Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA.
Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, MD, USA.
Prev Med. 2022 Oct;163:107225. doi: 10.1016/j.ypmed.2022.107225. Epub 2022 Aug 24.
Many men who have sex with men (MSM) do not disclose their sexuality to their healthcare provider, despite potential health benefits. Data from the 2017 Encuesta de Sexo Entre Hombres online survey of 13,277 HIV-negative or unknown status MSM in Mexico were used to explore MSM patients' sexuality disclosure experience on sexual health outcomes using multivariable Poisson models with robust variance estimation to estimate adjusted prevalence ratios (aPR). Sexual health outcomes included Hepatitis B (HepB) and human papillomavirus (HPV) vaccination, and lifetime and past year HIV testing. Overall, 53.9% (n/N) disclosed their sexuality to their healthcare provider, and of those 6.4%, 62.9%, and 30.7% reported a negative, neutral, or positive disclosure experience, respectively. In comparison to no disclosure, neutral and positive disclosure experiences were associated with HepB vaccination (aPR[95% Confidence Interval (95% CI)] = 1.17[1.09, 1.25], p < 0.001; aPR[95% CI] = 1.35[1.25, 1.46], p < 0.001, respectively) and positive disclosure experiences were associated with HPV vaccination (aPR[95% CI] = 1.46[1.24, 1.71], p < 0.001). Those who disclosed their sexual behavior were more likely than those who did not disclose their sexual behavior to have received an HIV test in their lifetime (negative: aPR[95% CI] = 1.51[1.43, 1.60], p < 0.001; neutral: aPR[95% CI] = 1.61[1.56, 1.66], p < 0.001; positive: aPR[95% CI] = 1.64[1.58, 1.69], p < 0.001) and an HIV test in the past year (negative: aPR[95% CI] = 1.89[1.70, 2.10], p < 0.001; neutral: aPR[95% CI] = 2.09[1.98, 2.20], p < 0.001; positive: aPR[95% CI] = 2.24[2.12, 2.37], p < 0.001). There is a need to implement trainings for healthcare providers that focus on sexual health risk assessments and creating a space that encourages MSM patients and healthcare providers to discuss sexual health.
许多男男性行为者 (MSM) 并未向其医疗保健提供者透露自己的性取向，尽管这可能对健康有益。本研究使用了来自墨西哥 2017 年男男性行为者在线调查（Encuesta de Sexo Entre Hombres）的数据，该调查对 13,277 名 HIV 阴性或未知状态的 MSM 进行了调查，以探索 MSM 患者的性取向披露经历对性健康结局的影响。采用多变量泊松模型和稳健方差估计来估计调整后的患病率比（aPR）。性健康结局包括乙型肝炎（HepB）和人乳头瘤病毒（HPV）疫苗接种，以及终生和过去一年的 HIV 检测。总体而言，有 53.9%（n/N）向其医疗保健提供者透露了自己的性取向，其中 6.4%、62.9%和 30.7%的人报告了负面、中性或正面的披露经历。与不披露相比，中性和正面的披露经历与 HepB 疫苗接种相关（aPR[95%置信区间（95%CI）] = 1.17[1.09, 1.25]，p < 0.001；aPR[95%CI] = 1.35[1.25, 1.46]，p < 0.001），而正面的披露经历与 HPV 疫苗接种相关（aPR[95%CI] = 1.46[1.24, 1.71]，p < 0.001）。与不披露相比，那些披露自己性行为的人更有可能接受过 HIV 检测（负面：aPR[95%CI] = 1.51[1.43, 1.60]，p < 0.001；中性：aPR[95%CI] = 1.61[1.56, 1.66]，p < 0.001；正面：aPR[95%CI] = 1.64[1.58, 1.69]，p < 0.001）和过去一年的 HIV 检测（负面：aPR[95%CI] = 1.89[1.70, 2.10]，p < 0.001；中性：aPR[95%CI] = 2.09[1.98, 2.20]，p < 0.001；正面：aPR[95%CI] = 2.24[2.12, 2.37]，p < 0.001）。需要为医疗保健提供者实施培训，重点是性健康风险评估，并创造一个鼓励男男性行为者患者和医疗保健提供者讨论性健康的空间。
