Health disparities refer to the inequalities or inequities related to health outcomes or healthcare. In the United States, health is a critical aspect of life for all people, yet health differences between populations exist. Specifically, health disparities exist to a greater degree among vulnerable populations and with the current socio-political climate. Among these vulnerable groups are men who have sex with fellow men. This paper reviews the distribution of conditions and disparities in different U.S. metropolitan areas, highlighting general health and socioeconomic factors impacting those living in each region. This article will also describe socioeconomic, social mobility, culture, discrimination, religion, education, and systematic oppression. It will also elaborate on why this group faces these issues. It also looks at how the system can be amended for this particular group to overcome their healthcare disparities. The article concludes by identifying ways interested individuals, such as nurses, can contribute to reducing health disparities across regions of the United States.
There are various health care issues that men who have sex with men and gay men. This group tends to acquire various sexually transmitted diseases, especially HIV/AIDs. Gay men are at a higher risk of contracting the virus that causes AIDS (Carnes, 2016). Heterosexuals are ten times more likely to contract Syphilis, Herpes, Gonorrhea, and Chlamydia than gays. Homophobia has been shown to prevent gay men from accessing the care that they need, thus increasing the risk of disease transmission. HIV is a primary concern among gay and bisexual communities in the United States. HIV is a significant cause of death among gay men. The CDC reports that in 2007 over 10,000 people had died of AIDS-related complications in the U.S. Of this number, 83% were gay men (DiNenno et al., 2018). Men who have sex with men and their families face many similar health issues as heterosexual couples, such as depression, domestic violence, and heart disease.
Gay older men rarely see a doctor because they do not want their sexual orientation exposed. The only time they will see a doctor is when they are sick. Therefore, they are unaware of any health risks or conditions that could lead to their deaths. This leads to the birth of further health disparities. Gay men having sex with men also have a higher risk of transmitting HIV than those who have sex with women. Therefore, gay HIV patients are often denied treatment or medications doctors recommend because they cannot provide insurance coverage (Zeeman et al., 2019).
The increased depression and domestic violence rate make it hard for gay men to seek health care. According to the Journal of Family Violence, Gay men face increased rates of depression, eating disorders, and self-destructive behavior (Prescott et al., 2021). Researchers have found that gay men are more likely to suffer from insomnia. In addition, the profound emotional distress associated with HIV status disclosure among gay men may further contribute to increased risk for insomnia”. Homophobia has also been linked to rising rates of suicide in gays and lesbians. Homophobia is discrimination against groups like gays or lesbians. It increases their vulnerability to depression and thoughts of suicide.
In the United States, this group of people also faces the challenge of discrimination. According to The Center of American Progress (2009), “the LGBT community faces discrimination in many areas including employment, the judicial system, and everyday transactions in health care, housing, and public accommodations (Cook, 2009).” Researchers have found that men who have sex with men are less likely to report an HIV-positive status to their doctor. They also say that gays are more likely to delay seeking medical help when needed. One researcher says that “gay men postpone health care because they fear discrimination from doctors, a factor linked not only to sexual orientation but also physical development” (Cook, 2009).
Gay men from all over the U.S. face oppression from conservative religious groups in their local areas. They are often subject to rejection from these churches or their families. Most religions have a negative view of homosexuality, which has led to the church rejecting homosexuals in the community. According to The Religious Congregations and Membership Study (2008), 20% of religious groups are against gay marriage. These groups contribute to the health disparities among gay men in America (Sherkat et al., 2010). In many communities, homosexuality is seen as immoral and unacceptable by people of different religious backgrounds, especially conservative Christians. Due to this religious oppression, many gay men have difficulty coming out of the closet and facing family and friends due to fear of rejection, discrimination, and violence.
This group also faces social mobility issues. Gay men or men who have sex with men who are 12 to 30 years old tend to be more educated than heterosexual men (Greenaway et al., 2020). Gay men have a higher college completion rate than heterosexual males. According to a study, gay boys and young adults are more likely to graduate high school, continue their education, and finish college. Gay adolescents have an equal opportunity of completing high school as the average heterosexual youth, but they are less likely to continue their education after graduation. When gay men reach adulthood, and after marriage, they tend to be able to maintain their status as full-fledged members of the middle class (Greenaway et al., 2020).
Gay men also combat socioeconomic and cultural challenges. According to the Journal of Marriage and Family, “gay men who are not in relationships report more social isolation and less contact with family members.” Men who have sex with men generally express a desire to have their children. Many gay men want children to fulfill the role of parenting and as an expression of love for another person. Gay couples are less likely than heterosexual couples to have children by choice (Greenaway et al., 2020). These two facts put them at risk of experiencing economic hardships in the United States because they cannot easily support a family.
The gay community has been known to face discrimination in other areas, such as corporations within the state. In a study done by the Gay & Lesbian Alliance Against Defamation, they found that 63% of companies within the United States state express intolerance towards gay employees (Quinn et al., 2019). In short, this group of people faces discrimination in many areas, including employment, family, health, and life. This form of violence reminds us that the LGBT community continues to face societal challenges and prejudices. It also shows how no matter what their sexual orientation is or what other challenges they have faced in their lives, they continue to be resilient and achieve more success in life.
Another reason gay men and men who have sex with other men face various challenges is the stigma attached to sexual orientation. Some people and organizations are not aware of the importance they must play towards ending these different health disparities. The government has a role as well, some schools have implemented sex education programs to decrease these disparities, and people like Andrew Sullivan, who educates society on gay rights, are contributing to the cause (Morgan et al., 2018).
Everyone has someone they can advocate for their cause, which is vital because there’s always someone who will support them and fight for them. In addition, the stigma attached to gay men and men who have sex with other men has caused a lot of people to be discriminated against, which led to the deaths of many gay men and men who have sex with other men. The health disparities between gay men and men who have sex with other men will continue if different individuals do not take these actions (Morgan et al., 2018). In addition, many insurance companies have denied coverage for many things people use daily. This is because these individuals do not identify themselves to be straight. Because they do not identify as straight, they are left without health care coverage, ultimately leading to their death.
The system, especially the healthcare system, can undertake various changes for this particular group to overcome healthcare disparities for gay men and men who have sex with other men in the United States. For one, more intensive public health promotion campaigns targeting gay men and men who have sex with other men should be established to deal with the high-risk behaviors (Yeung et al., 2019). Regarding the lack of screening practices, additional research needs to be conducted on how these health care disparities can be overcome specifically for this group. These are some of the many ways the system can change for this particular group to improve their health care status.
As a nurse, I can assist this demographic now that you are aware of the varying health circumstances in the United States by promoting healthy behavior while providing information on where they can seek preventive services and health screenings. Nurses are often in contact with male patients practicing higher-risk behaviors. By establishing a rapport, nurses can educate patients on the importance of preventive screenings such as prostate cancer. I will be able to help this group since I am aware of the varying health circumstances in the United States through my research for this assignment. Although many gay men and men who have sex with other men are fully aware of the health disparities, others are unaware of their risks and vulnerabilities. To start addressing these concerns, it is crucial to understand how these disparities have arisen in the first place. Hence, it is essential for gay men and men who have sex with other men to go for their health screenings early since the earlier one can be referred for treatment, the better.
References
Carnes, N. (2016). Gay men and men who have sex with men: Intersectionality and syndemics. Understanding the HIV/AIDS epidemic in the United States, 43-69.
Cook, P. W. (2009). Abused men: The hidden side of domestic violence. ABC-CLIO.
DiNenno, E. A., Prejean, J., Delaney, K. P., Bowles, K., Martin, T., Tailor, A., … & Lansky, A. (2018). Evaluating the evidence for more frequent than annual HIV screening of gay, bisexual, and other men who have sex with men in the United States: results from a systematic review and CDC expert consultation. Public Health Reports, 133(1), 3-21.
Greenaway, C., Hargreaves, S., Barkati, S., Coyle, C. M., Gobbi, F., Veizis, A., & Douglas, P. (2020). COVID-19: Exposing and addressing health disparities among ethnic minorities and migrants. Journal of travel medicine, 27(7), taaa113.
Morgan, J., Ferlatte, O., Salway, T., Wilton, J., & Hull, M. (2018). Awareness of, interest in, and willingness to pay for HIV pre-exposure prophylaxis among Canadian gay, bisexual, and other men who have sex with men. Canadian Journal of Public Health, 109(5), 791-799.
Prescott, A., Alcala, M., & Nakamura, N. (2021). Structural stigma and LGBTQ PoC health. In Heart, Brain and Mental Health Disparities for LGBTQ People of Color (pp. 149-160). Palgrave Macmillan, Cham.
Quinn, K., Bowleg, L., & Dickson-Gomez, J. (2019). “The fear of being Black plus the fear of being gay”: The effects of intersectional stigma on PrEP use among young Black gay, bisexual, and other men who have sex with men. Social science & medicine (1982), 232, 86.
Sherkat, D. E., De Vries, K. M., & Creek, S. (2010). Race, religion, and opposition to same‐sex marriage. Social Science Quarterly, 91(1), 80-98.
Yeung, H., Luk, K. M., Chen, S. C., Ginsberg, B. A., & Katz, K. A. (2019). Dermatologic care for lesbian, gay, bisexual, and transgender persons: terminology, demographics, health disparities, and approaches to care. Journal of the American Academy of Dermatology, 80(3), 581-589.
Zeeman, L., Sherriff, N., Browne, K., McGlynn, N., Mirandola, M., Gios, L., … & Health4LGBTI Network Taibjee Rafik Toskin Igor Jonas Kai van Der Veur Dennis Allen Odhrán Troussier Thierry De Sutter Petra. (2019). A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities. European journal of public health, 29(5), 974-980.
Jermaine Byrant
Nicole Johnson
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