Article

Same-sex attraction disclosure to health care providers among New York City men who have sex with men: implications for HIV testing approaches.

Department of Public Health, STD Prevention and Control, San Francisco, CA 94103, USA.
Archives of internal medicine (impact factor: 11.46). 08/2008; 168(13):1458-64. DOI:10.1001/archinte.168.13.1458 pp.1458-64
Source: PubMed

ABSTRACT 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.
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.
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).
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.

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Keywords

1 male sex partner
 
452 MSM respondents
 
95% confidence interval
 
[95% confidence interval
 
annual human immunodeficiency virus
 
behavioral factors
 
health care provider
 
health care providers
 
Hispanic MSM
 
HIV infections
 
medical providers
 
men recruited
 
New York
 
New York City
 
New York City National HIV Behavioral Surveillance
 
odds ratio
 
odds ratios
 
risk-based HIV testing
 
self-reported HIV testing
 
white MSM