Page 10, Out in the Mountains Choosing a. health care provider Many gay men and lesbians face the prospect of finding a health care provider with a certain amount of confusion and worry. It is important to find someone who is not only competent but trustworthy and caring. Finding such a person seems to be an overwhelming task. The time to look for a health care provider is when you are healthy. This will give you the time to find the person who views your health care needs in the same way that you do. When faced with this task, it helps to face it as you would hiring any service provider. Ask people you trust for recommendations, and interview the person you are bout to hire. Obviously there are some differences in hiring a health care provider - for one you have to pay for the interview. But, the principle is the same. A health care provider is someone who works for you to help you keep healthy. You pay for this service and deserve to be comfortable with the arrangement. One of the best ways to find someone you will be happy with is by asking around. Ask your friends and colleagues who they use. Many times local gay or lesbian organizations have lists of gay sympathetic providers. (There is a good list of providers in the Community Resources section of Out in the Mountains.) Find out the providers known to be homophobic and try to stay away from them. Even if you do not plan to come out to your provider, you will probably be uncomfortable with someone who is homophobic. The next step is to interview. Before interviewing a prospective health care provider you need to decide what will be important to you in your relationship with this person. The questions of whether to "come out" to a health care provider looms large when deciding who to go to and what the relationship will be like. Many gay and lesbian people are fearful of talking honestly about their sexuality. In a recent study done at the University of Iowa, forty percent of the lesbians surveyed "thought that their health care would be adversely a:_-f°°‘°_d if ihcif Physician were aware 0 their sexual preference." Certainly BODYWORK S by Deborah Kutzko in these times of increased homophobia, both lesbians and gay men have good reasons for these fears. Another concern is the effect that a breach of confidentiality might have on insurance companies, employers or family. There are some good reasons, however, to be open with a potential health care provider. Certainly the main reason is so that you can receive accurate information and complete care. Also in many cases it feels better. Questions of next of kin and who is allowed to see you and care for you in the event of serious illness are best handled when clarity and openness are allowed. Although our lives include more than our sexuality, complete health care should include attention to our sexual practices. For people with more than one sexual partner it is important to pay attention to the possibility of sexually transmitted diseases. For people who are not currently sexual or are sexual with one partner or themselves, there may be other problems or concerns that can be helped by talking to a health care provider. It sometimes helps to make a list of questions that you can take with you when interviewing a potential health care provider. Your list might include the following: 1) Do you have many gay or lesbian clients? 2) How do you feel about working with gay and lesbian people‘? 3) Are you familiar with gay and lesbian health problems? Who covers for you when Wu are not working? 5) Will my sexual preference be noted in my medical records’? 6) Who else will have access to my medical records’? A major point to remember when choosing a medical provider is that you are the boss. If you are not getting what you need from a particular provider, it is your right to ask for it or to find a better person for the job. 4) Letters Home "Letters Home" is for more than just letters to parents or children. We welcome your coming out stories in whatever fonn you've recorded them. We don’t Want to limit the column to just exchanges with family or just letters. Please share with us your experiences with co-workers, friends and acquaintances. Recollections of those conversations are fine. In short, we want "Letters Home" to be a forum for sharing all our coming out experiences. Some of our readers have told us that it is their favorite OITM feature! Help us continue the tradition by sharing your stories. . condom correctly) Risk reduction guidelines A.I.D.S. is spread primarily through sexual contact, and is epidemic right now in the gay men’s community. That doesn’t mean we can’t have sex anymore, but it does mean that we may need to change some of our activitie to make sure that both we and our partners stay healthy. With creativity and imagination, sex can still be as much fun as, or even more fun tha before. Some sex is completely safe, with no risk of transmission: - masturbation (alone or with a partner or partners) - massage and rubbing (frontage) - hugging, caressing, stroking wrestling - watching others, showing off to others - talking erotically, kinky, loving "dirty" or whatever. It's even safe to talk about things that aren't safe - provided that you don’t do them. Some sex is less risky. Although here is no guarantee that these ctivities are 100% foolproof, there is trong evidence that they significantly reduce your risk of being exposed. - anal intercourse with a condom (it is important 'to learn how to use a - oral sex without cumming in the mouth (or using a condom during oral sex) - water sports without swallowing (provided there are no open cuts or sores on the skin) .~ Some sex is more risky. Research indicates that these activities might allow transmission. - oral sex carried to a climax in the mouth - rimming (oral/anal contact) - fisting - anal intercourse without a condom (this is THE RISKIEST sexual activity) - sharing sex toys between partners - any semen or blood bein exchanged in an anus, mouth or opelii skin cuts and sores Multiple exposures probably increase your chances of becoming sick. If you think you have already been exposed, it becomes even mor important to practice safe sex (for both you and your partners). Take care of yourself. Take car of your friends and community.