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In a new study by researchers from the Medical College of Wisconsin and UW-Milwaukee, about 71 percent of some 270 gay man interviewed in Milwaukee said their primary care physician knew about their sexual orientation. Doctors for only about half, however, had recommended HIV testing.

(photo illustration by Adrian Palomo)

The U.S. Centers for Disease Control recommends such testing for anyone, ages 13 to 64, regardless of sexual orientation, according to lead author Andrew Petroll, an assistant professor of medicine and psychiatry at MCW’s Center for AIDS Intervention Research. But it’s especially important for gay men, he says.

“Performing HIV tests in gay men who are sexually active is essential since, as a group, their sex partners are more likely to have HIV than most heterosexual individuals,” Petroll says.

The study investigated how likely gay and bisexual men were to tell their doctors about their sexuality – and what testing those doctors recommended in response. Of the men surveyed who said their doctor knew about their sexuality, 70 percent said they had disclosed it voluntarily; 14 percent said they disclosed it after their doctor asked; and another 14 percent said their doctor had “correctly assumed their sexual orientation.”

White and Hispanic men were almost twice as likely as African American men to tell their doctors they were gay or bisexual; only about 38 percent of the African American men who took the survey said their doctors were aware of their sexual orientation.

Petroll says a reluctance to come forward with such information “may have to do with perceived stigma regarding homosexuality, fear of discrimination by the health care provider or fears regarding confidentiality. To some extent, these fears may be well-founded.”

He adds, “While many health care providers may be adept and at ease with caring for gay patients, many are not.”

This may stem, in part, from the near absence of sexual orientation-related training in medical schools. According to Petroll, past surveys have found that medical schools, on average, spend only two to four hours over four years discussing the topic. The paper recommends “universal and compulsory human sexuality education in all medical and other health professions’ schools” and in continuing education requirements for health care professionals.

And homophobia, although it has declined among doctors in recent decades, remains a barrier, the paper notes. Studies in the 1970s and 1980s found that between 37 and 69 percent of doctors “were uncomfortable with gay patients.” More recent ones, conducted since the late 1990s, have found that between 73 and 82 percent of physicians are comfortable with treating gay patients.

Of those men who had told their doctors (or been asked by them) about their sexuality, 59 percent said their physician had recommended HIV testing. For those whose doctors didn’t know, only 13 percent had received such a recommendation.

Only 32 percent of the men who said their doctors knew they were gay had received recommendations to get vaccinated for hepatitis A or B, other diseases sexually active gay men are at a higher risk for contracting. Only about 16 percent of those whose doctors didn’t know had received the same recommendation.

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