A MEDICAL VISIT COMPANION

Quality, access, and affordability. Everyone is concerned about health care, especially those past 60. The sicker you are, the less satisfied you are with the care you receive.

Now, a new study suggests that taking a companion to visits with your physician will improve satisfaction with the care you receive. Writing in the Archives of Internal Medicine (July 14, 2008), Wolff and Roter suggest that having a companion allows even the frailest and most vulnerable to have more confidence in their doctors’ skills, to feel better about the information they receive, and to have a better relationship with their doctor.

Companions facilitated communication, recorded physician’s instructions, provided medical history, asked questions, and explained instructions to patients. In addition they offered moral support, provided transportation and handled details like appointments and paperwork. This study also suggests that the more functions the companion performed, the higher the patients’ satisfaction for the services received.

Companions most frequently included spouses and adult children or other relatives, although much less commonly friends or care providers. This presents a challenge for some gay people.

Some findings from my survey of mature men over the age of 60 with same sex attraction:

• As expected, the number having fair to poor health increased with age from 11% between 60-69 years of age to 38% for those past 80 years of age; however, half of the men above 60 reported their health as very good to excellent.

• Those perceiving their health to be a major life stress increased from 28% in the 6th decade to 50% into their 8th decade.

• In this survey, 50-60% of gay men between 60-79 years of age live alone, although, unexpectedly, this percentage decreased with increasing age.

• The number reporting having a partner increased from 44% between ages 60-69 years of age, to 75% over the age of 80, although the number of men past 80 taking the survey was small.

• Of interest is the number of men having a partner but living alone. In the younger age group, 58% reported having a partner, but living alone. This dropped to 38% for those 70-79 years, and even lower for those past 80.

• Over half of the respondents are or were married, and between 1/2 -2/3 of those having been married had children.

Many of the men who responded to this survey are quite healthy and active, and many of the respondents are or have been married and have children who might be available to accompany them to their medical appointments. (The survey did not address the degree of involvement of families). Although many have friends who have become a “family of choice,

” a significant number are in poor health, live alone, and would seem to have no one to be a medical companion. Lessons learned: As your health declines, take someone with you to your appointments with your physician. As you become older or experience failing health, maintain relationships with family or those whom you have made your family of choice. Other research has established that those who have the greatest life satisfaction are those who assertively advocate for themselves. We must however, support our community by being aware of those with great needs and limited financial and social resources. We cannot assume from any survey that it is representative of all men who experience sexual attraction to other men, and in order to keep the scope of the project within manageable bounds, women were not asked to participate.

REDUCES RISK OF HIV - THE TOLERANCE

A recently released report from Emory University suggests that where tolerance of gays is higher, the spread of HIV may be slowed.

This study http://userwww.service.emory.edu/~hmialon/Tolerance_and_HIV.pdf, by Assistant Professors of Economics Andres Francis and Hugo Mialon of Emory, has not yet been published in a peer-reviewed academic publication, but because of the potential impact of their findings on policy decisions related to current discussions about same sex unions, Emory University has decided to promote the findings in a press release http://www.emory.edu/home/news/releases/2009/06/study-links-gay-marriage-bans-to-rise-in-hiv-rate.html.

The findings suggest:

1. Where tolerance of gays is higher, HIV rates are lower
2. Where tolerance is low, there is a higher rate of men having sex with men in underground “cruisy” areas, such as parks, beaches, restrooms and other public areas
3. Levels of tolerance did not effect more formal gay establishments like gay bars, bookstores, gay restaurants and GLBT churches
4. Higher levels of tolerance are positively associated with men reporting having had male partner in the last year.

In the press release, Mialon and Francis were quoted:

“We found the effects of tolerance for gays on HIV to be statistically significant and robust – they hold up under a range of empirical models,” says Hugo Mialon, an assistant professor of economics.

“Laws on gay marriage are in flux and under debate,” added Andrew Francis, also an assistant professor of economics, citing the recent decision by the California Supreme Court to uphold a ban on same-sex marriage. “It’s a hot issue, and we are hoping that policymakers will take our findings into account.”

Francis and Mialon theorize that the explanations for this correlation may be that higher tolerance induces more low risk gay men to come out, and that tolerance may cause gay men to shift away from anonymous encounters with high-risk individuals in secret venues to less risky sexual behaviors.

Detractors are suggesting this research is nothing more than propaganda and snake oil used to encourage the “disease rich act of sodomy.”

CHARACTERS GAY

For years, there has been a buzz about the lack of LGBT representation on the TV. Of late however, there has been a growing number of gay characters portrayed on TV, especially in the circle of daytime soaps. ABC’s “All My Children” has had a lesbian wedding, and CBS has had an ongoing gay drama (including sex) on their long running “As the World Turns”.

Well, it looks like CBS has yet again stumbled into the gay ring on daytime. This time it’s on the long running Young and Restless. That’s right, Y&R’s Yani Gellman, who plays the role of Rafe, is coming out as gay.