Department of Pediatrics, The Johns Hopkins University, School of Medicine, Baltimore, Maryland; Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland.
Department of Population, Family, and Reproductive Health, The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland.
J Adolesc Health. 2018 Apr;62(4):382-389. doi: 10.1016/j.jadohealth.2017.08.016. Epub 2017 Nov 8.
This study aimed to describe young men's sexual and reproductive health care (SRHC) receipt by sexual behavior and factors associated with greater SRHC receipt.
There were 427 male patients aged 15-24 who were recruited from 3 primary care and 2 sexually transmitted disease (STD) clinics in 1 urban city. Immediately after the visit, the survey assessed receipt of 18 recommended SRHC services across four domains: screening history (sexual health, STD/HIV test, family planning); laboratories (STDs/HIV); condom products (condoms/lubrication); and counseling (STD/HIV risk reduction, family planning, condoms); in addition, demographic, sexual behavior, and visit characteristics were examined. Multivariable Poisson regressions examined factors associated with each SRHC subdomain adjusting for participant clustering within clinics.
Of the participants, 90% were non-Hispanic black, 61% were aged 20-24, 90% were sexually active, 71% had female partners (FPs), and 20% had male or male and female partners (M/MFPs). Among sexually active males, 1 in 10 received all services. Half or more were asked about sexual health and STD/HIV tests, tested for STDs/HIV, and were counseled on STD/HIV risk reduction and correct condom use. Fewer were asked about family planning (23%), were provided condom products (32%), and were counseled about family planning (35%). Overall and for each subdomain, never sexually active males reported fewer services than sexually active males. Factors consistently associated with greater SRHC receipt across subdomains included having M/MFPs versus FPs, routine versus non-STD-acute visit, time alone with provider without parent, and seen at STD versus primary care clinic. Males having FPs versus M/MFPs reported greater family planning counseling.
Findings have implications for improving young men's SRHC delivery beyond the narrow scope of STD/HIV care.
本研究旨在通过性行为描述年轻男性的性健康和生殖健康护理（SRHC）的获得情况，并分析与其获得更多 SRHC 相关的因素。
从一个城市的 3 家初级保健和 2 家性传播疾病（STD）诊所招募了 427 名年龄在 15-24 岁的男性患者。就诊结束后，立即通过问卷调查评估了他们在四个领域获得的 18 项推荐的 SRHC 服务，这四个领域分别是：筛查史（性健康、性传播疾病/艾滋病毒检测、计划生育）；实验室（性传播疾病/艾滋病毒）；避孕套产品（避孕套/润滑剂）；咨询（性传播疾病/艾滋病毒风险降低、计划生育、避孕套）；此外，还调查了参与者的人口统计学、性行为和就诊特征。多变量泊松回归分析了在调整诊所内参与者聚类的情况下，每个 SRHC 子领域与相关因素的关系。
在参与者中，90%是非西班牙裔黑人，61%年龄在 20-24 岁之间，90%是活跃的性活跃者，71%有女性伴侣（FP），20%有男性或男性和女性伴侣（M/MFP）。在活跃的男性中，每 10 人中有 1 人接受了所有服务。一半以上的人被询问了性健康和性传播疾病/艾滋病毒检测，接受了性传播疾病/艾滋病毒检测，并接受了性传播疾病/艾滋病毒风险降低和正确使用避孕套的咨询。较少的人被问及计划生育（23%），获得了避孕套产品（32%），并接受了计划生育（35%）的咨询。总体而言，在每个子领域中，从未有过性行为的男性比有过性行为的男性报告接受的服务更少。在所有子领域中，与获得更多 SRHC 相关的一致因素包括有 M/MFP 而不是 FP、常规就诊而非急性性传播疾病就诊、与提供者单独相处而没有父母陪同、在 STD 诊所而非初级保健诊所就诊。有 FP 的男性比有 M/MFP 的男性报告接受了更多的计划生育咨询。
这些发现对改善年轻男性的 SRHC 服务提供具有重要意义，不仅限于性传播疾病/艾滋病毒护理的狭义范围。
