Characteristics Associated with Trust in and Disclosure of Sexual Behavior to Primary Care Providers Among Gay,Bisexual,and Other Men Who Have Sex with Men in the United States
Restricted accessResearch articleFirst published online June, 2020
Characteristics Associated with Trust in and Disclosure of Sexual Behavior to Primary Care Providers Among Gay,Bisexual,and Other Men Who Have Sex with Men in the United States
Characteristics associated with having a primary care provider (PCP), patient–provider trust, and sexual behavior disclosure were examined among men who have sex with men (MSM).
Methods:
MSM (N = 4239) were surveyed regarding demographic, behavioral, and medical characteristics. Multivariable logistic regression analyses were used.
Results:
Among 86.3% of MSM with a PCP, characteristics associated with lower patient–provider trust included younger age, Asian, bisexual, HIV-negative-not-on-pre-exposure prophylaxis, HIV-unknown, and lower medical literacy; with nondisclosure: Asian, bisexual, straight, HIV-negative, HIV-unknown, fewer partners, recruitment source, lower medical literacy, and lower patient–provider trust.
Conclusion:
Medical literacy and patient–provider trust are promising points of intervention to improve health outcomes among MSM.
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References
1.
Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities: The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC, National Academies Press, 2011.
WardBW, DahlhamerJM, GalinskyAM, JoestlSS: Sexual orientation and health amongU.S. adults: National Health Interview Survey, 2013. Natl Health Stat Rep, 2014; 77:1–10.
4.
MarcusJL, LevineK, GrassoC, et al.: HIV preexposure prophylaxis as a gateway to primary care. Am J Public Health, 2018; 108:1418–1420.
5.
BerkmanND, SheridanSL, DonahueKE, et al.: Low health literacy and health outcomes: An updated systematic review. Ann Intern Med, 2011; 155:97–107.
6.
MusaD, SchulzR, HarrisR, et al.: Trust in the health care system and the use of preventive health services by older black and white adults. Am J Public Health, 2009; 99:1293–1299.
7.
BraksmajerA, FedorTM, ChenSR, et al.: Willingness to take PrEP for HIV prevention: The combined effects of race/ethnicity and provider trust. AIDS Educ Prev, 2018; 30:1–12.
8.
RaceyCS, ZhangW, BrandsonEK, et al.: HIV antiviral drug resistance: Patient comprehension. AIDS Care, 2010; 22:816–826.
9.
BauerAM, ParkerMM, SchillingerD, et al.: Associations between antidepressant adherence and shared decision-making, patient-provider trust, and communication among adults with diabetes: Diabetes study of Northern California (DISTANCE). J Gen Intern Med, 2014; 29:1139–1147.
10.
GlanzJM, WagnerNM, NarwaneyKJ, et al.: A mixed methods study of parental vaccine decision making and parent-provider trust. Acad Pediatr, 2013; 13:481–488.
11.
BrooksH, LlewellynCD, NadarzynskiT, et al.: Sexual orientation disclosure in health care: A systematic review. Br J Gen Pract, 2018; 68:e187–e196.
12.
PetrollAE, MosackKE: Physician awareness of sexual orientation and preventive health recommendations to men who have sex with men. Sex Transm Dis, 2011; 38:63–67.
13.
NgBE, MooreD, MichelowW, et al.: Relationship between disclosure of same-sex sexual activity to providers, HIV diagnosis and sexual health services for men who have sex with men in Vancouver, Canada. Can J Public Health, 2014; 105:e186–e191.
14.
QiaoS, ZhouG, LiX: Disclosure of same-sex behaviors to health-care providers and uptake of HIV testing for men who have sex with men: A systematic review. Am J Mens Health, 2018; 12:1197–1214.
15.
PetrollAE, MitchellJW: Health insurance and disclosure of same-sex sexual behaviors among gay and bisexual men in same-sex relationships. LGBT Health, 2015; 2:48–54.
16.
MartinezJ, HosekSG: An exploration of the down-low identity: Nongay-identified young African-American men who have sex with men. J Natl Med Assoc, 2005; 97:1103–1112.
17.
GrovC, Jonathan RendinaH, PatelVV, et al.: Prevalence of and factors associated with the use of HIV serosorting and other biomedical prevention strategies among men who have sex with men in a US nationwide survey. AIDS Behav, 2018; 22:2743–2755.
18.
DuganE, TrachtenbergF, HallMA: Development of abbreviated measures to assess patient trust in a physician, a health insurer, and the medical profession. BMC Health Serv Res, 2005; 5:64.
19.
WallaceLS, RogersES, RoskosSE, et al.: Brief report: Screening items to identify patients with limited health literacy skills. J Gen Intern Med, 2006; 21:874–877.
20.
ThomDH: Stanford Trust Study Physicians: Physician behaviors that predict patient trust. J Fam Pract, 2001; 50:323–328.
21.
FisherCB, FriedAL, MacapagalK, MustanskiB: Patient-provider communication barriers and facilitators to HIV and STI preventive services for adolescent MSM. AIDS Behav, 2018; 22:3417–3428.
22.
SunCJ, AndersonKM, BangsbergD, et al.: Access to HIV pre-exposure prophylaxis in practice settings: A qualitative study of sexual and gender minority adults' perspectives. J Gen Intern Med, 2019; 34:535–543.
23.
KleinDA, MalcolmNM, Berry-BibeeEN, et al.: Quality primary care and family planning services for LGBT clients: A comprehensive review of clinical guidelines. LGBT Health, 2018; 5:153–170.
