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‘Gay Friendly GP’ List - Enhancing Primary Care
Models for Men Who Have Sex with Men
Kao SC1, Dabbhadatta J2, Ubrihien A3 Davies SC4,5, Bourne C6,7, O’Connor CC8,9,10, Dailey B1, Templeton DJ8,9,10, Adam P11
on behalf of Sexually Transmissible Infections in Gay Men Action (STIGMA) Group’s Clinicians Communication Project Working Group
1
HIV and Related Programs Health Promotion, Sexual Health Service, Sydney Local Health District, Australia 2 HIV/AIDS and Related Programs Unit, South Eastern Sydney Local Health District, Australia
3
HIV and Related Programs Unit, Northern Sydney Local Health District, Australia 4 North Shore Sexual Health Service, Royal North Shore Hospital, St Leonards NSW 2065,
5
Sydney Medical School, University of Sydney, NSW 2006 6 Sydney Sexual Health Centre, Sydney Hospital, Australia.
7
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. 8 RPA Sexual Health, Sydney Local Health District, Sydney, Australia
9
The Kirby Institute, University of New South Wales, Sydney, Australia 10 Central Clinical School, University of Sydney, Sydney, Australia
11
Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
Introduction
• Men Who Have Sex with Men (MSM) in Australia are
disproportionately affected by sexually transmissible
infections (STIs) including HIV.
• General Practitioners (GPs) diagnosed most STIs in
Australia.
• It is important for MSM to feel comfortable when visiting
GPs; especially as consultations present an opportunity
to discuss screening and management of STIs.
• ‘Sexually Transmissible Infections in Gay Men Action
Group’ (STIGMA) considered a ‘Gay Friendly GP List’
would be supportive of MSM access GPs sympathetic
to their needs.
• ‘Gay Friendly GP List’ was first developed in 2010. GPs
were invited to self-nominate for a gay friendly GP list
via STIGMA newsletter, GP networks (Medical Locals)
and Australasian Society of HIV Medicine (ASHM).
Current STIGMA partners are:
• NSW Ministry of Health
• Sydney Local Health District (RPA Sexual Health Clinic, HARP Health
Promotion, Public Health Unit)
• South Eastern Sydney Local Health District (Sydney Sexual Health
Centre, the Albion Centre, HARP Unit, Public Health Unit)
• Northern Sydney Local Health District (Clinic 16, HARP Team,
Public Health Unit)
• ACON (formally known as AIDS Council of NSW)
• Positive Life NSW
• Centre for Social Research in Health (CSRH)
• Kirby Institute
• Inner West Sydney Medicare Local (IWSML)
• Eastern Sydney Medicare Local (ESML)
• Sydney North Shore and Beaches Medicare Local (SNSBML)
• Australian Federation of AIDS Organisations (AFAO)
• Australasian Society for HIV Medicine (ASHM)
Demographics of Focus Group Participants
Country of Birth
• The list was promoted and hosted by ACON (formally
known as AIDS Council of NSW) website. In 2013,
STIGMA reviewed and updated the list.
• We were unsure how to define gay friendly so we
explored gay men’s perspective about GP ‘gay
friendliness’.
Employment Status
Methods
ACON recruited gay men aged over 18 years old, who had
seen a GP within the last six months. Eighteen gay men
participated in three focus group discussions in November
2013. The discussions focused on gay men’s perception
of what ‘gay friendly GP’ meant to them and their views on
the development of the list, including a new version.
Participants generally had very positive opinion about the
initiative of a gay friendly GP list. However, only 2 out of 18
participants were aware of the 2010 version. Upon further
questioning:
• Participants were pleased with the revised version –
divided by the names of suburbs, information about
bulk billing and language spoke other than English.
However, recruitment of gay friendly GPs has been
restricted by organisational and geographical limitations
– it would be ideal that invitation would be extended to
other LHDs.
• Self-nomination process is problematic – there is lack
of governance and monitoring system in regards to the
capabilities of GPs on the list
• There is no mechanism for the community members to
provide feedback based on their experiences with GPs
listed.
• Greater consideration needed in regarding the
promotion of the list – using social media, such as
Facebook and Twitter, and possibly developing mobile
phone app with GPS enhanced functions.
Level of Education
Focus group participants were:
• aged between 26 and 53 years (median age of 36yrs);
• resident across Sydney, South East and North Sydney
Local Health Districts (LHDs) – please see the map
below;
• mostly gay community connected;
• almost 50% were born overseas;
• Most of them are employed and were highly educated.
Findings
Participants agreed that to be ‘gay friendly’, GPs should
possess the following qualities:
• Understanding gay men’s health – including current
trends in sexual health (including HIV treatment), alcohol
and other drugs and mental health;
• Understanding of gay culture/life style and its diversity
– comprehend the shared issues about coming out,
relationship, ageing and not assuming all gay men are
the same;
• Having good interpersonal communication skills – know
how to discuss challenging topics appropriately, such
as sex, sexuality, drugs.
Participants strongly agreed that they are more likely to
consider or agree to recommendations regarding sexual
health prevention, testing and treatment from GPs who
possess the qualities listed above.
Recommendations
• Offer GPs information, training and support to increase
their knowledge and capacity in the areas identified by
gay men/MSM;
• Develop a feedback mechanism for community
members about the list;
• Consider a more comprehensive implementation plan,
especially accessing gay social and other media.
Conclusion
The development of a gay friendly GP list would appear to
meet the needs of MSM who are seeking a primary care
provider that understands the needs of this group. Further
development of the recommendations will assist in further
enhancing primary care referral pathways.