Suicide rates are twice as high in gay men living with HIV in the UK than in the general population. Despite working in the field of health and HIV for several years, I was still shocked when this was presented a few months ago and its haunted me ever since. Why are we failing this group when they most need support and how do we address this?
So yesterday I became very excited when attending an event organised by the NGO National Voices (If you don't know them and are interested in patient rights they're well worth checking out) where a GP was speaking about improving care for all. He was championing a new approach to how health care should be delivered by joining up services across GPs, mental health, long-term conditions and the voluntary sector. An approach that puts the needs of the individual at the centre and joins up what can be an increasingly fractured and complicated healthcare system.
I asked the question, as to whether any work had been done to engage people who traditionally have poor experiences of GPs such as people living with HIV, LGBT communities or any work in joining up general health and sexual health which are often treated as separate entities. In fairness, I wasn't expecting that anything had been done but was hoping was that they would look on this as an exciting opportunity to challenge some of these issues and fix a fractured system.
My excitement turned to disillusionment at a rapid pace. I was basically told that you couldn't expect GPs to manage everything, this fell out of their remit, you'd have to look at bigger cohorts as the numbers were too small etc. Basically, I was fobbed off.
Over one million people identify as LGBT in the UK and as a community we face specific health risks. Mental health issues and incidences of self-harm are higher within LGBT communities. Misuse and addiction to drug and alcohol are also high. Suicide rates are higher with gay men. Gay and bisexual men and trans communities are greater risk of HIV and STIs. The list goes on.
Yet overall health care providers and GPs are failing to address the needs of the LGBT community.
A study by Stonewall back in 2013 found that one in ten health and care providers reported they were not confident in their ability to understand and meet the specific needs of lesbian, gay or bisexual patients and service users. Also, nearly a quarter said they were not confident in their ability to respond to the specific care needs of trans patients. That's concerning, but at least this cohort recognise that LGBT patients do have specific needs. This contrasts with another finding from the same report where six in ten professionals say they don't think sexual orientation is relevant to one's health needs. Add to this research undertaken by Positively UK where over half of those questioned said their GP was uncomfortable talking about their sexual health and you have a worrying picture.
This begs several questions. Do GPs and other healthcare professionals understand the health risks associated with our community? Do they understand how our lives, societal pressures and prejudices impact upon our health? Why are certain health issues treated as taboo subjects by some healthcare professionals? Have they ever stopped to ask anyone from the LGBT community what is relevant to their health needs rather than making assumptions? And of course, let's not forget the inherent problem of tackling prejudice towards LGBT people amongst some healthcare providers?
No one expects healthcare professionals to be experts in everything but we do expect them to treat everyone fairly and seek solutions. One gay man living with HIV told us how his GP was at a loss as to whether one of his health issues was HIV related or not. What did the GP do? They picked up the phone and spoke to the HIV clinic directly and agree what was best. It's not difficult, it's not complex, and providing good care can be as simple as treating people fairly, recognising the need and having a conversation.