Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Sex Transm Infect. 2019 Jun;95(4):273-278. doi: 10.1136/sextrans-2018-053866. Epub 2019 Mar 27.
OBJECTIVES: Gay, bisexual and other men who have sex with men (GBMSM) in Singapore may fear disclosing their sexual orientation to others due to negative societal attitudes, and the law that criminalises sexual relations between men, which may, in turn, impede access to HIV/sexually transmitted infection (STI)-related health services. This study attempts to determine how selective disclosure to varying social groups, and the extent of disclosure, may serve to impact HIV/STI testing patterns among GBMSM. METHODS: In this observational study, we recruited GBMSM in Singapore through an online cross-sectional survey disseminated via the smartphone app Grindr from 14 January to 11 February 2018. Respondents provided information on their sociodemographic characteristics, disclosure of sexual orientation towards other lesbian, gay, bisexual, transgender and questioning (LGBTQ) individuals, non-LGBTQ family members, non-LGBTQ friends and non-LGBTQ colleagues, along with their HIV/STI testing patterns. Extent of disclosure was defined as the number of social groups that a participant had disclosed his sexual orientation to. Statistical analyses were conducted through descriptive statistics, multivariable binary, ordinal, and multinomial logistic regression models. RESULTS: We recruited 1339 respondents, of which 1098 who had provided their response to questions on HIV/STI testing were included in the analytic sample. Multivariable analyses indicated that disclosure towards non-LGBTQ family members (adjusted OR [aOR] 1.85, 95% CI 1.12 to 3.07) and other LGBTQ individuals (aOR 1.63, 95% CI 1.12 to 2.37) were positively associated with recent HIV testing, whereas disclosure towards non-LGBTQ colleagues (aOR 1.56, 95% CI 1.09 to 2.22) was positively associated with regular HIV testing. Extent of disclosure exhibited a positive, dose-response relationship with all testing outcomes. CONCLUSIONS: Results indicate how the fear of being identified as an LGBTQ individual may deter GBMSM from getting tested for HIV and other STIs. Health services should bridge the gaps to accessing healthcare among individuals who fear being stigmatised for attending sexual health-specific clinics or being identified as GBMSM.
目的：在新加坡，男同性恋、双性恋和其他与男性发生性关系的男性（GBMSM）可能由于社会负面态度以及将男性之间的性关系定罪的法律而担心向他人透露自己的性取向，这可能会反过来阻碍他们获得艾滋病毒/性传播感染（STI）相关的卫生服务。本研究试图确定向不同社会群体选择性披露以及披露程度如何影响 GBMSM 的艾滋病毒/性传播感染检测模式。
方法：在这项观察性研究中，我们通过智能手机应用程序 Grindr 于 2018 年 1 月 14 日至 2 月 11 日从新加坡招募了 GBMSM。受访者提供了他们的社会人口特征、向其他女同性恋、男同性恋、双性恋、跨性别和疑问（LGBTQ）个体、非 LGBTQ 家庭成员、非 LGBTQ 朋友和非 LGBTQ 同事披露性取向的信息，以及他们的艾滋病毒/性传播感染检测模式。披露程度定义为参与者向其透露性取向的社会群体数量。通过描述性统计、多变量二元、有序和多项逻辑回归模型进行统计分析。
结果：我们招募了 1339 名受访者，其中 1098 名提供了有关艾滋病毒/性传播感染检测的回复，被纳入分析样本。多变量分析表明，向非 LGBTQ 家庭成员（调整后的比值比[aOR]1.85，95%置信区间[CI]1.12 至 3.07）和其他 LGBTQ 个体（aOR1.63，95%CI1.12 至 2.37）披露与最近的 HIV 检测呈正相关，而向非 LGBTQ 同事（aOR1.56，95%CI1.09 至 2.22）披露与定期 HIV 检测呈正相关。披露程度与所有检测结果呈正相关、剂量反应关系。
结论：研究结果表明，对被认定为 LGBTQ 个体的恐惧可能会阻止 GBMSM 接受艾滋病毒和其他性传播感染的检测。卫生服务机构应弥合障碍，为那些因害怕因参加特定的性健康诊所或被认定为 GBMSM 而受到污名化的人提供获得医疗保健的机会。
N Engl J Med. 2016-9-1
BMJ Open. 2016-1-12
Zotero 插件