Metcalfe Rebecca, Laird George, Nandwani Rak
Sandyford Sexual Health Services, NHS Greater Glasgow & Clyde, Glasgow, UK
West of Scotland Sexual Health Services Managed Clinical Network (MCN), Glasgow, UK.
Int J STD AIDS. 2015 Dec;26(14):1028-34. doi: 10.1177/0956462414565404. Epub 2014 Dec 19.
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.
尽管近年来女同性恋、男同性恋、双性恋和跨性别者的平等状况有所进步，但一些男男性行为者的健康风险仍然较高。初级保健中的积极干预措施包括心理支持和降低风险的策略。男男性行为者能够在初级保健中披露性取向非常重要。为了量化在全科医疗就诊的男男性行为者的性取向披露情况，并确定披露的障碍，我们对一组苏格兰男性进行了调查。一份问卷由苏格兰西部的志愿组织和国民保健服务机构分发给农村和城市人口。204人给出了可评估的答复，涵盖了所有年龄段。共有199人（98%）在全科医生处登记，167人（83%）在上一年就诊。共有81人（40%）表示工作人员知晓他们的性取向。在其全科医生不知情的121名男男性行为者中，共有93人（75%）表示这是因为他们从未被询问过。在81名已披露性取向的男男性行为者中，共有36人（44%）将披露后从医疗机构获得的支持评为“优秀”，定性答复也是积极的。几乎所有受访者都在全科医生处登记并接受初级保健服务，这让人放心。然而，只有40%的人披露了性取向。这并非因为担心对医疗产生负面影响，而是因为男男性行为者觉得这与他们就诊无关。全科医生似乎在没有提示的情况下不愿意提出性取向问题。
