Healthcare Experiences of Men Who Have Sex with Men: Understanding Trauma, Patient-Provider Relationships, and the Lasting Impacts of the AIDS Crisis

Abstract

Studies of patients’ health outcomes and the quality of healthcare services show that the patient-provider relationship is crucial, and further, that a patient-centered approach to care is essential for effective public reporting and ensuring high quality health-care results (Theis 2016). However, what might happen if a patient-provider relationship is undeveloped, or even hostile? Inadequate treatment of patients in medical settings is a common experience of sexual minorities, who have historically experienced greater burdens of disease and discrimination. This study explores the narratives and lived-experiences of MSM to better understand the patient-provider relationships for MSM, and to some extent queer people in general, given the growing social and political acceptance of queer identities. MSM is the population of interest because it is a historically marginalized group that reports significant incidence of stigma, especially surrounding their sexual health and sexual behaviors. In order to assess how the evolving social landscape has affected the experiences of MSM, 20 men were interviewed about their healthcare experiences; 10 of these men were between the ages of 18 and 49, and the remaining 10 men were 50 years old or older. Through a comparative analysis, this study assesses differences and similarities in healthcare experiences—as well as the subsequent health-related needs and preferences—of participants, particularly with regard to social trauma, medical trauma, and their proximity to the AIDS crisis of the 1980s. Studies of patients’ health outcomes and the quality of healthcare services show that the patient-provider relationship is crucial and that a patient-centred approach to care is essential for ensuring high-quality healthcare results. However, what might happen if a patient-provider relationship were undeveloped, or even hostile? Inadequate treatment of patients in medical settings is a common experience of sexual minorities, who have historically experienced greater burdens of disease and discrimination. This study explores the lived experiences of men who have sex with men (MSM) to better understand their patient-provider relationships. MSM are the population of interest because they are historically marginalised and stigmatised, especially surrounding their sexual health and sexual behaviours. In order to assess how an evolving social landscape has affected the experiences of MSM, 20 men were interviewed. Among them, 10 men were between the ages of 18 and 49, and 10 were 50 or older. Through a comparative analysis, this study assesses differences and similarities in healthcare experiences – and the resulting health-related needs and preferences – of participants, particularly with regard to social trauma, medical trauma, and their proximity to the 1980s AIDS crisis. Additionally, race, ethnicity, and language emerged during interviews with participants of colour as salient factors which impacted their healthcare experiences.