Gay men's perceptions and responses to AIDS

National policy and sexual health of men who have sex with men

Nurses continue to play a crucial role in helping to deliver the Department of Health's 10-year National Strategy for Sexual Health and HIV (DH, 2001) and the Government's White Paper, Choosing Health (DH, 2004). Both policies aim to reduce the transmission of sexually transmitted infections (STIs) and the prevalence of undiagnosed cases. However, over the past 10-years the rate of newly diagnosed STIs among men who have sex with men (MSM) has increased by 77% (Health Protection Agency, 2007). Genitourinary medicine (GUM) clinics have long been popular with MSM owing to their provision of non-judgemental services, and are increasingly becoming nurse-led. However, the relative underfunding of GUM clinics and the pressures placed on nursing staff to reach waiting time targets has called in to question the quality of service provided. Concurrently, potential contributors to poor sexual health among MSM, including the deep-rooted effects of homophobia and low self-esteem, continue to be overlooked in the fight against rising STIs. Despite the Government's pledge to transform sexual health services with 300 million pounds of extra funding, there has been little significant improvement in the sexual health of MSM. Poor stewardship of resources and poor management of service targets arising from current policy contribute to a negative impact on the sexual health of MSM and the quality and effectiveness of nursing care.

The health needs of gay men: a discussion of the literature and implications for nursing

Although there is a general dearth of nursing literature on health issues specific to gay (homosexual) men, the literature reviewed shows that gay men have particular concerns related to anti-homosexual feelings anticipated and experienced from health professionals. The effects of homophobia in wider society may cause high levels of emotional distress in some gay men, which is associated with a higher incidence of substance misuse, parasuicide, bipolar psychiatric disorders and depression. Gay men also have specific needs with regard to general medical problems, including hepatitis, HIV infection and some other sexually transmitted diseases. Gay men may also present to health services for a wide range of general medical, surgical and mental health problems. Some specific health needs are discussed: general health, sexual health and bereavement counselling. These issues may affect individuals differently through various stages in the lifespan, and nurses should be cognizant of them during their assessment of client needs. Minimum counselling skills, together with appropriate training about gay issues, are required if nurses are to deal effectively with clients' needs.