Sexuality Disclosure, Trust, and Satisfaction With Primary Care Among Urban Young Adult Sexual Minority Men

Griffin, Marybec; Jaiswal, Jessica; King, Danielle; Singer, Stuart N.; Halkitis, Perry N.

doi:10.1016/j.nurpra.2020.02.001

Cited by 8 publications

(6 citation statements)

References 73 publications

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“…This has been attributed to experiences of homophobia and racism in healthcare contexts, as well as to broader structural racism, socioeconomic inequality and homophobia [10][11][12][13]. Successful navigation of health systems and medical care for young SMM and transgender women, especially in the contexts of sexual health care, demand heightened attention not only to physical qualities of access (e.g., proximity and transportation), but also to social qualities that foster trusting relationships between providers and patients, such as non-judgmental interactions and shared medical decision-making [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Correlates of PrEP Uptake Among Young Sexual Minority Men and Transgender Women in New York City: The Need to Reframe “Risk” Messaging and Normalize Preventative Health

et al. 2021

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Pre-exposure prophylaxis (PrEP) is an effective form of HIV prevention, but young sexual minority men face myriad barriers to PrEP uptake. Participants (n = 202) completed a survey on healthcare experiences and beliefs about HIV and PrEP. While 98% of the sample knew about PrEP, only 23.2% reported currently taking PrEP. Participants were more likely to be taking PrEP if they received PrEP information from a healthcare provider and endorsed STI-related risk compensation. Conversely, PrEP uptake was less likely among those with concerns about medication use and adherence. While there were no racial/ethnic differences in PrEP uptake, there were differences in correlates of PrEP use for White participants and participants of color. To facilitate PrEP uptake, clinicians should provide PrEP education and screen all patients for PrEP candidacy. Additionally, public health messaging must reframe HIV "risk", highlight benefits of STI testing, and emphasize the importance of preventive healthcare for SMM.

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Section: Introductionmentioning

confidence: 99%

Correlates of PrEP Uptake Among Young Sexual Minority Men and Transgender Women in New York City: The Need to Reframe “Risk” Messaging and Normalize Preventative Health

et al. 2021

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“…While lower rates of sexual and gender diversity exist at other institutions, fear of identity disclosure in less affirming environments may lead to greater inequities for SGM students. 13 Application of concepts and tools from this initiative may be of greater consequence in less diverse settings where SGM students experience more adversity. Furthermore, interventions and discoveries from this initiative may be applied to adolescent and adult primary care settings, improving sexual health equity for a wider population.…”

Section: Discussionmentioning

confidence: 99%

“…The marked diversity of this student population allowed for stratification of results and statistical testing to assure equity of care for SGM and straight/cisgender students. While lower rates of sexual and gender diversity exist at other institutions, fear of identity disclosure in less affirming environments may lead to greater inequities for SGM students 13 . Application of concepts and tools from this initiative may be of greater consequence in less diverse settings where SGM students experience more adversity.…”

Section: Discussionmentioning

confidence: 99%

“…In a 2019 qualitative study, Hood et al found that discomfort with identity disclosure, lack of knowledge about available services, and fear of in‐clinic microaggressions (such as misgendering or referring to sexuality as a “choice”) were common themes among SGM college students accessing university health services 12 . Similarly, Griffin et al 13 pointed to sexual orientation disclosure as a key factor in comfort with discussing sexual behaviors and overall trust in the healthcare system for young adult gay men. Efforts to mitigate disparities for SGM individuals must focus on creating affirming and inclusive care processes and increasing provider cultural humility 14,15 .…”

Section: Introductionmentioning

confidence: 99%

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Improving equitable access to inclusive sexual healthcare in a small urban college health setting

Gianelis

Butler

2022

Nursing Forum

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Background Sexual and gender minorities (SGM) experience many disparities in sexual health. College health centers must address early inequities for this population. Local Problem Significant access disparity was noted for SGM students at a small urban college health center. The aim of this quality initiative was to increase equitable access by 20% over 90 days. Methods A rapid‐cycle quality improvement project was initiated using a Plan‐Do‐Study‐Act model. Interventions Templated nurse‐led visits, a discussion starter tool, and an inclusive care checklist were introduced, with assurance of equity for each metric, and a focus on team collaboration. Results Access to sexual health services increased by 22.6% over 8 weeks with SGM utilization increasing 2.7‐fold. Guideline‐concordant care improved by 94% for all students. Student comfort scores (Likert range 1–5) also improved, from a baseline of 3.53 to a project mean of 4.62. Conclusions This project addressed equity in a college health setting through improved student engagement, targeted workflow innovation, and enhanced team collaboration. Application of key findings to other health topics will continue to mitigate disparities in college health centers. Tools may also be applied to adolescent and adult primary care settings to improve patient comfort and SGM‐inclusive sexual health service delivery.

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“…These are the very same factors that create vulnerability to COVID-19 and are much like the factors that create vulnerability to HIV. 95,100 Moreover, these factors are heightened by a health care system that does not address the nuanced needs of the population 12,[101][102][103][104] or the inherent biases of health care providers. 105,106 Although we did not find significant differences in COVID-19 PCR and antibody testing results by race/ethnicity or gender identity, future research is warranted to better understand the effects of COVID-19 on Black and/or transgender LGBTQ+ people, who face disparities in health conditions, health care access, and economic stability.…”

Section: Discussionmentioning

confidence: 99%

A Nationwide Survey of COVID-19 Testing in LGBTQ+ Populations in the United States

et al. 2021

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Objectives Lesbian, gay, bisexual, transgender, or queer and questioning (LGBTQ+) people and populations face myriad health disparities that are likely to be evident during the COVID-19 pandemic. The objectives of our study were to describe patterns of COVID-19 testing among LGBTQ+ people and to differentiate rates of COVID-19 testing and test results by sociodemographic characteristics. Methods Participants residing in the United States and US territories (N = 1090) aged ≥18 completed an internet-based survey from May through July 2020 that assessed COVID-19 testing and test results and sociodemographic characteristics, including sexual orientation and gender identity (SOGI). We analyzed data on receipt and results of polymerase chain reaction (PCR) and antibody testing for SARS-CoV-2 and symptoms of COVID-19 in relation to sociodemographic characteristics. Results Of the 1090 participants, 182 (16.7%) received a PCR test; of these, 16 (8.8%) had a positive test result. Of the 124 (11.4%) who received an antibody test, 45 (36.3%) had antibodies. Rates of PCR testing were higher among participants who were non–US-born (25.4%) versus US-born (16.3%) and employed full-time or part-time (18.5%) versus unemployed (10.8%). Antibody testing rates were higher among gay cisgender men (17.2%) versus other SOGI groups, non–US-born (25.4%) versus US-born participants, employed (12.6%) versus unemployed participants, and participants residing in the Northeast (20.0%) versus other regions. Among SOGI groups with sufficient cell sizes (n > 10), positive PCR results were highest among cisgender gay men (16.1%). Conclusions The differential patterns of testing and positivity, particularly among gay men in our sample, confirm the need to create COVID-19 public health messaging and programming that attend to the LGBTQ+ population.

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Sexuality Disclosure, Trust, and Satisfaction With Primary Care Among Urban Young Adult Sexual Minority Men

Cited by 8 publications

References 73 publications

Correlates of PrEP Uptake Among Young Sexual Minority Men and Transgender Women in New York City: The Need to Reframe “Risk” Messaging and Normalize Preventative Health

Correlates of PrEP Uptake Among Young Sexual Minority Men and Transgender Women in New York City: The Need to Reframe “Risk” Messaging and Normalize Preventative Health

Improving equitable access to inclusive sexual healthcare in a small urban college health setting

A Nationwide Survey of COVID-19 Testing in LGBTQ+ Populations in the United States

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