Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI.
Department of Medicine, Albert Einstein College of Medicine, New York, NY; and.
J Acquir Immune Defic Syndr. 2020 Nov 1;85(3):302-308. doi: 10.1097/QAI.0000000000002459.
Health care provider assessment of patient sexual behavior and substance use is essential for determining appropriate prevention interventions-including HIV pre-exposure prophylaxis (PrEP)-for sexual minority men (SMM). We sought to explore acceptability and utility of using electronic surveys to conduct health behavior assessments in clinical settings among SMM.
Among a US nationwide sample of SMM (n = 4187; mean age = 38.3 years; 60% white; 82% HIV-negative), we examined associations of demographics, recruitment venue, sexual behavior characteristics, and recent substance use with participants' comfort communicating verbally and through electronic survey with a health care provider about sexual and substance use behavior.
On average, SMM had greater comfort communicating through electronic survey vs. verbally. In our fully adjusted analysis, preference favoring electronic surveys more strongly than verbal communication differed by age (β = -0.07, P ≤ 0.001). SMM with a bachelor's degree or more (β = 0.04, P < 0.05), those recruited from nonclinical settings (β = 0.06, P ≤ 0.001), and those without primary care providers (β = 0.04, P < 0.05) favored electronic surveys more strongly in the fully adjusted multivariable model. SMM who reported any recent casual sex partners (β = 0.05, P < 0.01), those never tested for HIV (β = 0.03, P < 0.05), and HIV-negative/unknown men not on PrEP (compared with PrEP users; β = 0.09, P ≤ 0.001) also favored electronic surveys in the fully adjusted model.
Reducing communication barriers by incorporating electronic surveys into patient assessments could help identify HIV testing and PrEP needs for SMM most susceptible to HIV acquisition. Nonetheless, no one screening strategy is likely to work for most SMM, and multiple approaches are needed.
医疗保健提供者评估患者的性行为和药物使用情况对于确定适当的预防干预措施至关重要，包括对男同性恋者进行艾滋病毒暴露前预防（PrEP）。我们旨在探索在男同性恋者中使用电子调查在临床环境中进行健康行为评估的可接受性和实用性。
我们对来自美国全国范围内的男同性恋者样本（n=4187；平均年龄=38.3 岁；60%为白人；82%艾滋病毒阴性）进行了研究，分析了人口统计学特征、招募场所、性行为特征和最近的药物使用情况与参与者通过电子调查与医疗保健提供者交流性行为和药物使用情况的舒适度之间的关系。
平均而言，男同性恋者通过电子调查进行交流比口头交流更舒适。在我们的完全调整分析中，偏好电子调查而不是口头交流的程度因年龄而异（β=-0.07，P≤0.001）。具有学士或以上学位的男同性恋者（β=0.04，P<0.05）、从非临床场所招募的男同性恋者（β=0.06，P≤0.001）和没有初级保健提供者的男同性恋者（β=0.04，P<0.05）在完全调整的多变量模型中更倾向于电子调查。最近有过偶然性行为伴侣的男同性恋者（β=0.05，P<0.01）、从未接受过艾滋病毒检测的男同性恋者（β=0.03，P<0.05）和未接受 PrEP 的艾滋病毒阴性/未知的男同性恋者（与 PrEP 使用者相比；β=0.09，P≤0.001）在完全调整的模型中也更倾向于电子调查。
通过将电子调查纳入患者评估，减少沟通障碍，有助于发现最易感染艾滋病毒的男同性恋者的艾滋病毒检测和 PrEP 需求。然而，没有一种筛查策略可能适用于大多数男同性恋者，需要多种方法。
