Dr. Frank Spinelli: Cruise Control

BY Frank Spinelli, M D

February 18 2011 3:20 PM ET

COMMENTARY: Imagine for a moment that you’re a doctor — a gay doctor with a practice that predominantly treats gay men. Now guess how many text and phone calls you might receive during any given weekend involving questions that have to do with recreational drugs, penile discharge, or the risk of contracting HIV from unprotected sexual encounters. Now take that number and multiply it by 10 if that weekend should occur around Gay Pride, Folsom Street Fair, Gay Days at Disney, or any one of the Atlantis cruises. Welcome to my world.

At this point, you might be thinking, What did you expect when you decided to treat gay men? I knew what I was signing up for. The life of a gay party boy is not foreign to me. I’ve been to Folsom, Gay Days at Disney, and several Atlantis cruises. But even I struggle to understand the brain of a gay man, especially of those who make the regular 3 a.m. Sunday calls to me seeking advice, reassurance, or quick pharmaceutical relief.

Over the years I have monitored and treated gay men with curiosity. I’ve concluded that some of the most telling insights into the gay mind come from watching my own (presumably) heterosexual nephews. At age 15 and 16, they don’t always listen to their parents, they’re eager to push the limits set by their teachers, and when confronted about their risk-taking behavior, they invariably roll their eyes to show their disinterest in having a rational conversation. That’s because teenagers, like gay men, are a conundrum, baffling to scientists and doctors.

I’m not alone. My colleagues in Manhattan and Los Angeles give similar reports about their patients. We scratch our heads and wonder why the rates for syphilis are at an all-time high among men who have sex with men. And with all the media attention paid to HIV prevention and risk modification, the majority of new HIV cases in the United States are among gay men.





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