Same-Sex Attraction Disclosure to Health Care Providers Among New York City Men Who Have Sex With Men<subtitle>Implications for HIV Testing Approaches</subtitle>

Abstract

Background: While the Centers for Disease Control and Prevention recommends at least annual human immunodeficiency virus (HIV) screening for men who have sex with men (MSM), a large number of HIV infections among this population go unrecognized. We examined the association between disclosing to their medical providers (eg, physicians, nurses, physician assistants) same-sex attraction and self-reported HIV testing among MSM in New York City, New York.Methods: All men recruited from the New York City National HIV Behavioral Surveillance (NHBS) project who reported at least 1 male sex partner in the past year and self-reported as HIV seronegative were included in the analysis. The primary outcome of interest was a participant having told his health care provider that he is attracted to or has sex with other men. Sociodemographic and behavioral factors were examined in relation to disclosure of same-sex attraction.Results: Among the 452 MSM respondents, 175 (39%) did not disclose to their health care providers. Black and Hispanic MSM (adjusted odds ratios, 0.28 [95% confidence interval, 0.14-0.53] and 0.46 [95% confidence interval, 0.24-0.85], respectively) were less likely than white MSM to have disclosed to their health care providers. No MSM who identified themselves as bisexual had disclosed to their health care providers. Those who had ever been tested for HIV were more likely to have disclosed to their health care providers (adjusted odds ratio, 2.10; 95% confidence interval, 1.01-4.38).Conclusions: These data suggest that risk-based HIV testing, which is contingent on health care providers being aware of their patients' risks, could miss these high-risk persons.

Risk Behavior Disclosure During HIV Test Counseling

“…These results echo similar studies of risk disclosure to medical providers. 16,18,41 Although a previous analysis documented inaccuracies in the CTR surveillance database for HIV positive young men, 15 this is the first to document likely CTR inaccuracies among the broader testing population of young men, the majority of whom were likely HIV negative based on the local health department's average percent positivity.…”

Sexually transmissible infection control programs for men who have sex with men – what will they look like in 2020?

“…66 In a study investigating same-sex attraction disclosure to healthcare providers, only 39% of MSM discussed their history of sexual activity with men. 67 That issue could be remedied by including a question on pre-visit documents that allows patients to identify the gender of their sex partners before their provider encounter. However, knowledge of a patient's sexual behaviours is futile if the physician is unfamiliar with the special health needs of MSM.…”

Experiências homossexuais de adolescentes: considerações para o atendimento em saúde

“…Some suffer from a "synergy of vulnerabilities" 23 owing to oppression, marginalization and exposure to violence. It is therefore essential to identify and obtain an in-depth understanding of the particularities of sexual behavior among this group in order to effectively tackle diseases such as AIDS 40 . It is important to emphasize the importance of stimulating a reflection about high-risk sexual practices among adolescents and young adults given their lack of awareness of the AIDS epidemic and the fact that the sexual activity of this group comes after the advent of the cocktail of antiretroviral drugs which has led to a change in the concept of the disease from fatal to chronic.…”