Coming Out to Healthcare Providers: Factors Associated with Same-Sex Disclosure from the 2016 American Men’s Internet Survey Público
Schleifer, Grant (Spring 2018)
Abstract
Background: Patient disclosure of same-sex activity cues healthcare providers to implement recommended screenings for conditions common among gay, bisexual, and other men who have sex with men (GBMSM). However, not all GBMSM disclose their sexual behaviors to their providers, which may hinder the provision of appropriate care. The goal of the current research was to assess whether experiencing antigay stigma in the past year and lifetime levels of disclosure predict the likelihood of GBMSM disclosing same-sex behavior to their healthcare providers.
Methods: Participants (n=8917) were men ≥ 15 years old, residing in the United States, and reporting having oral or anal sex with ≥ one man ever. Recruitment occurred predominantly via banner advertisements on mobile applications for GBMSM sexual networking, which linked to an online survey. Survey questions assessed participant demographics, sexual history and behavior, interactions with healthcare providers, disclosure to others, and experience of antigay stigma.
Results: Nearly 72% of participants in the sample reported ever disclosing their same-sex behavior to a healthcare provider. Two exploratory analyses were conducted. In the first analysis, higher rates of antigay stigma were found to be significantly associated with disclosure to a provider (aOR= 1.09, CI95: 1.0-1.2). In the second, same-sex disclosure to non-LGB friends (aOR= 2.0, CI95: 1.6-2.5) and to employer (aOR= 3.5, CI95: 3.0-4.1) were significantly associated with disclosure to a provider.
Discussion: Both experience of antigay stigma and disclosure to others were found to be significantly associated with disclosure to healthcare providers. Future studies should examine the utility of measuring antigay stigma as a predictor, and/or potential outcome, of same-sex disclosure to providers, as well as explore the possibility of increasing provider competence for collecting sexual orientation from patients.
Table of Contents
Acknowledgements……………….…………………………………………………….……….…i
Table of Contents……………………..…………………………………………………………...ii
Introduction……………………………………………………………………….…………….…1
Literature Review…………………………………………………………………….……………3
Methods……………………………………………………………………………………………7
Results…………………………………………………………………………………………....10
Table 1. Participant Characteristics and GBMSM Disclosure………………………...…12
Table 2. Multivariable Model of GBMSM Disclosure…………………………….….....13
Discussion……………………………………………………………………………………..…15
References………………………………………………………………………………………..21
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