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Knowledge of gay men’s health reflects big city experience

Little known about those living in smaller areas: researchers

Eleven physicians completed a survey in BC's Interior Health region to evaluate their knowledge of gay men's needs. Researcher Kevin Saya-Moore (right), with Karly Drabot, blames low feedback on busy practitioners and discomfort about such issues. Credit: Nathaniel Christopher photo

Gay men are not mentioned in most federal and provincial health policies, and much of what is known about their health reflects the experience of populations in larger cities, according to the Community Based Research Centre (CBRC).

Since 2008, the University of British Columbia, Okanagan (UBCO), and the Living Positive Resource Centre in Kelowna, have worked to address the healthcare needs of men who have sex with men (MSM) in the Interior Health Authority region through the Engaging Physicians Project.

“Across Canada, and even the US, most of the research that’s been done on this population has been in places like Vancouver, Toronto, Montreal and New York, but there has been very little research in the experiences of gay men living in these smaller areas,” says Susan Holtzman, assistant professor of psychology at UBCO, and the project’s principal investigator.

Last summer, UBCO distributed a questionnaire and a PowerPoint presentation to physicians throughout the Interior Health region, which covers about 22 percent of the province, from Princeton to the Alberta border, and Williams Lake to the 49th parallel.

The project’s aim was to inform physicians of the needs of gay, bisexual and other men who have sex with men, reduce stigma and discrimination, and allow men to safely disclose sexual practices and health concerns, project coordinator Kevin Saya-Moore explains.

Only 11 physicians completed the online questionnaire, which contained questions to help evaluate physicians’ knowledge base of gay men’s healthcare needs.

“We have, unfortunately, encountered very low response from the [medical] community so far,” Saya-Moore reports. “I suspect this is the result of a number of factors. One is that physicians are very busy and have a very full practice and not a lot of spare time, so when you try to do any research with physicians, it’s challenging. There may also be a response of discomfort in talking about these issues.”

Though physician response was low, Saya-Moore noted that 10 of 11 agreed that the new information provided in the PowerPoint presentation would have an effect on their practice.

“That’s a really good thing,” he says. “One of the really specific goals of the project was to have at least one physician in each area of the Interior Health region who could report an increase in his or her knowledge of gay, bi and MSM patients.”

UBCO undergraduate researcher Karly Drabot presented the results of the project’s latest survey at the Gay Men’s Health Summit in Vancouver last month. “We’re in the process of finishing up a professional development workshop, which will be available to physicians,” she told the audience. “In just this past year we’ve enlisted a champion physician who has stated that he’s quite willing to speak with his colleagues about the burning issues around gay men’s healthcare needs.”

The information disseminated in the 2011 project came from the first-ever health survey of MSM living in the Interior, conducted by the Health Psychology Laboratory at UBCO in the fall of 2010.

“A couple of things came out in our survey, and one thing that wasn’t surprising is that about 45 percent of the 160 men in our survey reported significant depressive symptoms, which is actually not that unusual for gay men in other areas,” Holtzman reveals.

She notes that 37 percent of respondents had not disclosed that they have sex with men to their physicians, and that 25 percent had never been tested for HIV. The survey further revealed that 11 percent of respondents reported that they felt discriminated against by their healthcare providers in the previous 12 months.

“Based on what we can extrapolate from the data, our sense is that there are a lot of men who don’t feel comfortable disclosing mental and physical health concerns to their physicians,” Holtzman says.

CBRC managing director Rick Marchand said the national Sex Now Survey usually receives about 2,000 responses from men in British Columbia, many of whom live in rural regions. “Certainly what struck us at this summit was the need to make our resources and the findings we have from Sex Now available to all these communities. Getting the research findings moved out to the various areas so they can use them and build a case for themselves, in order to get funding from their health board,” he concludes.