Health Care Access and Sexually Transmitted Disease Screening Frequency Among at Risk Massachusetts Men Who Have Sex with Men (MSM)

Wednesday, March 12, 2008
Continental Ballroom
Sari L. Reisner, MA , Fenway Community Health, Boston, MA
Matthew J. Mimiaga, ScD, MPH , Fenway Community Health and Harvard Medical School, Boston, MA
Carey V. Johnson, MS , Fenway Community Health, Boston, MA
Ashley M. Tetu, BS , Fenway Community Health, Boston, MA
Kevin Cranston, MDiv , MA Department of Public Health, Boston, MA
David S. Novak, MSW , Online Buddies, Inc, Boston, MA
Kenneth H. Mayer, MD , Fenway Community Health and Brown University/Miriam Hospital, Boston, MA

Despite the Centers for Disease Control and Preventions (CDC) recommendations that all sexually active MSM receive routine screening for HIV and other STDs, many MSM remain unaware of their HIV/ STD status.

The current study assessed behavioral risk factors, health care access, and rates of screening for HIV and other STDs among at risk MSM in Massachusetts.

Using a modified respondent-driven sampling method, this study recruited a diverse sample of MSM (n=126). All participants completed a quantitative survey assessment between March 2006 and May 2007.

Fifty percent of MSM had a history of one or more STDs. HIV-infected MSM (54%) were more likely to report prior STD diagnoses (OR=4.04; P<0.001). Most participants (97%) had health insurance and had visited a health care provider (HCP) in the past year, but 39% had not been screened for STDs in 2 years. White MSM were more likely to have been tested for STDs (OR=3.82; P<0.01). Non-white MSM were more likely to be bisexual (OR=5.83; P<0.001) and less likely to have disclosed MSM activity to HCPs (OR=2.94; P<0.01). Bisexual men were less likely to have told HCPs about male-to-male sexual behavior (OR=4.66; P<0.001) and to have been tested for STDs in the past 2 years (OR=6.91; P<0.001); they were 5 times more likely to engage in insertive anal sex without a condom with an HIV-infected partner (OR=5.04; P<0.005).

The current study demonstrates high rates of sexual risk taking and low rates of HIV/STD screening among a diverse sample of Massachusetts MSM, particularly among non-white bisexual men who have not disclosed MSM sexual activity to HCPs.

Clinicians need to encourage discussion about sexual risk taking behaviors and more routinely screen for STDs in sexually active men irrespective of disclosure of MSM history.
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