Physicians' Attitudes Toward Homosexuality and HIV

Abstract

In 1982, Mathews et al. surveyed San Diego County Medical Society's (SDCMS) physicians about their attitudes toward homosexuality. They found significant differences in prevalence of homophobic attitudes by gender, year of medical school graduation, specialty, and practice setting. To assess current physicians' attitudes toward homosexuality and persons with HIV infection, an anonymous, self-administered, 17-item survey was mailed to all 4,385 members of the SDCMS and 1,271 UCSD physicians. The survey included items measuring attitudes toward homosexuality and toward entry to medical school and referral patterns, conditional on sexual orientation and HIV status of hypothetical referents. Only 3% of respondents would not admit a highly qualified homosexual applicant to medical school compared with 30% in 1982. Similarly, 9% would discontinue referrals to a gay pediatrician compared with 46% of respondents in 1982. Forty-two percent would not admit a "highly qualified but asymptomatic HIV-infected applicant with excellent response to antiretroviral therapy to medical school" and 66% would discontinue referral to a general surgeon known to be HIV infected. In multiple logistic regression analyses controlling for sex and medical school affiliation, significant (p < 0.05) independent predictors of being in the highest 10% on an HIV-phobia scale were year of graduation from medical school and degree of homophobia (model ROC = 0.77). This survey suggests a substantial reduction in homophobia since 1982. However, attitudes toward homosexuals and year of graduation from medical school appear to be significant predictors of attitudes toward persons with HIV infection.

Understanding Structural Barriers to Accessing HIV Testing and Prevention Services Among Black Men Who Have Sex with Men (BMSM) in the United States

“…Supportive social norms surrounding male-to-male sexual behavior as well as formal cultural competency of healthcare providers are critical for fostering positive relationships between providers and BMSM that facilitate access to HIV testing and prevention services at healthcare visits. Homophobia among physicians has decreased in recent years; however, research has shown that many physicians still express negative attitudes toward MSM [49, 50]. Many healthcare providers lack awareness of sexual identities and behaviors, and fail to recognize the importance of discussing sexual health with patients as a routine component of medical care [51–54].…”

Physician Awareness of Sexual Orientation and Preventive Health Recommendations to Men Who Have Sex With Men

“…Increased disclosure to younger PCPs may reflect an assumption that they are more likely to be comfortable with homosexuality, an assumption that is supported by a previous study. 12 Participants may also perceive a greater likelihood of acceptance among female PCPs. This is supported by Tellez's study, which demonstrated less homophobia among female physicians.…”

“…8–10 More recent studies showed that 73% to 82% of physicians were comfortable treating gay patients, with variations by physician gender, specialty, and year of medical school graduation, with increasing comfort levels in more recent graduates. 11,12 Despite these improvements, a substantial minority of providers report discomfort treating gay patients, have reservations about discussing sexual orientation, and would like further training in this area. 13 …”

Medical students’ attitudes toward gay men

“…Another study revealed “low-grade homophobia” among medical students that did not change significantly despite panel discussions and clinical experiences [14]. A more recent look at San Diego County Medical Society members’ view on gay students revealed a much decreased prevalence of sexual prejudice, but one that still existed and was associated with phobias about human immunodeficiency virus infection [15]. …”