What is a gay-friendly GP? Gay men’s health beyond PrEP and STI testing

Introduction

A gay-friendly GP should be someone you can speak to openly about sex, PrEP, STI testing, sexual performance or erectile difficulties, recreational drugs or other sensitive issues without needing to edit your story or worry about being judged. Good gay men’s healthcare should not end there.

The same doctor should also be able to move naturally from those conversations into ordinary general practice: checking blood pressure, assessing cardiovascular risk, discussing smoking or vaping, reviewing vaccinations, arranging cancer screening, assessing a changing skin lesion or managing a long-term medical condition.

The role of a gay-friendly GP is not to make every health concern about sexuality, but provide wholistic person-centred care in a non-judgemental and approachable manner. The consult should be one where sexuality can be discussed comfortably when it matters - but doesn’t become a barrier to looking after the rest of your health.

Sensitive conversations should fit naturally into ordinary healthcare

Many health concerns cannot be assessed properly when a patient feels they need to leave out important details.

That might mean not mentioning the anatomical sites involved during sex, the number or gender of partners, erectile medication use, recreational drug use, a recent possible HIV exposure, pain during sex or changes in sexual function.

These details can directly affect which tests, treatments and preventive measures are appropriate. Australian STI guidance recommends taking a sexual history and tailoring testing to sexual practices and relevant anatomical sites. Many STIs are asymptomatic, so testing based only on symptoms may miss infections.[1,2]

Patients may also worry that mentioning party drugs will produce an exaggerated reaction, that asking about PrEP will dominate the entire consultation, or that sexual symptoms will be interpreted through heterosexual assumptions.

The purpose of asking these questions is to understand what tests, treatment or advice are genuinely relevant. Gay men often have unique relationships and sexual health needs, health risks and priorities. Having a doctor who understands this context can remove much of the awkwardness from discussing sensitive concerns.

Sexual health should also sit within ordinary general practice rather than in a separate compartment. A consultation may begin with PrEP, STI testing, vaccination or a sexual-function concern, but it may also reveal that blood pressure has not been checked recently, vaping has increased, sleep has deteriorated or a persistent skin lesion needs examination.

Gay men’s health is broader than sexual health

Australia’s National Action Plan for the Health and Wellbeing of LGBTIQA+ People recognises that LGBTIQA+ people experience health inequities and barriers to safe, inclusive and effective healthcare.[3]

This does not mean every gay man has poor health or requires unusually intensive medical care. Population-level differences should inform healthcare without becoming stereotypes.

Australian survey data show that gay, lesbian and bisexual people are more likely than heterosexual people to smoke, vape, consume alcohol at risky levels and report recent illicit drug use.[4] These differences are relevant to preventive healthcare because tobacco, alcohol and other drug use can affect cancer risk, cardiovascular health, lung health, sleep, mental wellbeing, sexual function and medication safety.

There are also substantial differences in mental-health outcomes. In the Australian Bureau of Statistics National Study of Mental Health and Wellbeing, 42.8% of gay or lesbian people reported a mental disorder in the preceding 12 months, compared with 19.9% of heterosexual people.[5]

A gay-friendly GP does not need to turn every appointment into counselling. The practical value is being able to recognise when stress, sleep, substance use, stigma or previous negative healthcare experiences are affecting someone’s physical health or making them reluctant to seek care.

Just as importantly, gay men still experience the same common health problems as everyone else: hypertension, high cholesterol, diabetes, kidney disease, lung disease, skin cancer, sleep apnoea and other chronic conditions.

A doctor’s familiarity with PrEP should not come at the expense of these broader areas of general practice.

Preventive care should be individual rather than stereotyped

Being gay does not automatically determine which tests or treatments someone needs.

Preventive care should be based on age, anatomy, medical history, family history, vaccination status, medications, sexual practices and other individual risk factors.

For example, vaccination recommendations for men who have sex with men may include hepatitis A, hepatitis B for those who are not immune, HPV vaccination and mpox vaccination for people at increased risk of exposure.[6] Routine adult vaccinations should also be reviewed according to age, medical conditions and previous vaccination history.

Similarly, cancer screening should be based on the organs a person has, their age and their individual risk. Australian population screening programs currently cover bowel, cervical and breast cancer, while skin assessment is guided by symptoms and individual skin-cancer risk.[7]

Routine cardiovascular prevention may involve assessing blood pressure, smoking, cholesterol, diabetes risk, physical activity, diet, kidney health and overall cardiovascular risk where appropriate.[8]

The purpose is not to create an excessive checklist. It is to make sure that ordinary evidence-based preventive care is not neglected.

What does a gay-friendly GP appointment involve?

There is no compulsory checklist.

The consultation should begin with the reason the patient booked and what they want help with. Depending on that concern, the discussion might involve PrEP, PEP, STI testing, vaccinations, sexual function, recreational drug use or a completely unrelated medical problem.

The GP can then identify preventive care that is genuinely due rather than ordering broad panels of low-value tests. Preventive care in general practice should be targeted to age, risk factors and the individual patient rather than applied as an indiscriminate package.[8]

Some patients want a single focused appointment. Others are looking for a regular doctor who can gradually bring their preventive care up to date. Both approaches are reasonable.

Being gay-friendly does not mean that every appointment needs to focus on sexuality. It means that when sexuality or sexual behaviour is clinically relevant, it can be discussed directly, respectfully and without discomfort.

Gay-friendly general practice in Adelaide

Dr Christian Peut is a gay-friendly GP in Adelaide and provides general practice care with a particular interest in gay and bisexual men’s health, PrEP and HIV prevention.

My approach is to offer a comfortable environment for discussing sexual health, sexual function, recreational drugs and other sensitive concerns, while continuing to provide comprehensive general practice.

This includes preventive healthcare, skin checks, cancer screening, cardiovascular risk assessment, smoking and vaping support, vaccination and management of chronic conditions such as diabetes, kidney disease, heart disease and lung disease.

I consult in Adelaide’s north-eastern suburbs, including patients from Paradise, Campbelltown, Newton, Athelstone, Dernancourt, Rostrevor, Modbury, Marden, Klemzig, Magil and surrounding areas.

Book an appointment

You can book for PrEP, HIV prevention, STI testing, vaccination advice, sexual-function concerns, skin checks, preventive healthcare or a general medical review.

You do not need to decide in advance whether a concern belongs under “gay men’s health” or ordinary general practice. The purpose of the consultation is to discuss what is happening, identify what matters and decide what is worth doing next.

References

1. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. Men who have sex with men. STI Guidelines Australia [Internet]. Sydney: ASHM; [cited 2026 Jul 14]. Available from: https://sti.guidelines.org.au/populations-and-situations/men-who-have-sex-with-men/
2. Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine. Standard asymptomatic check-up. STI Guidelines Australia [Internet]. Sydney: ASHM; [cited 2026 Jul 14]. Available from: https://sti.guidelines.org.au/standard-asymptomatic-checkup/
3. Australian Government Department of Health and Aged Care. National Action Plan for the Health and Wellbeing of LGBTIQA+ People 2025–2035 [Internet]. Canberra: Australian Government; 2024 [cited 2026 Jul 14]. Available from: https://www.health.gov.au/resources/publications/national-action-plan-for-the-health-and-wellbeing-of-lgbtiqa-people-2025-2035
4. Australian Institute of Health and Welfare. LGBT people’s use of alcohol, tobacco, e-cigarettes and other drugs: National Drug Strategy Household Survey 2022–2023 [Internet]. Canberra: AIHW; 2024 [cited 2026 Jul 14]. Available from: https://www.aihw.gov.au/reports/lgbtiq-communities/lgbt-people-alcohol-drugs
5. Australian Bureau of Statistics. Mental health findings for LGBTQ+ Australians [Internet]. Canberra: ABS; 2024 Feb 27 [cited 2026 Jul 14]. Available from: https://www.abs.gov.au/articles/mental-health-findings-lgbtq-australians
6. Australian Technical Advisory Group on Immunisation. Vaccination for other groups: inmates, men who have sex with men, people who inject drugs and sex workers. Australian Immunisation Handbook [Internet]. Canberra: Australian Government Department of Health, Disability and Ageing; [cited 2026 Jul 14]. Available from: https://immunisationhandbook.health.gov.au/contents/vaccination-for-special-risk-groups/vaccination-for-other-groups-inmates-men-who-have-sex-with-men-people-who-inject-drugs-and-sex-workers
7. Cancer Council SA. LGBTQIA+ and cancer screening [Internet]. Adelaide: Cancer Council SA; [cited 2026 Jul 14]. Available from: https://www.cancersa.org.au/cancer-prevention/screening-and-finding-cancer-early/lgbtqia-and-cancer-screening
8. Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice. 10th ed. East Melbourne: RACGP; 2024. Available from: https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/preventive-activities-in-general-practice