Decision making in the provision of health care is influenced by not only scientific evidence but also by the systems in which decisions are made. We consider national decisions made in the UK related to sexually transmitted infection prevention in gay, bisexual, and other men who have sex with men (GBMSM), with three specific examples—HIV pre-exposure prophylaxis, mpox (formerly known as monkeypox) vaccination, and doxycycline prophylaxis. We suggest that entrenched societal and political homophobia results in unacceptable delays and limitations to accessing highly effective interventions and that these delays result in harm from preventable transmissions of HIV, mpox, and syphilis. GBMSM have been affected disproportionately by HIV, mpox, and bacterial sexually transmitted infections, and there is an ongoing unmet need for effective prevention. Denying access to public health interventions that meet these needs is unethical.

中文翻译：

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英国性保健服务中的同性恋恐惧症

提供医疗保健的决策不仅受到科学证据的影响，还受到决策系统的影响。我们考虑了英国做出的有关同性恋、双性恋和其他男男性行为者 (GBMSM) 性传播感染预防的国家决策，并举了三个具体例子：HIV 暴露前预防、mpox（以前称为猴痘）疫苗接种和多西环素预防。我们认为，根深蒂固的社会和政治恐同症导致了获得高效干预措施的不可接受的延误和限制，并且这些延误导致了可预防的艾滋病毒、麻疹和梅毒传播的危害。 GBMSM 受到 HIV、mpox 和细菌性传播感染的影响尤为严重，并且对有效预防的需求一直未得到满足。拒绝获得满足这些需求的公共卫生干预措施是不道德的。