title: Factors Influencing Access to Sexual Health Care Among Behaviorally Bisexual Men in Vientiane, Laos: A Qualitative Exploration.
abstract: In Laos, men who have sex with men (MSM) are disproportionately affected by HIV, and bisexual behavior among men is common. We conducted a qualitative study to explore access and influences on sexual health care seeking among bisexual men in Vientiane. In 2013, behaviorally bisexual men were recruited from bars, clubs and dormitories for 5 focus group discussions and 11 in-depth interviews. Participants (aged 18-35 years) commonly reported high-risk sexual behaviors, yet most had never been tested for HIV, and none reported testing for sexually transmitted infections. Common barriers to testing were low perception of risk, expectation of symptoms, fear of HIV, shyness, perceived stigma, confidentiality concerns, and waiting times. Many men were unaware of available services. Most clinics cannot provide comprehensive HIV and sexually transmitted infection services. Strategies are needed to generate demand for testing, improve the capacity of sexual health care providers, and promote available services among behaviorally bisexual men in Vientiane.
authors.affiliation: Burnet Institute, Melbourne, Victoria, Australia School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia annab@burnet.edu.au.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Bowring
authors.affiliation: Burnet Institute, Vientiane, Lao PDR.
authors.forename: Nakhornphet
authors.initials: N
authors.lastname: Pasomsouk
authors.affiliation: Burnet Institute, Melbourne, Victoria, Australia Faculty of Health Sciences, National Drug Research Institute, Curtin University, Fitzroy, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Higgs
authors.affiliation: Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR.
authors.forename: Vanphanom
authors.initials: V
authors.lastname: Sychareun
authors.affiliation: Burnet Institute, Melbourne, Victoria, Australia School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.affiliation: Burnet Institute, Melbourne, Victoria, Australia School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Power
mesh_terms: D000293:Adolescent; D000328:Adult; D001727:Bisexuality / Q000523:psychology* / Q000706:statistics & numerical data; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007812:Laos; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D060728:Reproductive Health; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000175:diagnosis; D055815:Young Adult
keywords: HIV testing; Laos; bisexuality; health care utilization; men who have sex with men; sexually transmitted infection testing