Physician awareness of sexual orientation and preventive health recommendations to men who have sex with men.
BACKGROUND
Men who have sex with men (MSM) have unique health risks and needs. Providers who assume patients to be heterosexual may be providing suboptimal care. This study sought (1) to describe primary care provider (PCP) knowledge of patients' sexual orientation and the demographic and provider-related factors associated with such knowledge; and, (2) to assess whether PCP knowledge of sexual orientation was associated with appropriate recommendations for preventive and diagnostic health care services.


METHODS
A total of 271 MSM completed a cross-sectional survey. We measured MSMs' disclosure of their sexual orientation and demographic information, and PCP recommendations for preventive health services.


RESULTS
Most participants' PCPs (72%) knew the participants' sexual orientation. Participants with female, gay, and/or younger PCPs were more likely to have disclosed their sexual orientation. Black men, men from rural areas, and men with incomes under $15,000 per year were less likely to have disclosed their sexual orientation. PCP knowledge of sexual orientation was associated with a higher likelihood that PCPs recommended disease screening and preventive health measures: 59% versus 13% for human immunodeficiency virus testing, 32% versus 16% for hepatitis A or B vaccination. Inconsistencies were found between participants' self-reported risk behaviors and PCP recommendations.


CONCLUSIONS
Disclosure of sexual orientation is associated with several patient-related and provider-related characteristics. Lack of disclosure to providers significantly decreased the likelihood that appropriate health services were recommended to participants. Efforts to promote discussion of sexual orientation within the primary health care setting should be directed toward both PCPs and MSM.
Petroll
Andrew E
AE
Department of Psychiatry and Behavioral Health, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N. Summit Ave, Milwaukee, WI 53202, USA. apetroll@mcw.edu
Mosack
Katie E
KE
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D011314:Preventive Health Services / Q000379:methods; D011320:Primary Health Care / Q000379:methods; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission; D014342:Truth Disclosure; D055815:Young Adult