The other day I was having a conversation with a friend of mine who is gay who had recently visited a doctor, however, he mentioned to me that there was some information he omitted because he felt embarrassed talking about it.

This got me thinking about the important things we should be discussing with our health practitioners that we omit because we don’t want to be too much or experiencing feelings of embarrassment.

Gay men are already ashamed of going to clinics because of stigma but if you ever do I have come up with a few things that I feel are important things we should be discussing with our health practitioners on your next visit.

Sexual Health: HIV/AIDS

Men who have sex with men have an increased risk of HIV infection and this is evident in the stats in South Africa. 27% is the HIV infection rate of MSM (men who have sex with men) in the country, KZN having the highest percentage in comparison to other provinces. Discussing things such as your sexual history, number of current partners and whether or not you practice safe sex are important because it will help the health care professionals be aware of how to counsel and support you in your journey. They’ll also be able to advise on preventative measures that may fit your lifestyle such as PrEP or be able to point you in the right direction when needing safe sex paraphernalia. We cannot ignore the fact that there are still many unsafe sex practices that are still happening in the gay community especially in spaces such as bath houses. As much as there are effective HIV treatments on the way in the future, it is still important to speak to your health practitioner about safe sex practices and preventative measures or staying on ART effectively.

STIs are also common amongst us gay men, I for one have experienced having one and luckily I had a doctor who made me feel comfortable talking about what had happened and he was able to advise me while also cautioning me on other ways I could contract the same STI, FYI it was Syph-Syph.

Substance Use: Do you drink? Smoke?

It is known that gay men use substances when out and about painting the town red and the boys pink. These include a number of substances ranging from “poppers (amyl nitrate)” to cocaine, weed, MDMA etc. Some of these substances have become popular that it is normal to see 5 people walking out of a cubicle at night club and people carrying on with their lives while we mind our business. Substance use sometimes leads to bad decisions where you find yourself having sex without a condom or not realising when someone is stealthing you. There’s also the issue of how some medication may affect you whilst under the influence or how it may react when you use a certain substance such as cocaine. This particular one is important because a lot of us do drink when we’re out and we all know that our doctors usually warn us not to drink when we’re on antibiotics but have you ever been warned about other substances?

I am a smoker and there is history of cancer in my family (my Mom had Colon Cancer,) this is something I always mention when I go for a check-up. I have already gone for a screening for prostate and colon cancer, I usually do my testes in the shower but I only know the technique because I spoke with my health practitioner who showed me the correct way of doing it.

Mental Health: Are you okay?

A lot of us in the gay community are dealing with trauma from our childhood. A lot of gay men experienced homophobia and rejection from a young age from the people who are supposed to be protecting them. This is why depression and anxiety affects some of us in comparison to the general population, this is also evident in the number of suicides we usually hear about especially in countries like America where teens are bullied for the sexuality. There already isn’t enough support for mental health in our healthcare system that is sensitised to deal with LGBTQ+ related issues and a lot of people cannot afford therapy. Speaking to your health practitioner about this may help him advise you on medication to stay away from which may contribute to how you’re ready feeling or they may also be able to direct you to services that may cater for gay men. There’s also body dysmorphia that affects some gay men because we are such a materialistic community that we value six-packs and muscles. Yes, they are great to look at but it shouldn’t be a reason to make others feel bad for not looking like that, this often leads to bad diets where people starve themselves etc, discussing this with your healthcare practitioner is also very important. This could even lead to health problems such as diabetes, high blood pressure and anorexia. There’s also the supplements we consume to get the bodies we want, most of us do not know how these could react to certain medication.

There may be things I have omitted but from all my doctor’s visits, these are 3 things I have always discussed with my doctors and since then every other consultation has been a breeze because he understands me better now and my lifestyle.

Phumlani Kango is a contributing writer for the Anova Health Institute and these are his views, which may or may not reflect those of Anova and its affiliates.