Health status, behavior, and care utilization in the Geneva Gay Men's Health Survey
Introduction
The focus of public health efforts among gay men in the past 20 years has been dominated by the HIV/AIDS epidemic, yet recent reviews of health issues relevant to gay men, lesbians, bisexual men and women, and transgender people (GLBT) released on three continents (Dean et al., 2000, Gay and Lesbian Medical Association and LGBT health experts, 2001, Ryan and Chervin, 2001, Ministerial Advisory Committee on Gay and Lesbian Health, 2002, Douglas Scott et al., 2004) suggest higher morbidity in sexual health (e.g., HIV and other sexually transmitted infections), mental health (e.g., depression and suicide), and substance use (e.g., smoking, alcohol, and drugs). Yet while GLBT are gaining recognition as a “community” for targeted public health policies, the evidence basis is poor (Sell and Becker, 2001, Boehmer, 2002), leading the American Public Health Association (APHA) to pass a resolution calling for more research on the relationship between disease and sexual orientation (1999).
The Geneva Gay Men's Health Survey (GGMHS) was a comprehensive health survey – i.e., patterned along national health interview surveys – conducted among a community sample of gay men. In order to explore the possible existence of distinctive health needs, this paper presents a comparison between a community sample of gay men and matched general population controls along key health indicators.
Section snippets
Sample
The Geneva Gay Men's Health Survey (GGMHS) was a cross-sectional venue-based probability survey using time-space sampling developed by the Centers for Disease Control and Prevention (CDC) (MacKellar et al., 1996, Stueve et al., 2001). All meeting points (N = 35) frequented by an important number of gay men in Geneva – i.e., gay organization events, bars/cafes, clubs, sex clubs, bathhouses, parks/public toilets, and chatrooms – were enumerated for visits over a 1-week period, providing the basis
Socio-demographic factors
The GGMHS sample consisted largely of a young and mid-life population with an average age of 35 years (SD = 10.7). Although matching by canton of residence could not be carried out to the point of parity between the two samples, cultural region could as 96% of both samples live in French-speaking Switzerland. Even after matching, however, the two samples still exhibited considerable differences in socio-economic status (SES) and habitation patterns (see Table 2). Although there were twice as many
Discussion
Although the gay male sample presented a healthier profile for attention to food choices and body mass index, all other health indicators were either equivocal or suggested greater morbidity than the general male population, even after controlling for differences in socio-demographic characteristics and health behaviors. While the findings underscore greater morbidity (Dean et al., 2000, Ryan and Chervin, 2001, Stall et al., 2003, Douglas Scott et al., 2004), this study is among the first to
Conclusions
Although poor indicators for chronic conditions in the SHS make it difficult to establish higher disease morbidity in this gay male sample with certainty, gay men were more likely to have suffered from moderate/severe symptoms in the past 4 weeks and have reported short-term disability. Furthermore, gay men were more likely to report high cholesterol, high blood pressure, high glucose, and smoking which are all major risk factors for serious chronic diseases. Finally, greater health care
Acknowledgments
The authors wish to thank project assistant Vincent Jobin and the many volunteers and experts who have contributed to the Geneva Gay Men's Health Project. Special acknowledgement goes to Ron Clarke at Health Canada for his participation in discussions on the overall project. Data collection for the Geneva Gay Men's Health Survey was financed by the Swiss National Research Foundation grant 3326-062448 and the Swiss Federal Office of Public Health. This publication and the analyses therein were
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