Same-Sex Attraction Disclosure to Health Care Providers Among New York City Men Who Have Sex with Men

UNITED STATES:   "Same-Sex Attraction Disclosure to Health Care Providers Among New York City Men Who Have Sex with Men"
Archives of Internal Medicine Vol. 168; No. 13: P. 1458-1464    (07.14.08):: Kyle T. Bernstein, PhD, ScM; Kai-Lih Liu, PhD; Elizabeth M. Begier, MD, MPH; Beryl Koblin, PhD; Adam Karpati, MD, MPH, Christopher Murrill, PhD, MPH

Though CDC recommends that men who have sex with men (MSM) undergo at least annual HIV screening, a large number of HIV infections among this population go undetected, explained researchers in the current study. They sought to examine the association between disclosing to their medical providers (e.g., physicians, nurses, physicians assistants) same-sex attraction and self-reported HIV testing among MSM in New York City.

The analysis included all men recruited from the New York City National HIV Behavioral Surveillance (NHBS) project who reported at least one male sex partner in the previous year and self-reported as HIV-negative. The primary outcome of interest was a participant having told his medical 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.

Of the 452 MSM respondents, 175 (39 percent) did not disclose to their medical provider, with black (adjusted odds ratio, 0.28 [95 percent confidence interval, 0.14-0.53] and Hispanic (AOR, 0.46; 95 percent CI, 0.24-0.85) MSM less likely to have disclosed than their white counterparts. No MSM who identified themselves as bisexual had disclosed to their provider. Those who had ever been tested for HIV were more likely to have disclosed (AOR, 2.10; 95 percent CI, 1.01-4.38).

"These data suggest that risk-based HIV testing, which is contingent on health care providers being aware of their patients' risk, could miss these high-risk persons," the researchers concluded.