Gay, bisexual, and other men who have sex with men: Barriers and facilitators to healthcare access in Ottawa

2021 ◽  
pp. e20210002
Author(s):  
Marlene Haines ◽  
Patrick O’Byrne ◽  
Paul MacPherson
Keyword(s):  
Therapeutic Relationship ◽  
Healthcare Professionals ◽  
Healthcare Access ◽  
Delivery Of Healthcare ◽  
Sexually Transmitted ◽  
Safe Spaces ◽  
Clinical Encounters ◽  
Sex With Men ◽  
Stis And Hiv ◽  
Specific Health

Despite access to healthcare that is similar to the entire population, gay, bisexual, and other men who have sex with men (gbMSM) have worse rates for many pathologies, including sexually transmitted infections (STIs) and HIV, mental health, and substance use. To better understand the barriers to care that occur during healthcare interactions—in an effort to make recommendations to improve these clinical encounters—we engaged in focus groups with three groups of gbMSM. We explored the experiences and concerns of these men regarding healthcare. In total, we interviewed 32 men. Our findings identified that the two most pronounced barriers to delivery of comprehensive and impactful healthcare for gbMSM were (1) wariness and distrust of the healthcare system and fears of neglect and overt discrimination, and (2) a lack of knowledge among healthcare professionals about specific health concerns for MSM. Facilitators as identified by participants were (1) creating safe spaces where MSM are recognized, (2) not only developing but demonstrating an accepting and supportive therapeutic relationship with patients, and (3) attention to issues of disclosure and confidentiality. These findings highlight both ongoing issues in the delivery of healthcare for gbMSM in Canada, and tangible solutions that practitioners can implement immediately to address these problems.

Sexually transmitted infection screening and diagnosis among adolescent men who have sex with men, three US cities, 2015

2019 ◽  
Vol 31 (1) ◽  
pp. 53-61
Author(s):  
Qian An ◽  
Kyle T Bernstein ◽  
Alexandra B Balaji ◽  
Cyprian Wejnert ◽  
Keyword(s):  
Transmitted Infection ◽  
Sexually Transmitted ◽  
National Hiv Behavioral Surveillance ◽  
Increased Risk ◽  
Characteristics Analysis ◽  
Young Msm ◽  
Sex With Men ◽  
Stis And Hiv ◽  
Associated Risk Factors ◽  
Screening And Diagnosis

Adolescent men who have sex with men (MSM) are at increased risk for sexually transmitted infections (STIs) and HIV; however, data documenting STI screening, STI burden, and associated risk factors for STIs are extremely limited. Using 2015 data from the National HIV Behavioral Surveillance among Young MSM, we examined self-reported STI screening and STI diagnosis of chlamydia, gonorrhea, or syphilis among sexually active adolescent MSM by selected characteristics. Analysis of STI diagnosis was limited to participants who reported an STI screening. Differences in STI screening and STI diagnosis and factors associated with screening and diagnosis were examined using bivariate and multivariable binomial regression models. Less than half of adolescent MSM reported having ever been screened for an STI. Among these, more than a quarter reported having ever been diagnosed with chlamydia, gonorrhea, or syphilis. STI screening was associated with visiting a healthcare provider in the past 12 months and having ever been tested for HIV. Having ever had an STI diagnosis was associated with the participant age of 18 years and having sex before 13 years old. Among adolescent MSM, STI screening was suboptimal and STI burden was significant. STI intervention and prevention programs are urgently needed to promote STI awareness, timely screening, and early diagnosis to interrupt transmission among this vulnerable population.

Sexual health advice for MSM and WSW in general practice

2019 ◽  
Vol 30 (5) ◽  
pp. 232-236
Author(s):  
Sally Kelsey
Keyword(s):  
Sexual Health ◽  
Health Needs ◽  
Sexually Transmitted ◽  
Practice Nurses ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Health Advice ◽  
Sex With Men ◽  
Asymptomatic Individuals ◽  
Specific Health

Men who have sex with men and women who have sex with women need specialised health considerations regarding their sexual health. Sally Kelsey describes what these health needs are and what practice nurses can do to ensure health inequalities are reduced People who identify as lesbian, gay or bisexual (LGB) make up a minority of the population, but carry a large burden of sexually transmitted infections (STIs). Some behaviours among men who have sex with men lead to an increased risk of some STIs and women who have sex with women have specific health needs. While specialist sexual health services are well placed to provide services for these patients, many people choose not to or are not able to access these services. Therefore, primary care has a prime opportunity to offer advice and screening for asymptomatic individuals, and to offer opportunistic advice. Health professionals should be educated in these specific health needs, develop awareness of patient risks and discuss sexual behaviours and risks in an open and non-judgmental way.

A comparison of HIV-risk behaviors between young black cisgender men who have sex with men and young black transgender women who have sex with men

2018 ◽  
Vol 29 (7) ◽  
pp. 665-672 ◽  
Author(s):  
Richard A Crosby ◽  
Laura F Salazar ◽  
Brandon Hill ◽  
Leandro Mena
Keyword(s):  
Oral Sex ◽  
Computer Assisted ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Exchange Sex ◽  
Sexually Transmitted ◽  
Multiple Risk Factors ◽  
The Usa ◽  
Sex With Men ◽  
Stis And Hiv

This study compared sexually transmitted infection (STI)-associated risks between young Black cisgender men who have sex with men (YBMSM) and young Black transwomen who have sex with men (YBTWSM). Comparisons pertained to: (1) prevalence of infections; (2) sexual risk; (3) partner-related risks; and (4) socioeconomic marginalization. YBMSM (n = 577) and YBTWSM (n = 32) were recruited from an STI clinic in the USA. Volunteers completed a computer-assisted self-interview and medical records were abstracted for STI/HIV information. Significantly greater prevalence of pharyngeal Chlamydia ( P < .001) and pharyngeal gonorrhea ( P = .04) occurred among YBTWSM; however, both associations were moderated and only significant for HIV-uninfected volunteers. YBTWSM had more oral sex partners and more frequent engagement in oral sex. The number of new sex partners for anal receptive sex was greater in YBTWSM. YBTWSM were more likely to exchange sex for money/drugs ( P < .001), have sex with men recently in prison ( P < .001), who were “anonymous” ( P = .004), or who were “one night stands” ( P < .001). YBTWSM were more likely to depend on sex partners for money food, etc. ( P < .001), to miss meals due to lack of money ( P = .01), and to report having ever being incarcerated ( P = .009). Compared to cisgender YBMSM, YBTWSM experience multiple risk factors relative to the acquisition/transmission of STIs and HIV.

scholarly journals Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037608
Author(s):  
Mario Martín-Sánchez ◽  
Richard Case ◽  
Christopher Fairley ◽  
Jane S Hocking ◽  
Catriona Bradshaw ◽  
...  
Keyword(s):  
Health Centre ◽  
Cross Sectional Study ◽  
Sexual Practices ◽  
Sectional Study ◽  
Anal Sex ◽  
Cross Sectional ◽  
Men And Women ◽  
Sexually Transmitted ◽  
Receptive Anal Sex ◽  
Sex With Men

ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals. Men who have sex with both men and women (MSMW) have characteristics that may differ from both men who have sex with men only (MSMO) and heterosexual men. We aimed to compare the sexual practices and the trends in HIV/STI positivity between MSMO and MSMW.DesignRepeated cross-sectional study.SettingA sexual health centre in Melbourne, Australia.ParticipantsMSM aged 18 years and above who attended the Melbourne Sexual Health Centre for the first time between 2011 and 2018. This includes 12 795 MSMO and 1979 MSMW.Primary outcome measuresDemographic characterics, sexual practices and HIV/STI positivity.ResultsCompared with MSMW, MSMO were more likely to practice anal sex and to have condomless receptive anal sex with casual male partners, and less likely to have a current regular relationship. Over the 8-year period, there was an increase in condomless receptive anal sex with casual male partners for both groups (MSMO: from 46.2% to 63.3%, ptrend <0.001; MSMW: from 41.3% to 57.9%, ptrend=0.011). Syphilis positivity increased in MSMO (from 5.5% to 7.9%, ptrend=0.012) and MSMW (from 0.9% to 6.4%, ptrend=0.004) and HIV remained stable. Gonorrhoea increased among MSMO from 2011 to 2014 (from 6.7% to 9.6%, ptrend=0.002), and remained stable from 2015 to 2018. MSMO had higher odds of testing positive for gonorrhoea (adjusted OR (aOR) 1.36, 95% CI 1.13 to 1.64), chlamydia (aOR 1.39, 95% CI 1.16 to 1.67), syphilis (aOR 1.74, 95% CI 1.37 to 2.22) and HIV (aOR 4.60, 95% CI 2.43 to 8.70) than MSMW.ConclusionsMSMW have overall lower condomless sex and lower HIV/STI positivity. In the last years, changes in sexual practices in MSM have affected both MSMW and MSMO leading to an increased STI risk.

scholarly journals Testing as Prevention of Resistance in Bacteria Causing Sexually Transmitted Infections—A Population-Based Model for Germany

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 929
Author(s):  
Andreas Hahn ◽  
Hagen Frickmann ◽  
Ulrike Loderstädt
Keyword(s):  
Sexually Transmitted Infections ◽  
False Negative ◽  
Population Based ◽  
Sexually Transmitted ◽  
Test Characteristics ◽  
Antibiotic Drugs ◽  
False Positive Signal ◽  
Antibiotic Drug ◽  
Potential Applicability ◽  
Sex With Men

Prescribed antibiotic treatments which do not match the therapeutic requirements of potentially co-existing undetected sexually transmitted infections (STIs) can facilitate the selection of antibiotic-drug-resistant clones. To reduce this risk, this modelling assessed the potential applicability of reliable rapid molecular test assays targeting bacterial STI prior to the prescription of antibiotic drugs. The modelling was based on the prevalence of three bacterial STIs in German heterosexual and men-having-sex-with-men (MSM) populations, as well as on reported test characteristics of respective assays. In the case of the application of rapid molecular STI assays for screening, the numbers needed to test in order to correctly identify any of the included bacterial STIs ranged from 103 to 104 for the heterosexual population and from 5 to 14 for the MSM population. The number needed to harm—defined as getting a false negative result for any of the STIs and a false positive signal for another one, potentially leading to an even more inappropriate adaptation of antibiotic therapy than without any STI screening—was at least 208,995 for the heterosexuals and 16,977 for the MSM. Therefore, the screening approach may indeed be suitable to avoid unnecessary selective pressure on bacterial causes of sexually transmitted infections.

Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

2016 ◽  
Vol 28 (6) ◽  
pp. 573-583 ◽  
Author(s):  
Jamie Frankis ◽  
Lisa Goodall ◽  
Dan Clutterbuck ◽  
Abdul-Razak Abubakari ◽  
Paul Flowers
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Anal Intercourse ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Male Sex ◽  
Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

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