimination they perceive they will experience if they are open about their sexual experiences and attractions."

In addition, the survey found that about half of men younger than age 28 had discussed their sexuality with their doctors, compared with 69% of older men (Lite, New York Daily News, 7/24). MSM born in the U.S. were more likely than immigrants to discuss their sexual practices, and those with more education had higher disclosure rates than those with less education, according to the survey.

In reaction to the survey, health officials called on patients to be more forthcoming, as well as on physicians to inquire about sexual history. "Health care providers should screen patients routinely for HIV," Begier said, adding, "They should also ask their patients about behavior that may put them at risk. And New Yorkers shouldn't hesitate to talk openly with their health care providers" ("City Room," New York Times, 7/24). Sweeney said that as a "group, doctors fail miserably" at asking patients about their sexual histories. "People were not reluctant to talk once you brought it up," she said, adding, "They're reluctant to initiate, but once you bring up highly emotional issues, patients will talk about it if you're not judgmental" (New York Daily News, 7/24). Gay Men's Health Crisis Executive Director Marjorie Hill said that although she is "distressed" by the survey's findings, she is not "at all surprised." She added, "Medical providers are not sufficiently trained in outreach and engagement with gay, lesbian, bisexual and transgendered people" ("City Room," New York Times, 7/23).

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