Effect of Same-Sex Marriage Laws on Health Care Use and Expenditures in Sexual Minority Men: A Quasi-Natural Experiment

Background: Despite decreasing rates of HIV among many populations, HIV-related health disparities among gay, bisexual and other men who have sex with men persist, with disproportional percentages of new HIV diagnoses among racial and ethnic minority men. Despite increasing awareness of HIV pre-exposure prophylaxis (PrEP), PrEP use remains low. In addition to exploring individual-level factors for this slow uptake, structural drivers of PrEP use must also be identified in order to maximize the effectiveness of biomedical HIV prevention strategies. Method: Using cross-sectional data from an ongoing cohort study of young sexual minority men (N=492), we examine the extent to which structural-level barriers, including access to health care, medication logistics, counseling support, and stigma are related to PrEP use. Results: While almost all participants indicated awareness of PrEP, only 14% had ever used PrEP. PrEP use was associated with lower concerns about health care access, particularly paying for PrEP. Those with greater concerns talking with their provider about their sexual behaviors were less likely to use PrEP. Conclusion: Paying for PrEP and talking to one’s provider about sexual behaviors are concerns for young sexual minority men. In particular, stigma from healthcare providers poses a significant barrier to PrEP use in this population. Providers need not only to increase their own awareness of and advocacy for PrEP as an effective risk-management strategy for HIV prevention, but also must work to create open and non-judgmental spaces in which patients can discuss sexual behaviors without the fear of stigma.

Download Full-text

Co-occurring psychosocial problems predict HIV status and increased health care costs and utilization among sexual minority men

Journal of Behavioral Medicine ◽

10.1007/s10865-018-9913-z ◽

2018 ◽

Vol 41 (4) ◽

pp. 450-457 ◽

Cited By ~ 3

Author(s):

Conall O’Cleirigh ◽

David W. Pantalone ◽

Abigail W. Batchelder ◽

Mark L. Hatzenbuehler ◽

Samantha M. Marquez ◽

...

Keyword(s):

Health Care ◽

Health Care Costs ◽

Sexual Minority ◽

Psychosocial Problems ◽

Hiv Status ◽

Sexual Minority Men ◽

Minority Men ◽

Care Costs

Download Full-text

Nursing and Health Care Preferences Among Opioid and Stimulant Using Black Sexual Minority Men

Journal of the Association of Nurses in AIDS Care ◽

10.1097/jnc.0000000000000201 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Derek T. Dangerfield ◽

Jessica Cooper ◽

Omeid Heidari ◽

Sophia Allen ◽

Terrell J.A. Winder ◽

...

Keyword(s):

Health Care ◽

Sexual Minority ◽

Sexual Minority Men ◽

Minority Men ◽

Health Care Preferences

Download Full-text

Demographic, Regional, and Political Influences on the Sexual Health Care Experiences of Adolescent Sexual Minority Men

LGBT Health ◽

10.1089/lgbt.2019.0122 ◽

2020 ◽

Vol 7 (1) ◽

pp. 28-36 ◽

Cited By ~ 1

Author(s):

Michael E. Newcomb ◽

Kevin Moran ◽

Dennis H. Li ◽

Brian Mustanski

Keyword(s):

Health Care ◽

Sexual Health ◽

Sexual Minority ◽

Sexual Minority Men ◽

Sexual Health Care ◽

Political Influences ◽

Health Care Experiences ◽

Minority Men

Download Full-text

Predicting Sexual Fulfillment from Sexual Satisfaction and Outness During First Same-Sex Anal Intercourse in Young Black Sexual Minority Men

Journal of Adolescent Health ◽

10.1016/j.jadohealth.2016.10.358 ◽

2017 ◽

Vol 60 (2) ◽

pp. S90

Author(s):

Jessica C. Raisanen ◽

Anthony Morgan ◽

Jessica Oidtman ◽

Pamela A. Matson ◽

Joshua Rosenberger ◽

...

Keyword(s):

Sexual Satisfaction ◽

Sexual Minority ◽

Anal Intercourse ◽

Same Sex ◽

Sexual Minority Men ◽

Minority Men

Download Full-text

Relationship Power and Intimate Partner Violence in Sexual Minority Male Couples

Journal of Interpersonal Violence ◽

10.1177/0886260520916271 ◽

2020 ◽

pp. 088626052091627

Author(s):

Stephen C. Bosco ◽

Gabriel Robles ◽

Rob Stephenson ◽

Tyrel J. Starks

Keyword(s):

Risk Factors ◽

Sexual Minority ◽

Partner Violence ◽

Intimate Partner ◽

Relationship Power ◽

Same Sex ◽

Male Couples ◽

Sexual Minority Men ◽

Individual Family ◽

Minority Men

Objective: The objective of the present study was to test pathways implied by Disempowerment Theory to predict intimate partner violence (IPV) among men in a same-sex relationship. Background: Sexual minority men in relationships experience rates of IPV comparable with heterosexual women, yet most research on IPV focuses on heterosexual couples. Disempowerment Theory suggests that a range of individual, family-of-origin, and intimate relationship risk factors predict the use of violence to re-establish power in a relationship. Method: Data for the present study were gathered from an online survey completed by sexual minority men currently in a same-sex relationship ( n = 339). Analysis of data included two steps: (a) we tested the direct effect of individual, family, and relational predictors on the odds of IPV and (b) we calculated a path model that included relationship power as a link between the predictors (individual, family, and relational) and IPV. Results: In line with Disempowerment Theory, relationship power was negatively associated with IPV. Bivariate analysis indicated an association between childhood sexual abuse and IPV, but childhood sexual abuse was not predictive of IPV through relationship power. Other individual (depression) and relationship-specific (sexual communication and relationship satisfaction) risk factors were associated with IPV indirectly through relationship power. Conclusion: Disempowerment Theory may provide a useful framework for understanding the occurrence of IPV in sexual minority male couples. It may also provide a starting point for the development of multi-component interventions to reduce violence in these couples.

Download Full-text

Association between same-sex marriage introduction and attitudes towards homosexuality in Europe

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.769 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Hagen ◽

E Goldmann

Keyword(s):

Sexual Minority ◽

Sexual Minorities ◽

Public Attitudes ◽

Well Being ◽

Social Determinant ◽

European Countries ◽

Same Sex ◽

Same Sex Marriage ◽

Country Level ◽

Marriage Laws

Abstract Background Existing research suggests a positive relationship between the introduction of same-sex marriage and country-level acceptance of homosexuality across Europe in the first decade of the 21st century. Between 2010 and 2018, another 8 countries in Europe introduced same-sex marriage. Given the well-established association between greater social acceptance of sexual minorities and LGBT health, it is important to continue to monitor the effect of same-sex marriage policies on public attitudes. Methods Using data from waves 1 through 9 of the European Social Survey (ESS), the lagged association between same-sex marriage and acceptance of homosexuality in the subsequent wave was analysed for 12 European countries that introduced same-sex marriage between 2002 and 2018. Acceptance of sexual minorities was assessed using the statement, “Gay men and lesbians should be free to live their own life as they wish”, which was dichotomised into two groups: “agree strongly” or “agree” vs. “neither agree nor disagree”, “disagree”, or “disagree strongly”. The association between same-sex marriage laws and acceptance was analysed in mixed-effects logistic regression models adjusting for country-level and individual-level confounders and survey year. Results On the country level, acceptance of homosexuality ranged from 61% in Portugal in 2006 to 96% in Iceland in 2016. Based on the total sample of 171,683 observations, acceptance increased from 77% in 2002 to 88% in 2018. Preliminary analyses indicate that existence of same-sex marriage at the time of data collection was associated with 24% increased odds of acceptance of homosexuality in fully adjusted models (95% CI: 1.05-1.48). Conclusions This study provides further evidence of an association between same-sex marriage laws and public acceptance of homosexuality. Additional research will be needed in order to further investigate this relationship beyond Western Europe and in relation to sexual minority health and well-being. Key messages For 12 European countries, evidence of an association between the introduction of same-sex marriage between 2002 and 2018, and subsequent accepting public attitudes towards homosexuality was found. Given their role as a key social determinant of health, further research on the association between social norms accepting of sexual minority populations and inclusive social policies is warranted.

Download Full-text