1 New Jersey City University, Health Sciences Department, Jersey City, NJ, USA.
2 Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Newark, NJ, USA.
Am J Mens Health. 2019 Jan-Feb;13(1):1557988318818683. doi: 10.1177/1557988318818683. Epub 2018 Dec 20.
This research is a cross-sectional study of young adult gay men (YAGM), ages 18 to 29, that aims to understand their health-care access including: having a primary care provider (PCP), frequency of health-care visits, and instances of foregone health care. Surveys were conducted with a modified time-space sample of 800 YAGM in New York City (NYC). Surveys were conducted between November 2015 and June 2016. This study examined associations between sociodemographic characteristics and health-care access using multivariable logistic regression models. In multivariable logistic regression models, there were higher odds of having a PCP among participants enrolled in school (Adjusted Odds Ratio [AOR] = 1.85, 95% CI [1.18, 2.91], p < .01) and covered by insurance (AOR = 21.29, 95% CI [11.77, 38.53], p < .001). Modeling indicated higher odds of more than one health visit in the past 12 months for non-White participants (AOR = 2.27, 95% CI [1.43, 3.63], p < .001), those covered by insurance (AOR = 3.10, 95% CI [1.06, 9.04], p < .05), and those who disclosed their sexual orientation to their PCP (AOR = 2.99, 95% CI [1.58, 5.69], p < .001). Participants with insurance were less likely to report instances of foregone care (AOR = 0.21, 95% CI [0.21, 0.13], p < .001). Understanding the facilitators and barriers to health-care access among YAGM populations is of critical importance, as many YAGM between the ages of 18 and 29 are establishing their access to health care without parental guidance. Health-care access, including the decision to forego care, can represent a missed opportunity for primary prevention and early diagnosis of health issues, as well as more effective, less invasive, and less costly treatments.
这项研究是一项针对 18 至 29 岁年轻男同性恋者 (YAGM) 的横断面研究，旨在了解他们的医疗保健获取情况，包括：有初级保健提供者 (PCP)、医疗保健访问频率以及放弃医疗保健的情况。该研究使用纽约市 (NYC) 的改良时空样本对 800 名 YAGM 进行了调查。调查于 2015 年 11 月至 2016 年 6 月进行。本研究使用多变量逻辑回归模型，分析了社会人口特征与医疗保健获取之间的关联。在多变量逻辑回归模型中，与未入学的参与者相比，在校学生 (调整后的优势比 [AOR] = 1.85，95%置信区间 [1.18, 2.91]，p <.01) 和有保险的参与者 (AOR = 21.29，95%置信区间 [11.77, 38.53]，p <.001) 更有可能拥有 PCP。模型表明，非白人参与者在过去 12 个月内有更多医疗访问的可能性更高 (AOR = 2.27，95%置信区间 [1.43, 3.63]，p <.001)、有保险的参与者 (AOR = 3.10，95%置信区间 [1.06, 9.04]，p <.05) 和向 PCP 透露性取向的参与者 (AOR = 2.99，95%置信区间 [1.58, 5.69]，p <.001)。有保险的参与者报告放弃医疗保健的可能性较低 (AOR = 0.21，95%置信区间 [0.21, 0.13]，p <.001)。了解 YAGM 人群获得医疗保健的促进因素和障碍至关重要，因为许多 18 至 29 岁的 YAGM 在没有父母指导的情况下正在建立他们获得医疗保健的途径。医疗保健的获取，包括放弃治疗的决定，可能会错失初级预防和早期诊断健康问题的机会，以及更有效、侵入性更小、成本更低的治疗机会。
