Clinical Research Building, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, 33146, USA.
J Behav Med. 2021 Dec;44(6):784-793. doi: 10.1007/s10865-021-00230-0. Epub 2021 May 16.
Engagement with HIV-prevention services varies among sexual minority men (SMM). 183 HIV-negative SMM completed a baseline assessment including sociodemographic, psychosocial, identity and stigma, and sexuality measures, as well as HIV-prevention behaviors: (1) date of most recent HIV test, (2) whether they discussed HIV or (3) sexual behavior with their provider, and (4) disclosure to provider about engaging in condomless anal sex (CAS). Factor analysis of these four items yielded an HIV-prevention engagement factor score. Stochastic search variable selection (SSVS) followed by multiple linear regression identified variables associated with HIV-prevention engagement. SSVS identified three variables for inclusion in a multiple linear regression model. Not disclosing sexual orientation to one's provider (p < 0.001), discomfort discussing sex with provider (p < 0.001) and lower education (p = 0.007) were associated with less HIV-prevention engagement. Findings suggest the importance of training providers in culturally competent care to mitigate observed barriers.
性少数男性（SMM）之间对艾滋病预防服务的参与程度存在差异。183 名 HIV 阴性的 SMM 完成了一项基线评估，其中包括社会人口统计学、心理社会、身份和耻辱感以及性行为方面的措施，以及艾滋病预防行为：(1) 最近一次 HIV 检测的日期，(2) 他们是否与提供者讨论过 HIV 或 (3) 性行为，以及 (4) 向提供者透露进行无保护肛交（CAS）的情况。对这四个项目进行因子分析得出了一个艾滋病预防参与因子得分。随机搜索变量选择（SSVS）随后进行多元线性回归，确定了与艾滋病预防参与相关的变量。SSVS 确定了三个变量纳入多元线性回归模型。未向提供者透露性取向（p<0.001）、与提供者讨论性问题时感到不适（p<0.001）和教育程度较低（p=0.007）与艾滋病预防参与度较低有关。研究结果表明，培训提供者进行文化上适应的护理非常重要，以减轻观察到的障碍。
