Week 3 - LGBT - Lgbt issues in primary care and the assessment

Question 1

What is the scale, aka the homophobia scale, known as? It was developed in 1973 as a way to classifiy attitudes to homosexual individuals

Answer 1

The homophobia scale is actually known as the Riddle scale
Range as followes:
Repulsion - Pity - Tolerance - Acceptance - Support - Admiration - Appreciation - Nurturance

Question 2

What is heterosexism?

What is homophobia?

Answer 2

Heterosexism is the assumption that everyone is heterosexual or that it would be obvious if someone was not heterosexual

Homophobia is defined as a dislike, or prejudice, towards homophobic people

Question 3

Homosexuality is still punishable by death in some countries

When were homosexual acts legalised in the UK and what for what age?
What was it reduced to and when?

Answer 3

Homosexual acts were legalised in the UK for those aged 21 and over in 1967
In 2001, the age was reduced to 16 making the age of consent for sexual activity the same for all

Question 4

Are insurance companies allowed to ask about
Sexual orientation
Negative HIV tests
and why?

Answer 4

Insurance companies are now not allowed to ask about negative HIV tests or sexual orientation - can cause discrimination

Question 5

What percentage of LGB people suffer from a mental health condition?

What percentage of transexual people suffer from a mental health condition?

Answer 5

40% of LGB people suffer from a mental health condition

67% of transgender people suffer from a mental health condition

Question 6

Do more bisexual men or women suffer from a mental health condition?

Answer 6

It is more common for bisexual women (63%) to suffer from a mental health condition than bisexual men (20%)

Question 7

Generally, 1in15 teenagers under the age of 20 are thought to have self harmed

How does this compare with lesbian and bisexual women?

Answer 7

It is thought that more than half of lesbian and bisexual women under the age of 20 have self-harmed

Question 8

It is important not to make assumptions about sexual practices in the LGB community

WHat percentage of gay men have never had anal sex?

Answer 8

Almost one quarter (24%) of gay men have never had anal sex

Question 9

What group is the most commonly affected by HIV in the UK?

Answer 9

Men who have sex with men (MSM)

Question 10

Post-exposure prophylaxis is a short course of anti-retrovirals that can be offered after HIV exposure

How long is the course and when must the course be started?

Answer 10

Course lasts at least 28 days and must be started within 72 hours to exposure

Question 11

When seeing a young man with procititis or other rectal symptoms it is important to ask about sexual orientation.

What bacteria should be considered that is not common in primary care?
What is the treatmnet?

Answer 11

Think off lymphogranuloma venereum
Chalmydia trachomatis serovars L1-L3

3weeks of doxycycline is treatment

Question 12

What percentage of lesbian women and gay men have received negative or mixed reactions from mental health professionals when they came out to them?

Answer 12

1in5 lesbian women have received negative reactions

1in3 gay men have received negative reactions

Question 13

Compound discrimination refers to the challenge of being in more than one minority group ie black and lesbian

What are 4 groups that may be discrimnated against?

Answer 13

Disability
Race and ethnicity

Bisexual

Older adults

Question 14

MSM are still remain the group most affected by HIV in the UK

When is testing for HIV carried out?

Answer 14

Testing for HIV is carried out generally carried out 4-6 weeks after exposure an then 3months after exposure if initial test was negative

Question 15

What percentages of gay men who have gonorrhea will test positive for HIV?

Answer 15

24%

same as the percentage of gay men who have never had anal sex

Question 16

A 26 year old woman attends surgery and asks about having a smear. She is a lesbian
and has never had sex with a man – does she really need a smear test?
a . She should have one smear, but her ongoing risk is low so if her first smear is negative she doesn’t need to keep having them

b . It depends on the sexual history of her partner

c . Women who have never had sex with a man do not need to have smears

d . All sexually active women should have a smear test

Answer 16

d - All sexually active women should have a smear test - it is possible to exposed to HPV during lesbian sex and partners may have had previous relationships with men

Question 17

In what year did 16 become the age of consent for homosexual sex, giving equality with
heterosexual sex for the first time?

Select one:

a. 2001
b. 1985
c. 1990
d. 1967

When was homosexuality legalised in the UK?

Answer 17

a) in 2001, the age of consent for homosexual sex became 16

Homosexuality was legalised in the UK in 1967 for all those aged 21 and above

Question 18

When completing an insurance form:
Select one:

a. Insurance companies may ask for negative test results for HIV
b. Insurance companies may ask for someone’s stated sexual orientation
c. Insurance companies may ask for both of these
d. Neither should be asked for

Answer 18

D - Neither should be asked for

Question 19

What percentage of gay men have never had anal sex?
Select one:

a. 54%
b. 10%
c. 24%
d. 3%

Answer 19

c - 24%

Question 20

Regarding gonorrhoea: Select one

• a. Infection confers some immunity, making re-infection less likely
• b. It is the most common STI among men who have sex with men
• c. Rates of diagnosis have decreased over the last 10 years, reflecting the reduction in unprotected sex since the emergence of HIV
• d. Of those who are diagnosed with gonorrhoea, the majority will also have HIV

Answer 20

B - It i the most common STI among men who have sex with men

Question 21

What percentage of MSM diagnosed with gonorrhea will also have an HIV infection?

Answer 21

24%

Question 22

The largest demographic group affected by HIV in the UK is:
Select one:

a. Intravenous drug users
b. Men who have sex with men
c. Haemophiliacs
d. Black Africans

Answer 22

B - Men who have sex with men

Question 23

When compared to gay patients, those who are bisexual:
Select one or more:

a. Have higher rates of STIs
b. Have higher rates of self-harm
c. Are more likely to have disclosed their sexual orientation to their GP
d. Are more likely to drink alcohol to excess

Answer 23

B - Have higher rates of self harm

D - Are more likely to drink alcohol to excess

Question 24

Which of the following might benefit from the HPV vaccine?
Select one:

a. Gay men
b. Lesbian women
c. None of the above – it is only useful when given before a person is sexually

active

d. All of the above

Answer 24

D - All of the above

Ie both Gay men and lesbian women may benefit from the HPV vaccine

Question 25

Which of the following are more common amongst BME LGB people than their
Caucasian counterparts?
Select one or more:

a. Harassment from a stranger
b. Self harm
c. Domestic violence
d. Drug use

BME - black and minority ethnicity

Answer 25

A - Harassment from a stranger
B - Self harm
C - Domestive violence

Question 26

If a lesbian couple want to have a child:
Select one
a. The woman who carries the pregnancy automatically has parental responsibility whereas her partner will need to apply for this through the courts

b. Nneed to be a social assessment first, as clinics must take into account the need for the child to have a father
c. CCGs are obliged to provide funding for IVF for lesbian couples who wish to conceive
d. The donor of the sperm will not at any point have parental responsibility

Answer 26

D - The donor of the sperm will not at any point have parental responsibility

If a lesbian couple has a child together parental

responsibility is shared equally between the two women and not held by the donor of the

sperm