While there are many more items that could have easily made my list of important topics for gay men to discuss with their doctor, I have found these to be the most important issues in my particular practice. While not all of these items apply to everyone, it’s a wise idea to be aware of these issues.

1. HIV/AIDS and Safe Sex
It is a well known and documented fact that men who have sex with other men are at an increased risk of HIV. But the effectiveness of safe sex in reducing the rate of HIV infection is one of the greatest success stories in the gay community. But, in the last few years we have seen the return of unsafe sex practices, and although there are effective HIV treatments on the horizon, there is absolutely no substitute for safe sex practices. Safe sex is proven to reduce the risk of receiving or transmitting HIV.

2. Substance Abuse
Gay men use substances at a higher rate than the general public, and I’m not just talking about San Francisco, New York or Los Angeles. These include a number of substances ranging from amyl nitrate (“poppers”), to marijuana, Ecstasy, alcohol and amphetamines. The truth is that the long term effects of these substances are still unknown, but it is safe to say that they have potentially serious consequences as we age.

3. Depression/Anxiety
Depression and anxiety effect gay men at a higher rate than the general population. What’s more, the problems may be more severe for those who remain in the closet or do not have adequate social support systems. Young adults may be at a particularly high risk of suicide because of these concerns. Early detection and treatment of these conditions is essential for good health.

4. Hepatitis Immunization
Gay men are at an increased risk of sexually transmitted infection with the viruses that cause the serious condition of the liver known as hepatitis. These infections can be potentially fatal, and can also lead to very serious long-term issues such as cirrhosis and liver cancer. Fortunately, immunizations exist to prevent two of the three most serious viruses. Universal immunization for Hepatitis A and B should be mandatory for all gay men. And I know that I sound like a broken Frank Sinatra record when I say that safe sex is currently the only means of prevention of the extremely serious Hepatitis C Virus. I am obviously ignoring the issue of “dirty needles.”

5. STD’s
Sexually transmitted diseases (STD’s) occur at an alarming rate in gay men. Effective treatments are available for some STD’s like syphilis, gonorrhea, Chlamydia, and pubic lice. But there is no cure available for Hepatitis A, B, or C virus, Human Papilloma Virus, etc. There is absolutely no doubt that safe sex reduces the risk of sexually transmitted diseases, and prevention of these infections through safe sex is the key!

6. Alcohol
I briefly mentioned this issue before, but it deserves its own category. Recent studies have improved our understanding of alcohol use in the gay community, but it is still thought that gay men have higher alcohol rates of alcohol dependence and abuse than straight men. One drink daily may not adversely affect your health. But be serious, who only drinks one a day?! It is a medical fact that even low levels of alcohol consumption can cause serious health problems. Special services that are targeted towards gay men are important in successful prevention and treatment programs.

7. Tobacco
OK. I smoke…so shoot me. It’s the last vice that I have left, and I will quit shortly. But the fact remains that recent studies support the notion that gay men use tobacco at a much higher rate than straight men—reaching nearly 50 percent in several of the most recent studies. Ouch! We all know that tobacco related illnesses include heart disease, high blood pressure, lung cancer and a whole host of other wonderful things that none of us want to get. If you can, cut back. As for me, I’ll quit.

8. Fitness
Your doctor tells you to exercise. Now what? Problems with body image are more common among gay men than their straight counterparts, and gay men are more likely to experience eating disorders such as bulimia or anorexia nervosa. While regular execerise is a good thing for cardiovascular health and in other areas, too much of a good thing can be harmful. The best advice I can give to you as a former professional sports doctor in this matter is to use good judgment: start slow and build up.

9. Anal Papilloma
Of all the sexually transmitted infections gay men are at risk for, human Papilloma virus—which causes anal and genital warts—is often thought to be more than just an unsightly inconvenience. These infections may play a role in the increased rates of anal cancers in gay men. Some health professionals now recommend routine screening with anal Pap Smears. Again, safe sex needs to be emphasized. Treatments for HPV do exist, but recurrences of the warts are very common, and the rate at which the infection can spread between partners is extremely high.

Above all, talk to your doctor. He or she is more often than not your best defense.

Contact Information:
Ken Romeo, Ph.D., MD (A.M.)
Doctor Romeo’s Exotic Medicines from Around the World, LLC
359 Cheney Street
Reno NV 89502
775-329-4900
E-Mail: DrKenRomeo@aol.com
Copyright © 2008 Dr. Romeo’s Exotic Medicines from Around the World, LLC
All Rights Reserved

Dr. Romeo is a professional member of the Gay & Lesbian Medical Association (GLMA), a non-profit organization representing the interests of the millions of LBGT patients throughout North America who seek quality in healthcare access and delivery. GLMA promotes quality health care for HIV positive people and supports members challenged by discrimination on the basis of sexual orientation.