I Am Homosexual: Will My Autonomy as a Patient Be Respected by Health Care Providers?

Abstract

SESSION TITLE: Ethics SESSION TYPE: Original Investigation Slide PRESENTED ON: Saturday, April 16, 2016 at 04:00 PM - 05:00 PM PURPOSE: This study intended to determine the attitudes of healthcare providers towards homosexual patients, with particular emphasis on respect towards patient autonomy regarding HIV testing. METHODS: After IRB approval, a 30-question survey was conducted among the medical and paramedical staff of 24 different health care centers in 8 countries. The questionnaire included information regarding respondent demographics, their individual sexual preference and their attitudes towards treatment of a homosexual patient. All questionnaires were completed anonymously. RESULTS: 1450 surveys were filled in full. Males comprised 38.6% of the cohort (n=559) and 3.8% stated they are homosexual themselves (n=55). Respondents were almost equally divided between physicians (18.5%), nurses (27%), medical students (34.3%) and other paramedical staff members (19.0%). Most respondents (59%) had >5 years of experience working with patients. In response to the question “Do you feel that you are prepared to provide care to a homosexual patient?” there was a 15% negative response rate (n=217). Almost one fifth of the respondents (17.3%, n=251) stated they would be more likely to test for HIV without patient knowledge in homosexual patients compared to non-homosexual patients. Male healthcare workers (7.2% n=39, vs. 4.7% n=39) seemed more likely to state that their beliefs about homosexuality affect the care they provide to a homosexual patient, but this difference did not achieve statistical significance (p=0.051). Male healthcare workers were significantly more likely than female healthcare workers (22.6% n=123 vs. 14.5 n=120) to override patient autonomy by testing homosexual patients for HIV without their knowledge (p<0.001). Respondent sexual preferences were not associated with a different respect towards autonomy. CONCLUSIONS: In our cohort, the autonomy of a homosexual patient was not respected by one in six medical heath care practitioners regardless of their personal sexual preference. Male practitioners seem to respect patient autonomy less than women practitioners. CLINICAL IMPLICATIONS: To the best of our knowledge this is the first study to address the controversial issue of healthcare practitioner's attitude towards homosexual patients and potential differential treatment. Further research on the topic is clearly indicated to learn how healthcare practitioner may learn to overcome cultural and psychological barriers towards homosexuality. DISCLOSURE: The following authors have nothing to disclose: Fernando Aragon, Stephanie Bustamante, Ismael Garcia, Samaria Mejia, Mauricio Schiavon, Sharon Einav, Joseph Varon No Product/Research Disclosure Information