Differences in access to healthcare and utilisation of HIV and sexually transmissible infection services between men who have sex with men and men who have sex only with women: results of the 2006–10 National Survey of Family Growth in the United States

Sexual Health ◽  
2013 ◽  
Vol 10 (4) ◽  
pp. 363 ◽  
Author(s):  
Guoyu Tao ◽  
Karen W. Hoover

Background Men who have sex with men (MSM) experience disparities in access to healthcare and have specific healthcare needs. Methods: We analysed data from the 2006–10 National Survey of Family Growth (NSFG) to examine differences in access to healthcare and HIV and sexually transmissible infection (STI) related health services by MSM and non-MSM among men in the United States aged 15–44 years who have ever had sex. MSM and sexually active MSM were identified in the NSFG as men who had ever had oral or anal sex with another man, or who had sex in the past 12 months with another man, respectively. Access was measured by the type of health insurance, having a usual place for receiving healthcare and type of usual place. Results: Of men aged 15–44 years who have ever had sex, there were no significant differences between MSM and non-MSM in the three access measures. MSM were more likely than non-MSM to receive HIV counselling (22.5% v. 8.3%) and STI testing (26.2% v. 15.6%) in the past 12 months, or to ever have had HIV testing (67.8% v. 44.6%). STI testing in the past 12 months was reported by 38.7% of sexually active MSM. Conclusion: Our findings show no significant differences in access to healthcare between MSM and non-MSM. MSM were more likely to receive HIV- and STI-related preventive services than non-MSM. However, the low STI testing rate among MSM highlights the need for interventions to increase STI testing, and HIV and STI counselling for MSM.


2017 ◽  
Vol 23 (3) ◽  
pp. 272 ◽  
Author(s):  
Caitlin H. Douglass ◽  
Alyce M. Vella ◽  
Margaret E. Hellard ◽  
Megan S. C. Lim

Annual chlamydia testing is recommended for all sexually active Australians aged 15–29 years; however, the testing rate is below recommended levels. Three surveys at a Melbourne music festival were conducted over 2012–14 to identify correlates of sexually transmissible infection (STI) testing among young people at risk of STIs. In total, 3588 participants were recruited; 72% reported having sex in the past year. Based on sexual behaviours, 38% of sexually active participants were classified as at risk of contracting STIs. In the past year, at-risk participants had significantly higher odds of reporting a STI test (37%) than participants classified as not at risk (24%) (OR=1.9; CI=1.6–2.3). Among at-risk participants, correlates of STI testing in the past year included being aged 20–24 years, visiting a GP, higher knowledge levels, earlier sexual debut and reporting more than five lifetime partners. Testing rates in our sample did not meet levels required to reduce chlamydia prevalence. However, the testing rate was higher in at-risk participants than participants who were not at risk. Future programs aiming to increase chlamydia testing should improve knowledge and promote the importance of testing after risk exposure, particularly among 16- to 19-year-olds.



Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 217 ◽  
Author(s):  
David J. Templeton ◽  
Phillip Read ◽  
Rajesh Varma ◽  
Christopher Bourne

Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009–May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.



Sexual Health ◽  
2015 ◽  
Vol 12 (4) ◽  
pp. 360 ◽  
Author(s):  
Byron C. Minas ◽  
Carolien M. Giele ◽  
Sue C. Laing ◽  
Lisa Bastian ◽  
Andrew W. Burry ◽  
...  

Background In July 2010, the Western Australian AIDS Council established the ‘M Clinic’, a peer-led STI testing service for MSM. This study describes trends in HIV notifications among MSM in WA from 2004 to 2013, particularly the impact of the M Clinic on newly acquired HIV diagnoses. Methods: The number and proportion of MSM HIV cases with newly acquired infection were compared for the 2004–2006, 2007–2009 and 2011–2013 time periods. Data from 2010 were excluded as the M Clinic opened in July 2010. Results: Between the 2004–2006 and 2007–2009 periods, the number of MSM with newly acquired HIV increased by 50% (23 to 33 cases) and the number of newly acquired cases as a proportion of all new HIV diagnoses among MSM increased from 27% to 35% (30% increase) (P = 0.25). In the 2011–2013 period, the number of newly acquired HIV cases among MSM more than doubled to 70 cases and comprised 53% of all new HIV diagnoses among MSM (P < 0.05). Of the 70 newly acquired HIV cases in the 2011–2013 period, 30% (n = 21) were diagnosed at the M Clinic. Conclusions: The proportion of MSM HIV notifications that were newly acquired increased between 2004 and 2013 in WA, with the greatest increase seen after the M Clinic commenced operation. A peer-led approach to HIV testing should be considered in order to achieve early diagnosis and treatment of HIV among MSM.



Sexual Health ◽  
2018 ◽  
Vol 15 (4) ◽  
pp. 325 ◽  
Author(s):  
Carmen H. Logie ◽  
Kathleen S. Kenny ◽  
Ashley Lacombe-Duncan ◽  
Ying Wang ◽  
Kandasi Levermore ◽  
...  

Background Men who have sex with men (MSM) are at elevated risk for sexually transmissible infection (STI) acquisition globally. Yet, limited research has explored STI testing practices among MSM in contexts where same-sex practices are criminalised, such as in Jamaica. Methods: A cross-sectional, tablet-based survey with MSM in Kingston, Ocho Rios and Montego Bay, Jamaica, was conducted. Multivariable logistic regression analyses were conducted to determine the adjusted risk ratio for lifetime STI testing and lifetime STI diagnosis. Multinomial logistic regression analyses were conducted to determine the relative odds of having had an STI test 3–5 months ago and 6–12 months ago in comparison with <3 months ago. Results: Three-quarters (74.8%) of the 556 participants reported receiving an STI test (44% <3 months ago; 32% 3–5 months ago; 13% 6–12 months ago; 10% >12 months ago); 12.1% reported ever receiving an STI diagnosis. In adjusted multivariable analyses, STI testing was associated with sociodemographic (education, location), individual (depression, perceived risk), social (relationship status, sexual stigma) and structural (healthcare provider access) factors. In multinomial analysis, reporting a less recent STI test (>3 months ago) versus <3 months ago was associated with increased likelihood of sexual stigma and food insecurity. Lifetime STI diagnosis was associated with sociodemographic (location), individual (HIV infection) and social (lower social support) factors. Conclusions: Findings document associations between structural factors and delayed timing of STI testing. Further research is necessary to explore how to address social ecological factors in sexual health interventions with MSM in Jamaica.



Sexual Health ◽  
2015 ◽  
Vol 12 (6) ◽  
pp. 472 ◽  
Author(s):  
Melissa A. Habel ◽  
Roberta Scheinmann ◽  
Elizabeth Verdesoto ◽  
Charlotte Gaydos ◽  
Maggie Bertisch ◽  
...  

Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. Methods: The study included two phases in February 2011–July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. Results: Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. Conclusions: This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases.



Author(s):  
Rowland W Pettit ◽  
Jordan Kaplan ◽  
Matthew M Delancy ◽  
Edward Reece ◽  
Sebastian Winocour ◽  
...  

Abstract Background The Open Payments Program, as designated by the Physician Payments Sunshine Act is the single largest repository of industry payments made to licensed physicians within the United States. Though sizeable in its dataset, the database and user interface are limited in their ability to permit expansive data interpretation and summarization. Objectives We sought to comprehensively compare industry payments made to plastic surgeons with payments made to all surgeons and all physicians to elucidate industry relationships since implementation. Methods The Open Payments Database was queried between 2014 and 2019, and inclusion criteria were applied. These data were evaluated in aggregate and for yearly totals, payment type, and geographic distribution. Results 61,000,728 unique payments totaling $11,815,248,549 were identified over the six-year study period. 9,089 plastic surgeons, 121,151 surgeons, and 796,260 total physicians received these payments. Plastic surgeons annually received significantly less payment than all surgeons (p=0.0005). However, plastic surgeons did not receive significantly more payment than all physicians (p = 0.0840). Cash and cash equivalents proved to be the most common form of payment; Stock and stock options were least commonly transferred. Plastic surgeons in Tennessee received the most in payments between 2014-2019 (mean $ 76,420.75). California had the greatest number of plastic surgeons to receive payments (1,452 surgeons). Conclusions Plastic surgeons received more in industry payments than the average of all physicians but received less than all surgeons. The most common payment was cash transactions. Over the past six years, geographic trends in industry payments have remained stable.



Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 273 ◽  
Author(s):  
Sara K. Head ◽  
Richard A. Crosby ◽  
Lydia A. Shrier ◽  
Gregory R. Moore

Background: This exploratory study investigated young women’s perceptions of sexually transmissible infection (STI) testing received during gynaecological care. Correlates of the incorrect perception that STI testing occurred were assessed. Methods: Cross-sectional study of sexually active young women, age 18–24 years, attending a university healthcare setting for gynaecological care (n = 109). Two hundred and four women were approached and 87 were ineligible; of the remaining 117, 93.2% chose to enrol. Results: Of the women enrolled, 25.7% falsely perceived that they were STI tested (labelled ‘clean and clear’). Only approximately one in seven (14.7%) accurately understood the STI for which they were tested. In multivariate analyses, controlling for race, STI symptoms, depression, number of lifetime visits to the gynaecologist, and suspicion of current STI, three variables were significant: minority race (adjusted odds ratio (AOR) = 4.84, confidence interval (CI) = 1.38–16.96, P = 0.01), earlier age at sexual debut (AOR = 4.67, CI = 1.73–12.57, P = 0.002), and previous STI diagnosis (AOR = 3.38, CI = 1.07–10.66, P = 0.04). Comment: The findings suggest that many young women may have an inaccurate understanding of the STI testing they undergo during gynaecological care and may operate under the misperception they are ‘clean and clear’ of STI. Women with said misperception were more likely to be of minority race and report relatively earlier age of sexual debut and previous STI diagnosis. Further investigation is warranted to determine whether the ‘clean and clear’ misperception influences young women’s sexual risk behaviour.



Sexual Health ◽  
2007 ◽  
Vol 4 (1) ◽  
pp. 75 ◽  
Author(s):  
Danielle Esler ◽  
Catriona Ooi

Australian guidelines for sexual history taking and sexually transmissible infection (STI) screening of HIV-positive patients do not exist. An audit was conducted to assess current practices of sexual history taking and STI testing of HIV-positive patients attending Hunter New England Sexual Health Unit.



2018 ◽  
Vol 12 (6) ◽  
pp. 1824-1834 ◽  
Author(s):  
Akshay Sharma ◽  
Erin M. Kahle ◽  
Stephen P. Sullivan ◽  
Rob Stephenson

Gay, bisexual, and other men who have sex with men (GBMSM) in the United States remain heavily impacted by HIV. The purpose of this study was to describe intergenerational differences in functional knowledge of HIV prevention strategies, perceived risk, recent condomless anal sex (CAS), and HIV testing behavior. Eight hundred sexually active GBMSM were recruited via Facebook from August to September 2015, and administered a Web-based survey which included 12 multiple-choice questions to elicit data regarding functional knowledge of different HIV prevention approaches (e.g., condom use, pre-exposure prophylaxis post-exposure prophylaxis, treatment as prevention, circumcision). Cumulative logit and multivariable logistic models were formulated to examine birth cohort variations across four analytic outcomes. Younger generations were significantly more knowledgeable, as were GBMSM with higher education. Non-Hispanic non-White GBMSM and those reporting a bisexual/other sexual orientation had lower functional knowledge. Younger generations were equally concerned about contracting HIV as their older counterparts. Perceived risk was significantly higher among non-Hispanic non-White and Hispanic GBMSM, but lower among those with higher education and those in a relationship. Finally, birth cohort variations with respect to engaging in CAS with ≥2 men in the past 3 months and testing for HIV in the past year were not markedly pronounced. Younger GBMSM might be more knowledgeable about HIV prevention strategies compared to their predecessors, but are equally concerned about contracting HIV. Researchers and practitioners should consider intergenerational and other demographic differences while designing multifaceted HIV prevention programs for GBMSM.



Sexual Health ◽  
2014 ◽  
Vol 11 (6) ◽  
pp. 592
Author(s):  
Christina A. Muzny ◽  
Richa Kapil ◽  
Erika L. Austin ◽  
Edward W. Hook ◽  
William M. Geisler

Background Sexually transmissible infection (STI) history, prevalence and seroprevalence among lifetime exclusive women who have sex with women (WSW) and an age-matched group of women who have sex with women and men (WSWM) was evaluated. Methods: Participants completed a study questionnaire and had genital specimens and sera collected for STI testing. Results: Twenty-one lifetime exclusive WSW and 42 WSWM were included. WSWM were more likely to report a history of prior STIs and be seropositive for chlamydia and HSV-2. Prevalent STIs were less common among WSW. Conclusions: While lifetime exclusive WSW are at risk of contracting STIs, WSWM are disproportionally affected. Healthcare providers should consider routine STI screening among WSW.



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