Engaging Aboriginal and Torres Strait Islander men in primary care settings

To the Editor: It is well recognised that Aboriginal and Torres Strait Islander men are one of the most disadvantaged population groups in Australia in terms of physical wellbeing.1 Annual Medicare Benefits Schedule health assessment items are essential tools to help Aboriginal and Torres Strait Islander men (and women and children) receive primary health care matched to their needs, as well as opportunities for preventive health care and education.

A growing body of evidence suggests that erectile dysfunction (ED) coexists with, or is a clinical marker for, other common life-threatening conditions, such as coronary heart disease and type 2 diabetes, due to shared underlying neurovascular mechanisms.2 Indeed, the relative risk and severity of coronary artery disease appears to be higher for young men reporting ED.3 Despite this, discussion with Aboriginal and Torres Strait Islander men about sexual health is often lacking. In such population groups at risk of chronic disease, the opportunity to assess erectile function may present a window of opportunity to identify and better manage life-threatening disease.2

To engage these men in sexual health discussions, a greater focus on culturally appropriate health services is needed. Cultural competency training is essential to overcome the barriers affecting how Aboriginal and Torres Strait Islander men access health services (Box 1). However, the sex-specific nature of some barriers and the impact of traditional and cultural roles on health service access pathways for men often require further attention, particularly for more culturally sensitive issues such as sexual health.

There are many other strategies and practical approaches that health services and primary health care professionals can implement to better engage Aboriginal and Torres Strait Islander men in positive and broader help-seeking behaviour and health service access (Box 2).6 Being able to implement such strategies may be an indirect reflection on the ability of health services to support cultural respect and provide culturally safe health care more broadly.