C2f Health System and Personal Barriers Resulting in Decreased Utilization of STD Testing Services Among at Risk Black Men Who Have Sex with Men (MSM) in Massachusetts

Wednesday, March 10, 2010: 11:45 AM
Grand Ballroom B (M4) (Omni Hotel)
Matthew Mimiaga, ScD, MPH1, Sari Reisner, MA2, Sean Bland, BA2, Margie Skeer, ScD, MPH, MSW2, Kevin Cranston, MDiv3, Deborah Isenberg, MPH, CHES3, Maura Driscoll, MPH4, Benny Vega, BA2 and Kenneth Mayer, MD5, 1The Fenway Institute and Harvard Medical School, Boston, MA, 2The Fenway Institute, Boston, MA, 3Bureau of Infectious Disease Prevention, Response, and Services, Massachusetts Department of Public Health, Boston, MA, 4Office of HIV/AIDS, Bureau of Infectious Disease, Massachusetts Department of Publich Health, Boston, MA, 5The Fenway Institute and Brown University, Boston, MA

Background: Black MSM are at increased risk for HIV and other STDs, which cause morbidity and potentiate HIV spread. Given the noted racial disparities in STD/HIV incidence, additional research is needed to understand the frequency of, and factors related to, STD testing among Black MSM in the U.S.

Objectives: To examine factors associated with not having tested for STDs in the prior two years.

Methods: Black MSM (N=197) recruited via respondent-driven-sampling between January-July 2008 completed an interviewer-administered assessment, with optional HIV counseling/testing/referral-services. Odds ratios obtained from logistic regression analyses were converted to relative risks.

Results: Mean age was 40.8 (SD=9.4); 61% identified as straight/bisexual, 100% reported sexual behavior with a man in the prior year. 53% reported unprotected anal sex (UAS) with a male; 30% reported UAS/vaginal sex with a female in the past year. 60% had not been tested for STDs in the prior two years, and 24% had never been tested for STDs. Factors associated with not having a recent STD test include: age (RR=1.02;p=0.008); having a prior STD (RR=1.46;p=0.005); substance-use during last sex with a casual-partner (RR=1.49;p=0.006); feeling that using a condom during sex is “very difficult” (RR=1.32;p=0.02); frequent social contact with MSM (RR=0.69;p=0.04); visiting a healthcare provider (HCP) in the past 12-months (RR=0.48;p=0.01); and having a HCP recommend STD testing at their last visit (RR=0.29;p=0.0001). In a multivariable adjusted model, Black MSM who reported that a HCP recommended getting an STD test at their last visit were significantly less likely to have not been tested for STDs in the past two years (ARR=0.11;p=0.0004).

Conclusions: Many sexually active Black MSM do not regularly test for STDs. HCPs play a pivotal role in encouraging STD testing for Black MSM.

Implications for Programs, Policy, and/or Research: Additional provider training is warranted to educate HCPs about the specific health care needs of Black MSM, in order to facilitate access to timely, culturally-competent STD testing/treatment services.

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