Talk about sex? - how HIV-positive gay men talk about sexual health with their doctors and health care providers

This thesis is a qualitative study investigating the communication about sexual health between HIV-positive gay men and their doctors and other health care providers. The study was conducted in 2007 and 2008 in Sydney, Australia. Data was collected through in-depth interviews with eleven HIV-positive gay men, and analysed according to a modified grounded theory approach. The study aims to explore the men’s needs, expectations and experiences in relation to how sexual health is addressed in clinical consultations. While previous research has documented that HIV/AIDS is a diagnosis that poses significant physical, emotional and social challenges for People Living With HIV/AIDS (PLWHA) which may impact on their sexual health and well-being, this thesis examines whether, and to what extent this is communicated between HIV-positive gay men and their doctors. In doing so the study identifies and describes the ways in which HIV-positive gay men understand sexual health, how they currently talk to their clinicians about sexual health issues, the priority that such issues have for these men, and barriers and ‘incentives’ to sexual health being discussed within HIV treatment settings.The study reveals that the men’s communication about sexual health with their doctors is essentially limited to discussions about sexually transmissible infections (STIs), which represent a common understanding of what constitutes sexual health. The emotional and social aspects of sexual health and well-being are rarely discussed in doctor-patient communication. Instead, the men rely on sources outside the health system, such as friends, peers, partners, gay and HIV community organizations and the gay and HIV media for sexual health information, advice and support. This indicates that broad, holistic sexual health has a low priority in discussions between patients and their doctors, and that social networks therefore play an important role in how HIV-positive gay men take care of their sexual health