Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors

J Aging Health. 2024 Mar;36(3-4):147-160. doi: 10.1177/08982643231177725. Epub 2023 May 30.

Abstract

Objectives: Advance care planning (ACP) specifies decision-making surrogates and preferences for serious illness or end-of-life medical care. ACP research has largely neglected sexual minority men (SMM), a population that experiences disparities in health care and health status. Methods: We examined formal and informal ACP among SMM ages 40+ in the Multicenter AIDS Cohort Study (N = 1,071). Results: For informal ACP (50%), younger SMM and men with past cardiovascular events had greater odds of planning; single men had lower odds of planning. For formal ACP (39%), SMM with greater socioeconomic status had greater odds of planning; SMM who were younger, of racial/ethnic minority identities, who were single or in a relationship without legal protections, and who lacked a primary care home had lower odds of planning. Discussion: Findings warrant further exploration of both informal and formal planning. More equitable, culturally-humble engagement of SMM may facilitate access, uptake, and person-centered planning.

Keywords: advance care planning; advance directives; aging; sexual minority men.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Advance Care Planning*
  • Cohort Studies
  • Delivery of Health Care
  • Ethnicity*
  • Health Status
  • Humans
  • Male
  • Minority Groups