Gay, bisexual, and other men who have sex with men: Barriers and facilitators to healthcare access in Ottawa

Abstract

Despite access to healthcare that is similar to the entire population, gay, bisexual, and other men who have sex with men (gbMSM) have worse rates for many pathologies, including sexually transmitted infections (STIs) and HIV, mental health, and substance use. To better understand the barriers to care that occur during healthcare interactions—in an effort to make recommendations to improve these clinical encounters—we engaged in focus groups with three groups of gbMSM. We explored the experiences and concerns of these men regarding healthcare. In total, we interviewed 32 men. Our findings identified that the two most pronounced barriers to delivery of comprehensive and impactful healthcare for gbMSM were (1) wariness and distrust of the healthcare system and fears of neglect and overt discrimination, and (2) a lack of knowledge among healthcare professionals about specific health concerns for MSM. Facilitators as identified by participants were (1) creating safe spaces where MSM are recognized, (2) not only developing but demonstrating an accepting and supportive therapeutic relationship with patients, and (3) attention to issues of disclosure and confidentiality. These findings highlight both ongoing issues in the delivery of healthcare for gbMSM in Canada, and tangible solutions that practitioners can implement immediately to address these problems.