ABSTRACT
A significant proportion of the population is predominantly gay or lesbian, but the unique health care needs of these patients and their families often are ignored. The most significant health risk for lesbians and gays may be that they avoid routine health care. Families that include gay members may have special needs, largely related to how homosexuality is perceived. Physicians can improve the health care of gay and bisexual men and women and their families by maintaining a non-homophobic attitude, being sure to distinguish sexual behavior from sexual identity, communicating clearly and sensitively by using gender-neutral terms, and being aware of how their own attitudes affect clinical judgment.
Subject(s)
Delivery of Health Care/organization & administration , Homosexuality , Primary Health Care/organization & administration , Female , Health Services Needs and Demand , Homosexuality/psychology , Humans , Male , Physician-Patient Relations , Prejudice , United StatesABSTRACT
Although a significant proportion of the population is gay or lesbian, physicians receive little formal training about homosexuality, and the unique health care needs of these patients are often ignored. Gay men and women may have higher rates of depression, suicide, alcoholism, certain cancers, and cardiovascular disease than their heterosexual counterparts. In addition, they are at risk of being victims of violence because of their sexual orientation. Due to fear of stigmatization by the medical community, the most significant health risk for lesbians, gays, and bisexuals may be that they avoid routine health care. Gay youth are particularly vulnerable to internal and external pressures, resulting in higher rates of substance abuse, suicide, and homelessness. Older gay men and women, who generally view themselves positively, may be troubled by declining health and loneliness. Physicians can improve the health care of gay and bisexual men and women and their families by maintaining a non-homophobic attitude toward these patients, distinguishing sexual behavior from sexual identity, communicating with gender-neutral terms, and maintaining awareness of how their own attitudes affect clinical judgment. Medical educators should avoid making assumptions about the sexuality of their residents and students. Institutions need to realize that the presence of supportive heterosexual and openly gay faculty will help create an environment that fosters learning for all students. Scant research exists about the best ways to teach about the special challenges gay men and lesbians face. However, the majority of surveyed medical students prefer that issues regarding gays and lesbians be integrated throughout the entire medical school curriculum.
Subject(s)
Education, Medical , Family Practice , Homosexuality, Female , Homosexuality, Male , Physician-Patient Relations , Adolescent , Adolescent Health Services , Aging , Attitude of Health Personnel , Female , Health Services Needs and Demand , Homosexuality, Female/psychology , Homosexuality, Male/psychology , Humans , MaleABSTRACT
We tested 187 strains of coagulase-negative staphylococci (CNS) for the production of toxic shock syndrome toxin 1 (TSST-1). A total of 111 CNS strains were isolated from the tampons of menstruating women and 74 were isolated from unused tampons. Two strains were isolated from the genital tract of a patient with toxic shock syndrome. Strains were cultivated by the membrane-over-agar method to enhance production of TSST-1, and culture supernatants were tested by two exquisitely sensitive enzyme-linked immunosorbent assays. None of the 187 CNS strains produced TSST-1. We conclude that CNS colonizing the genital tracts of menstruating women and unused tampons produce TSST-1 infrequently, if ever, and are unlikely to play a role in toxic shock syndrome.
