HIV, Gay Men, and MD's: The Elephant in the Room

More than half of gay and bisexual men say that a doctor has never recommended they get tested for HIV, and nearly two-thirds say they rarely or never discuss HIV when they visit their doctor, according to a new survey by the Henry J. Kaiser Family Foundation.

Lack of communication with doctors may be a barrier to more gay and bisexual men getting tested for HIV infections. “Almost half say they’ve never discussed their sexual orientation with a doctor, and 3 in 10 say they don’t feel comfortable discussing sexual behaviors with health professionals,” states the report.

Some 30% of gay and bisexual men report that they don’t have a regular physician, and these men (who tend to be younger, lower-income, and more racially diverse) are even less likely to report discussing HIV with doctors and to say they have been tested for HIV.

The Kaiser Family Foundation conducted a survey of 431 gay and bisexual men in the US that focused on attitudes, knowledge, and experiences with HIV/AIDS and new HIV therapies. The survey was conducted July 17-August 3, 2014 with a sample of men who self-identified as either gay or bisexual using a nationally representative, probability-based Internet panel.

The results show about half of gay and bisexual men say HIV/AIDS is a “very” or “somewhat” significant issue for them personally, while the other half say it is “not too significant” or “not a significant issue” in their lives. However, just more than one third say they are personally concerned about becoming infected, while more than half say they are not personally concerned.

Most gay and bisexual men are not aware of current treatment recommendations for those who are HIV-positive, or of the latest developments in reducing new infections. Only about a quarter know about pre-exposure prophylaxis (PrEP). Just 10% know someone, including themselves, who has taken PrEP, and 80% say they have heard only a little or nothing at all about the new medication.

Fewer than half of gay and bisexual men are aware that people with HIV should start antiretroviral (ARV) treatment as soon as they are diagnosed, and only a quarter know that taking consistent ARV treatment significantly reduces the risk of passing HIV on to one’s sexual partners.

The report notes that lack of awareness of HIV status (75%), complacency about HIV in the gay community (62%), and HIV-related stigma (56%) are major reasons it has been hard to control the spread of HIV among gay men.

Relatively few gay and bisexual men report getting tested for HIV as regularly as is often advised. While 70% say they have been tested at some point in their lives, just 30% say they were tested in the last year, including 19% who say their most recent test was within the past 6 months. Some 30% say they have never been tested for HIV.

The Henry J. Kaiser Family Foundation report, "HIV/AIDS in the Lives of Gay and Bisexual Men in the United States," was published online September 25, 2014.