The health concerns of gay identified men have been well documented, including a greater vulnerability to depression, due in no small part to continuing experiences of marginalisation and discrimination. This is certainly true of Australian gay men, including those who are HIV positive.1–4 However, Australian research also indicates that many gay men have access to open minded and supportive general practitioners, at least in the major cities.5–11 This is at odds with some reports in international literature which suggest that many gay men avoid disclosing sexual orientation and/or HIV status in health care settings due to fear or evidence of homophobia and stigma,12–15 which can seriously impact quality of care, including the prevention and treatment of mental illness. This opens up questions about the roles that Australian gay men with depression ascribe to their chosen GP and how this might influence the dynamics of clinical interactions between gay men and their doctors in high HIV caseload general practice settings.
This article identifies the roles that
gay men with depression ascribe to
their chosen general practitioner and
considers how they might influence
the dynamics of clinical interactions
between gay men and their doctors.
Forty gay identified men with
depression (recruited from high HIV
caseload general practices in New
South Wales and South Australia) took
part in semistructured interviews that
were analysed using the principles
of thematic analysis. Seventeen men
(aged 20–73 years) were HIV positive.
Five distinct roles were identified: GP as
trusted confidant, gentle guide, provider
of services, effective conduit, and
Gay men who have ongoing contact
with their GP may expect them to
intuitively understand which roles are
expected and appropriate to perform
in each consultation and over time.
General practitioners should consider
these changing roles, and take them
into account (as appropriate) to achieve
open and trusting relationships in the
care of their gay male patients.
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