深南地区黑人男同性恋者的医疗保健机会、医疗保健利用和性取向披露。
Health care access, health care utilisation and sexual orientation disclosure among Black sexual minority men in the Deep South.
机构信息
My Brother's Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA.
Johns Hopkins School of Nursing, 525 N Wolfe Street, Baltimore, MD 21205, USA; and Us Helping Us, People Into Living, Inc., 3636 Georgia Avenue NW, Washington, DC 20010, USA; and Corresponding author. Email:
出版信息
Sex Health. 2020 Nov;17(5):421-428. doi: 10.1071/SH20051.
UNLABELLED
Background Black gay, bisexual, and other sexual minority men (BSMM) account for 39.1% of new HIV infections among men who have sex with men and 78.9% of newly diagnosed cases among Black men. Health care access, health care utilisation and disclosing sexuality to providers are important factors in HIV prevention and treatment. This study explored the associations among sexual orientation disclosure, health care access and health care utilisation among BSMM in the Deep South.
METHODS
Secondary analysis of existing data of a population-based study in Jackson, Mississippi, and Atlanta, Georgia, was conducted among 386 BSMM. Poisson regression models were used to estimate prevalence ratios (PR) between sexual orientation disclosure to healthcare providers, health care access and health care utilisation.
RESULTS
The mean (±s.d.) age of participants was 30.5 ± 11.2 years; 35.3% were previously diagnosed with HIV and 3.7% were newly diagnosed with HIV. Two-thirds (67.2%) self-identified as homosexual or gay; 70.6% reported being very open about their sexual orientation with their healthcare providers. After adjustment, BSMM who were not open about their sexual orientation had a lower prevalence of visiting a healthcare provider in the previous 12 months than those who were very open with their healthcare provider (PR 0.42; 95% confidence interval 0.18-0.97).
CONCLUSION
Clinics, hospitals and other healthcare settings should promote affirming environments that support sexuality disclosure for BSMM.
目的
背景黑人男同性恋、双性恋和其他性少数群体男性（BSMM）占男男性行为人群中新增 HIV 感染人数的 39.1%，占黑人男性中新诊断 HIV 感染人数的 78.9%。获得医疗保健、利用医疗保健服务以及向提供者披露性取向是 HIV 预防和治疗的重要因素。本研究旨在探讨南部腹地 BSMM 中性取向披露、获得医疗保健服务和利用医疗保健服务之间的关联。
方法
对密西西比州杰克逊市和佐治亚州亚特兰大市基于人群的研究中现有的 386 名 BSMM 数据进行二次分析。使用泊松回归模型估计向医疗保健提供者披露性取向、获得医疗保健服务和利用医疗保健服务之间的患病率比（PR）。
结果
参与者的平均（±标准差）年龄为 30.5±11.2 岁；35.3%曾被诊断出 HIV 感染，3.7%新被诊断出 HIV 感染。三分之二（67.2%）自我认同为同性恋或男同性恋；70.6%表示对其医疗保健提供者非常开放地表达其性取向。调整后，与非常开放地向医疗保健提供者披露性取向的 BSMM 相比，对性取向不太开放的 BSMM 在过去 12 个月中去看医疗保健提供者的频率较低（PR0.42；95%置信区间 0.18-0.97）。
结论
诊所、医院和其他医疗保健机构应营造支持 BSMM 披露性取向的肯定环境。
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