Research ArticleOriginal Research

Disclosure of Sexual Orientation and Uptake of HIV Testing and Hepatitis Vaccination for Rural Men Who Have Sex With Men

Nicholas Metheny and Rob Stephenson
The Annals of Family Medicine March 2016, 14 (2) 155-158; DOI: https://doi.org/10.1370/afm.1907

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Uptake of HIV testing and hepatitis vaccination by men reporting to being out to clinicians among a nationwide sample of rural men who have sex with men in the United States.

    HAV = hepatitis A virus; HBV = hepatitis B virus; HIV = human immunodeficiency virus.

    aBased on a scale in which 1 = no disclosure and 7 = full disclosure of sexual orientation.

Tables

  • Table 1

    Sample Characteristics and Receipt of HIV Testing and HAV and HBV Vaccinations Among an Online Sample of Rural Men Who Have Sex With Men (N = 319)

    CharacteristicRespondents in Each Category % (No.)Respondents With Recent HIV Testing and HAV and HBV Vaccinations %Respondents With HIV Testing and HAV and HBV Vaccinations OR (95% CI)
    Hepatitis A vaccination43.0 (137)……
    Hepatitis B vaccination50.5 (161)……
    HIV testing in the past 12 months37.3 (108)……
    HAV/HBV vaccination and HIV testing18.8 (60)……
    Age, y
     18–2448.0 (153)20.31.00 [reference]
     25–3424.8 (79)19.000.64 (0.29–1.42)
     35–4411.9 (38)15.80.43 (0.14–1.28)
     ≥ 4515.4 (49)16.30.44(0.16–1.17)
    Race
     White89.7 (286)18.91.00 [reference]
     Black/other10.3 (33)18.20.98 (0.36–2.65)
    Education
     High school or less25.4 (81)16.11.00 [reference]
     Some college51.1 (163)19.61.36 (0.64–2.87)
     College or higher23.5 (75)20.01.42 (0.59–3.46)
    Employment
     Employed68.0 (217)17.11.00 [reference]
     Unemployed10.3 (33)21.21.60 (0.60–4.28)
     Not in workforce21.6 (69)23.21.57 (0.77–3.19)
    Relationship status
     Single62.1 (198)18.71.00 [reference]
     Cohabiting22.3 (71)21.11.13 (0.55–2.30)
     Married, widowed, divorced15.7 (50)16.00.83 (0.33–2.09)
    Sexual orientation
     Gay95.3 (304)18.40.58 (0.16–2.04)
    Mean disclosure to clinician (1–7)a   5.2 (4.7–5.7)      4.3 (4.0–4.5)1.26 (1.08–1.47)b

    • HAV = hepatitis A virus; HBV = hepatitis B virus; HIV = human immunodeficiency virus.

    • ↵a Based on a scale ranging from 1 to 7, in which 1 = no disclosure and 7 = full disclosure.

    • ↵b P <.05.

Additional Files

  • The Article in Brief

    Disclosure of Sexual Orientation and Uptake of HIV Testing and Hepatitis Vaccination for Rural Men Who Have Sex With Men

    Nicholas Metheny , and colleagues

    Background Primary care clinicians' ability of to make recommendations for routine HIV testing and hepatitis vaccines are shaped by knowledge of their patient's risk behaviors. For men who have sex with men (MSM), this requires disclosure of same-sex sexual behavior or sexual identity. This study analyzes whether disclosing sexual identity is associated with increased HIV testing and hepatitis vaccinations among rural MSM.

    What This Study Found For rural MSM, being fully "out" to their clinician and talking openly about their sexuality is a fundamental gateway to receiving appropriate sexual health services. Full disclosure of sexual orientation to their primary care clinician sharply increases the probability that rural men who have sex with men receive recommended HIV testing and hepatitis A and B vaccinations.

    Implications

    • This finding, according to the authors, reinforces the need for safe, nonjudgemental spaces for patients to freely discuss their sexual identities with their clinicians.
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