性行为披露与接受推荐给男男性行为者的一组保健服务显著相关。
Disclosure of Sexual Behavior Is Significantly Associated With Receiving a Panel of Health Care Services Recommended for Men Who Have Sex With Men.
机构信息
College of Public Health, University of Kentucky at Lexington, Lexington, KY.
Howard Brown Health, Chicago, IL.
出版信息
Sex Transm Dis. 2018 Dec;45(12):803-807. doi: 10.1097/OLQ.0000000000000886.
BACKGROUND
Men who have sex with men (MSM) are at high risk for sexually transmitted infections (STIs). National guidelines recommend that MSM receive HIV, syphilis, gonorrhea, and chlamydia screening at least annually, and hepatitis A and B and human papillomavirus vaccinations. We investigated associations between disclosure of male-male sexual orientation/behavior and receipt of this panel of services.
METHODS
Gay, bisexual, and other MSM aged 18 through 26 years were enrolled from health clinics serving lesbian, gay, bisexual, and transgender communities in Los Angeles and Chicago during 2012 to 2014. Participants completed a computer-assisted self-interview regarding health care services, disclosure of sexual orientation/behavior, and recent HIV test results. Proportions receiving recommended care, prevalence ratios (PRs), and 95% confidence intervals (CIs) were calculated using SAS 9.4.
RESULTS
Overall, 817 participants visited a provider within the past year. Of these, 525 (64.3%) had disclosed, and 749 (91.7%) felt they could disclose if important to health. In total, 548 (67.1%) received all STI screenings, and 74 (9.1%) received all vaccinations. Only 105 (12.9%) received any human papillomavirus vaccination. More disclosing participants received all recommended screenings (adjusted PR [aPR],1.4; 95% CI, 1.3-1.6) and all recommended care components (aPR, 2.2; 95% CI, 1.4-4.3) than nondisclosing participants.
CONCLUSIONS
Despite national recommendations, receipt of a complete panel of STI care services was low among young MSM. Vaccine uptake was lower than STI screening. However, most participants visited a health care provider in the past year and most disclosed, suggesting opportunities to improve services. Providers might encourage disclosure by improving sexual history taking and education, which could increase opportunities for MSM to receive recommended care.
背景
男男性行为者（MSM）存在较高的性传播感染（STI）风险。国家指南建议 MSM 至少每年接受 HIV、梅毒、淋病和衣原体筛查，并接种甲型肝炎和乙型肝炎以及人乳头瘤病毒疫苗。我们研究了男性同性性行为/行为的披露与接受该套服务之间的关联。
方法
2012 年至 2014 年，在洛杉矶和芝加哥的男女同性恋、双性恋和跨性别社区的健康诊所招募了年龄在 18 至 26 岁的男同性恋、双性恋和其他 MSM。参与者通过计算机辅助的自我访谈，报告了医疗服务、性取向/行为的披露情况以及最近的 HIV 检测结果。使用 SAS 9.4 计算了接受推荐护理的比例、患病率比（PR）和 95%置信区间（CI）。
结果
总体而言，817 名参与者在过去一年中曾就诊过医生。其中，525 名（64.3%）进行了披露，749 名（91.7%）认为如果对健康重要，他们可以进行披露。共有 548 名（67.1%）接受了所有性传播感染筛查，74 名（9.1%）接受了所有疫苗接种。只有 105 名（12.9%）接受了任何人乳头瘤病毒疫苗接种。更多的披露参与者接受了所有推荐的筛查（调整后的患病率比[aPR]，1.4；95%CI，1.3-1.6）和所有推荐的护理成分（aPR，2.2；95%CI，1.4-4.3），而未披露的参与者则较少。
结论
尽管有国家建议，但年轻 MSM 接受完整的性传播感染护理套餐的比例仍然较低。疫苗接种率低于性传播感染筛查率。然而，大多数参与者在过去一年中访问了医疗保健提供者，大多数人进行了披露，这表明有机会改善服务。提供者可以通过改善性病史采集和教育来鼓励披露，这可以增加 MSM 接受推荐护理的机会。
Zotero 插件