Men who have sex with men (MSM) are at high risk for sexually transmitted infections (STIs). National guidelines recommend that MSM receive HIV, syphilis, gonorrhea, and chlamydia screening at least annually, and hepatitis A and B and human papillomavirus (HPV) vaccinations. A multi-site team of researchers investigated associations between disclosure of male-male sexual orientation/behavior and receipt of this panel of services. The authors are Dr. Vidisha Singh, Centers for Disease Control and Prevention; Dr. Richard Crosby, University of Kentucky College of Public Health; Dr. Beau Gratzer, Howard Brown Health; Dr. Pamina M. Gorbach, UCLA Fielding School of Public Health; and Dr. Lauri Markowitz and Dr. Elissa Meites, CDC. The results of their investigation appear in the journal Sexually Transmitted Diseases.
Gay, bisexual and other MSM aged 18-26 years were enrolled from health clinics serving lesbian, gay, bisexual, and transgender communities in Los Angeles and Chicago during 2012-2014. Participants completed a computer-assisted self-interview regarding healthcare services, disclosure of sexual orientation/behavior, and recent HIV test results.
Overall, 817 participants said they had visited a healthcare provider within the past year. Of these, 525 (64.3 percent) had disclosed, and 749 (91.7 percent) felt they could disclose if important to health. In total, 548 (67.1 percent) received all sexually transmitted infection (STI) screenings and 74 (9.1 percent) received all vaccinations. Only 105 (12.9 percent) received any HPV vaccination. More disclosing participants received all recommended screenings and all recommended care components than did non-disclosing participants.
The investigators found that, despite national recommendations, receipt of a complete panel of STI care services was low among young MSM. Vaccine uptake was lower than STI screening. However, most participants visited a healthcare provider in the past year and most disclosed, suggesting opportunities to improve services. The authors conclude that providers might encourage disclosure by improving sexual history-taking and education, which could increase opportunities for MSM to receive recommended care.