Patient-Provider Communication Barriers and Facilitators to HIV and STI Preventive Services for Adolescent MSM

AIDS Behav. 2018 Oct;22(10):3417-3428. doi: 10.1007/s10461-018-2081-x.


Adolescent males who have sex with males (AMSM) are at increased risk of contracting HIV/AIDS and other sexually transmitted infections (STIs). Healthcare providers are a critical source of HIV/STI prevention, yet little is known about AMSM patient-provider sexual health communications and services. To explore this issue, we surveyed a national sample of 198 AMSM 14-17 years. Four online psychometrically validated scales indicated over half the youth avoided communicating their sexual orientation and sexual health concerns to providers due to fear of heterosexist bias, concern their sexual health information would be disclosed to parents, and a general belief that sexual minority youth do not receive equitable treatment in health care settings. Youth who reported their physicians had initiated discussion about their sexual orientation were significantly more likely to have received HIV/STI preventive services and testing. Discussion includes the importance of medical training that meets the unique sexual health needs of AMSM.

Keywords: Adolescent; Discrimination; HIV; Healthcare; MSM; Men who have sex with men; Mistrust; Patient–provider communication; Physician; Prevention; Sexually transmitted infections; Stigma.

MeSH terms

  • Adolescent
  • Adult
  • Attitude of Health Personnel
  • Communication Barriers*
  • Female
  • HIV Infections / prevention & control*
  • HIV Infections / psychology
  • Health Personnel*
  • Homosexuality, Male / psychology*
  • Homosexuality, Male / statistics & numerical data
  • Humans
  • Male
  • Physicians
  • Preventive Health Services / statistics & numerical data*
  • Professional-Patient Relations*
  • Self Disclosure
  • Sexual Behavior
  • Sexually Transmitted Diseases / prevention & control*
  • Social Stigma
  • Surveys and Questionnaires