Health care access, health care utilisation and sexual orientation disclosure among Black sexual minority men in the Deep South

Ying He; Derek T. Dangerfield II; Errol L. Fields; Milton R. Dawkins; Rodman E. Turpin; Damon Johnson; Dorothy C. Browne; DeMarc A. Hickson

doi:10.1071/SH20051

RESEARCH ARTICLE (Open Access)

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Health care access, health care utilisation and sexual orientation disclosure among Black sexual minority men in the Deep South

Ying He ^A , Derek T. Dangerfield II

^B ^C ^J , Errol L. Fields ^D , Milton R. Dawkins Jr ^A ^E , Rodman E. Turpin

^F , Damon Johnson ^G , Dorothy C. Browne ^H ^I and DeMarc A. Hickson ^A ^C

+ Author Affiliations

- Author Affiliations

^A My Brother’s Keeper, Inc., 407 Orchard Park, Ridgeland, MS 39157, USA.

^B Johns Hopkins School of Nursing, 525 N Wolfe Street, Baltimore, MD 21205, USA.

^C Us Helping Us, People Into Living, Inc., 3636 Georgia Avenue NW, Washington, DC 20010, USA.

^D Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, 200 N Wolfe Street, Baltimore, MD 21287, USA.

^E Department of Psychology, Jackson State University, Jackson, MS 39213, USA.

^F School of Public Health, University of Maryland, 4200 Valley Drive #2242, College Park, MD 20742, USA.

^G USA National AIDS and Education Services for Minorities, Inc., 2140 Martin Luther King Jr Drive SW, Atlanta, GA 30310, USA.

^H Department of Maternal and Child Health, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

^I University of Duy Tan, 254 Nguyen Van Linh, Thanh Khe District, Da Nang, Vietnam.

^J Corresponding author. Email: ddanger2@jhu.edu

Sexual Health 17(5) 421-428 https://doi.org/10.1071/SH20051
Submitted: 31 March 2020 Accepted: 1 September 2020 Published: 12 November 2020

Journal Compilation © CSIRO 2020 Open Access CC BY-NC-ND

Abstract

Background: Black gay, bisexual, and other sexual minority men (BSMM) account for 39.1% of new HIV infections among men who have sex with men and 78.9% of newly diagnosed cases among Black men. Health care access, health care utilisation and disclosing sexuality to providers are important factors in HIV prevention and treatment. This study explored the associations among sexual orientation disclosure, health care access and health care utilisation among BSMM in the Deep South. Methods:Secondary analysis of existing data of a population-based study in Jackson, Mississippi, and Atlanta, Georgia, was conducted among 386 BSMM. Poisson regression models were used to estimate prevalence ratios (PR) between sexual orientation disclosure to healthcare providers, health care access and health care utilisation. Results:The mean (±s.d.) age of participants was 30.5 ± 11.2 years; 35.3% were previously diagnosed with HIV and 3.7% were newly diagnosed with HIV. Two-thirds (67.2%) self-identified as homosexual or gay; 70.6% reported being very open about their sexual orientation with their healthcare providers. After adjustment, BSMM who were not open about their sexual orientation had a lower prevalence of visiting a healthcare provider in the previous 12 months than those who were very open with their healthcare provider (PR 0.42; 95% confidence interval 0.18–0.97). Conclusion:Clinics, hospitals and other healthcare settings should promote affirming environments that support sexuality disclosure for BSMM.

Keywords: HIV, sexual health, sexually transmissible infection (STI), stigma.

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