Stupiansky Nathan W, Liau Adrian, Rosenberger Joshua, Rosenthal Susan L, Tu Wanzhu, Xiao Shan, Fontenot Holly, Zimet Gregory D
1 Department of Health Promotion Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health , Tucson, Arizona.
2 Indiana University School of Medicine , Indianapolis, Indiana.
AIDS Patient Care STDS. 2017 Aug;31(8):342-347. doi: 10.1089/apc.2017.0011.
Many men who have sex with men (MSM) do not disclose their same sex behaviors to healthcare providers (HCPs). We used a series of logistic regression models to explore a conceptual framework that first identified predictors of disclosure to HCPs among young MSM (YMSM), and subsequently examined young men's disclosure of male-male sexual behaviors to HCPs as a mediator between sociodemographic and behavioral factors and three distinct health outcomes [HIV testing, sexually transmitted infection (STI) testing, and human papillomavirus (HPV) vaccination]. We determined the predictors of disclosure to HCPs among YMSM and examined the relationship between disclosure and the receipt of appropriate healthcare services. Data were collected online through a US national sample of 1750 YMSM (ages 18-29 years) using a social and sexual networking website for MSM. Sexual history, STI/HIV screening history, sexual health, and patient-provider communication were analyzed in the logistic regression models. Participants were predominantly white (75.2%) and gay/homosexual (76.7%) with at least some college education (82.7%). Young men's disclosure of male-male sexual behaviors to HCPs was associated with the receipt of all healthcare outcomes in our model. Disclosure was a stronger mediator in HPV vaccination than in HIV and STI testing. Disclosure to non-HCP friends and family, HCP visit in the past year, and previous STI diagnosis were the strongest predictors of disclosure. Young men's disclosure of male-male sexual behaviors to HCPs is integral to the receipt of appropriate healthcare services among YMSM. HPV vaccination is more dependent on provider-level interaction with patients than HIV/STI testing.
许多男男性行为者(MSM)不会向医疗服务提供者(HCP)透露他们的同性性行为。我们使用了一系列逻辑回归模型来探索一个概念框架,该框架首先确定了年轻男男性行为者(YMSM)向HCP透露信息的预测因素,随后将年轻男性向HCP透露男男性行为作为社会人口统计学和行为因素与三种不同健康结果[HIV检测、性传播感染(STI)检测和人乳头瘤病毒(HPV)疫苗接种]之间的中介因素进行研究。我们确定了YMSM中向HCP透露信息的预测因素,并研究了透露信息与获得适当医疗服务之间的关系。通过一个针对男男性行为者的社交和性网络网站,从1750名年龄在18 - 29岁的美国YMSM全国样本中在线收集数据。在逻辑回归模型中分析了性史、性传播感染/艾滋病毒筛查史、性健康和医患沟通情况。参与者主要是白人(75.2%)、男同性恋者(76.7%),且至少接受过一些大学教育(82.7%)。在我们的模型中,年轻男性向HCP透露男男性行为与所有医疗结果的获得相关。在HPV疫苗接种方面,透露信息作为中介因素的作用比在HIV和STI检测中更强。向非HCP朋友和家人透露信息、过去一年中看HCP以及之前被诊断为性传播感染是透露信息的最强预测因素。年轻男性向HCP透露男男性行为对于YMSM获得适当医疗服务至关重要。与HIV/STI检测相比,HPV疫苗接种更依赖于医疗服务提供者与患者之间的互动。
Int J Environ Res Public Health. 2022-8-24