Health Inequities among Men who have Sex with Men

Health Inequities among Men who have Sex with Men

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[Dr. Richard Wolitski] It's important to focus on gay and bisexual men, specifically because the data show that they experience a number of health inequities. Obviously, higher rates of HIV infection and sexually transmitted diseases, but also higher rates of depression and other mental health problems, higher rates of smoking, higher rates of suicide, domestic violence compared to heterosexual men. So, this is a population that is vulnerable to a number of health threats, and it's an issue that public health needs to be concerned about.

I think often times there's been a lack of recognition about the various health threats that this population experiences and a lack of recognition of the common underlying factors that are driving these health inequities. Prejudice and discrimination are a root cause of many health inequities in this country. They affect socioeconomic status, they affect people's ability to obtain high quality medical care, they affect people's mental health, they add to stress, and so, it really is just the root of all of the health inequities that we see among men who have sex with men.

We look at health inequities in any population, we often see that economic factors are one of the contributing factors. Now, it's a myth that among gay men, for example, that gay men earn more than other men when, in fact, gay men actually earn less compared to their heterosexual counterparts. Their wages are lower, they are more likely to be fired from a job, and when they lose their employment, they're more likely to be unemployed for a longer period of time. So, obviously this affects people's ability to maintain healthcare insurance and to access medical care when they need it.

Policies and laws can affect health in a number of ways. One of the most obvious ones is people's ability to keep their jobs and to get health insurance and keep their health insurance through their employment. So the lack of nondiscrimination laws to protect gay, bisexual men and other sexual minorities clearly is a barrier to people's ability to get and keep health insurance.

Unfortunately, homophobia and negative attitudes about homosexuality may also play a role in terms of people's insensitivity to the needs of gay and bisexual men and other sexual minority populations. Often times it's not even negative attitudes or homophobia, but it just may be a lack of awareness or a lack of sensitivity to the special health needs that this population experiences.

There's a growing recognition in public health that if we focus only on individual behaviors, we're missing a huge array of factors that really are contributing to risk, not just in terms of individuals' behavior, but that are affecting how risky those behaviors are. So, understanding the broader social and structural context that surrounds these behaviors is critically important.

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