How do I come out to my doctor? What sexually transmitted diseases am I at a higher risk of contracting because I am a gay man? Is there any truth to the concept of HIV re-infection? Will casual drug use really hurt me that much? What’s the real deal on the ‘flesh-eating’ MRSA bacteria I keep reading about affecting gay men in urban areas? If you’ve ever asked any of these questions, The Advocate Guide to Gay Men’s Health and Wellness by Dr. Frank Spinelli will provide the kind of straightforward and honest answers you’ve been in search of.
From the physical effects of drugs like cocaine and crystal meth on the body to the health risks associated with fisting and ‘watersports’ right down to the realities of gay sex and the unfortunate implications of the “Gay Body Beautiful” syndrome, Dr. Spinelli recounts his own personal experience both as a physician and a gay men in his conversational new guide which should become a well worn addition to any gay man’s personal library.
During a recent chat Dr. Spinelli talked to GayWired about why he wrote his new guide, the greatest health risk facing gay men today, his thoughts on crystal meth and how he really feels about being called the “gay Dr. McDreamy.”GW:
First off, who should read The Advocate Guide to Gay Men’s Health and Wellness
There is valuable information in the book for gay men of all ages. Gay sex tips, issues with addiction, and lifestyle concerns are just of a few of the areas that all gay men should be aware of. Because preventative health care issues begin at forty, gay men forty years and older will be particularly interested in the extensive coverage of preventative medicine.GW:
Why do gay men need their own health and wellness book?FS:
It would be nice to think that all men are created equally but that’s just not the case. Traditional medical teachings do not focus on gay health, and clinicians, like myself, who treat gay men find that that the average gay man has many concerns about their lifestyle.
Somewhere along the way gay health became synonymous with HIV, and I wanted gay men to know that there was more to it than that. Over the years I compiled questions from gay men and most were eager to learn about how their bodies worked in relationship to sex and how different diseases and conditions are predicated upon our lifestyle.GW:
What health issues are specific to gay men?FS:
Some specifics gay health issues include HIV but all sexually transmitted diseases. Anal cancer rates are higher in gay men due to the Human Papilloma Virus, which causes genital warts. That is why gay men should have annual anal Pap smears.
Recently, we’ve heard about the number of cases of drug resistant staph infection that has been affecting the general population, but MRSA has been affecting gay men since 2002.
Also the rates of depression, alcohol and substance abuse are higher. Then there are issues associated with the party lifestyle especially crystal meth, which is an epidemic in the gay community.GW:
Of all the concerns you just mentioned, what do you see as the single greatest health threat facing gay men today?FS:
HIV and crystal meth are still big health care concerns for gay men. It has been well documented that the rate of HIV infection is increased when men use recreational drugs.GW:
What are your thoughts on casual crystal meth use?FS:
Crystal meth’s ingredients are combustible, toxic and highly addictive.
Recreational drugs are illegal and it would be misleading for me to suggest that moderation is okay. I do however urge gay men to discuss their drug and alcohol use openly with their doctor.GW:
You mention in the guide that Staphylococcus aureus has been plaguing the gay community since 2002. Talk about that and why we haven’t heard more about it?FS:
MRSA is a growing problem. Initially, it was seen in the hospital setting, but then it began popping up in gay men. For the past few years I have been seeing more and more cases but it wasn’t being widely reported. I think it was just because it was affecting gay men.
Now that there are cases reported in children the media recognizes the significant impact MRSA is having on the entire community. And for good reason. The issue remains that MRSA needs to be publicized more because gay men are not recognizing what it looks like or know how it is transmitted.GW:
The New York Times
just reported this week that a new, highly drug-resistant strain of the “flesh-eating” MRSA bacteria is being spread among gay men in San Francisco and Boston. What does this mean in laymen’s terms and how should gay men protect themselves? Also, how great a threat is this new bacteria in terms of the risk that it will spread far and wide?FS:
This report talks about a new strain of MRSA which is affecting gay men in highly populated gay cities. MRSA commonly affects the skin causing infection and boils, however progressive cases can affect the underlying muscles.
This particular strain is resistant to 3 out of the 6 antibiotics used to treat MRSA. This makes treating this strain even more difficult for doctors. Gay men need to take precautions by routinely washing hands with soap and water. Lay down a towel to avoid contact with bare skin while using gym equipment and shower after sex.GW:
What is the greatest misconception gay men have about their health concerns and unique needs?FS:
Gay men often have misconceptions about how their bodies work whether it’s in relationship to disease, sexual practices, and aging. One of the reasons I wrote The Advocate Guide to Gay Health and Wellness
was to dispel some of these myths.GW:
Why is it important that gay men have a gay or gay-friendly doctor?FS:
This is so important. Gay men need to find a gay doctor or a gay friendly health care provider. Your clinician needs to have some insight into how gay men live and function. You shouldn’t feel embarrassed to talk to your doctor.
Your health care provider should be objective and aware of all the different facets of your life. Coming out to your doctor should not be burdened by shame, and if your doctor is not comfortable with treating homosexuals, then you should find yourself a new doctor.
Some people argue that their sexuality is something that they feel they do not need to disclose to their doctor, but this is nonsense. Your sexuality and your lifestyle are important contributing factors to your health. It is vital that your doctor understands everything there is to know about you.GW:
What three things should every gay man do today to insure he remains healthy tomorrow?FS:
First and foremost is to find a gay doctor or a gay friendly health care professional. You need to feel completely comfortable with whomever you pick. A doctor is not your mother and not the police. They are there to help you and without the truth they can’t.
Second, pay attention to your body. You should know yourself best. Listen for cues that might suggest something is wrong and seek out professional help.
Finally, nothing beats a healthy diet and routine exercise. And remember to visit your doctor at least once annually for a full physical exam.GW:
You treated the "The Godfather of Disco" Mel Cheren prior to his sudden death at age 77 due to AIDS/HIV related complications.
Did that experience in particular impart any new wisdom to you about the general health concerns of the gay community?FS:
I feel fortunate to have known him. The experience reminded me that men continue to have sex in their later years. Likewise HIV testing should be recommended to all gay men especially those who are sexually active with more than one partner no matter what age they are.GW:
Last question. What do you think of being called the gay ‘Dr. McDreamy’?FS:
I think its great. Now that I am forty, I feel good about the way I look, but that wasn’t always the case. Hopefully, I'll be remembered for being a doctor who provided gay men with advice on how to stay healthy physically and mentally.The Advocate Guide To Gay Men’s Health and Wellness by Dr. Frank Spinelli, M.D. is in stores now and available online.
Article provided in partnership with GayLinkContent.com.