Healthcare Provider Discussions of Sexual Orientation and Associated Health Screenings Among Adolescent Men Who Have Sex with Men in the United States Open Access

Abstract

Background: Among sexual and gender minority youth, adolescent men who have sex with men

(AMSM) are at a greater risk for HIV and STIs; physicians provide a crucial role in the delivery

of sexual health information and preventive care for AMSM. We sought to investigate the role of

patient-provider communication about sexual health topics to understanding the disparities in

HIV and other STIs among AMSM.

Methods: We used data from the iReach trial six-month follow-up survey to describe the

proportion of AMSM not disclosing their sexual orientation to their provider and to assess the

relationship between provider discussion of sexual health topics and uptake of HIV/STI testing.

Sexual health topics discussed by provider included HIV/STI prevention, sexual pleasure, sexual

dysfunction, family planning, sexual orientation disclosure, and no sexual health topics. Chi-

square testing was used to assess the association of disclosure of sexual orientation to provider

with descriptive variables and family discussion variables. Logistic regression was used to

evaluate associations between HIV/STI testing and disclosure of sexual orientation to provider

and provider-initiated discussions of sexual health.

Results: Highest rates of non-disclosure were among 13–14-year old’s, Hispanic/Latino

ethnicity, and AMSM living in the Chicago-Detroit area. Disclosure of sexual orientation to

provider and provider discussion of any sexual health topic was found to be significantly

associated with HIV/STI testing. Additionally, we found that frequency of family discussions

were strongly associated with AMSM disclosure to provider.

Conclusions: Providers should initiate discussions of sexual orientation and sexual health topics

to help facilitate access to recommended testing and preventive services. Parents and families

should encourage the normalization and discussion of sexual health topics, because may

encourage their AMSM family members to feel more open to discussing their sexual health with

a provider.

Table of Contents

Introduction ......................................................................................................................................1

Data and Methods ..............................................................................................................................5

Measures ............................................................................................................................6

Study Variables ...................................................................................................................6

Statistical Analyses .............................................................................................................8

Results .............................................................................................................................................8

Discussion .......................................................................................................................................10

References .......................................................................................................................................15

Appendix .........................................................................................................................................18

Table 1 ...............................................................................................................................19

Table 2 ...............................................................................................................................21

Table 3 ...............................................................................................................................22

Figure 1 ..............................................................................................................................23

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	HIV Adolescents MSM Sexual and Reproductive Health
Committee Chair / Thesis Advisor	Patrick Sullivan, Emory University

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