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APHA Scientific Session and Event Listing

Patient-provider communication, STD and HIV testing, and sexual risk perceptions among men who have sex with men (MSM)

Matthew Mimiaga, MPH1, Hilary Goldhammer, MS2, Ashley Tetu, BS2, Rodney VanDerwarker, BA2, Thomas Bertrand, MPH3, Kevin Cranston, MDiv3, David Novak, MSW3, Eric Rubenstein, MPH3, and Kenneth Mayer, MD4. (1) Fenway Community Health and Harvard School of Public Health, 7 Haviland Street, Boston, MA 02115, 617-927-6084, mmimiaga@fenwayhealth.org, (2) Fenway Community Health, 7 Haviland Street, Boston, MA 02115, (3) MA Department of Public Health, 250 Washington Street, Boston, MA 02108, (4) Fenway Community Health and Brown University/Miriam Hospital, 7 Haviland Street, Boston, MA 02115

Background: Primary-care-providers are in a strategic position to provide STD/HIV screening/counseling services to MSM. MSM may face numerous obstacles to discussions of sexual orientation and behavior with providers.

Method: This study examined the perceptions of Boston MSM regarding STD/HIV risk and patient-provider communication using semi-structured interviews. Fifty MSM were recruited utilizing a modified respondent-driven-sampling method. NVIVO software was used to identify emerging themes. Tests of independence were performed using chi-square analysis.

Result: Sixty-six percent were HIV-infected. Eighty-eight percent reported having a primary-care-provider; 92% reported visiting a health-care-provider in the past 12-months. Twelve percent of the HIV-uninfected men reported that their provider recommended HIV-testing at their last visit; only 22% of the entire cohort had STD-screening recommended. Providers had recommended HIV-testing for only 20% of the men ever, and STD-testing for only 40%, despite 43% of the men reporting at least one prior STD. HIV-infected participants were more likely to report ever being tested for an STD (P<.05) and diagnosed with an STD (P<.01) compared to HIV-uninfected participants. Quantitative data revealed that a majority of participants engaged in sexual-behavior that put them at moderate-to-high risk of acquiring an STD; however, this data also suggests the majority of participants perceived themselves at low-to-moderate risk.

Conclusion: Although 88% reported having a current primary-care-provider and the majority of these (82%) were ‘out' about their sexuality to their providers, only a minority were screened for STD/HIV. There is a need for improved provider education on STD/HIV screening/counseling for MSM, including training to conduct culturally-sensitive behavioral-risk-assessments.

Learning Objectives: Learning Objectives