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HIV Prevention Services Received at Health Care and HIV Test Providers by Young Men who Have Sex with Men: An Examination of Racial Disparities

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Abstract

We investigated whether there were racial/ethnic differences among young men who have sex with men (MSM) in their use of, perceived importance of, receipt of, and satisfaction with HIV prevention services received at health care providers (HCP) and HIV test providers (HTP) that explain racial disparities in HIV prevalence. Young men, aged 23 to 29 years, were interviewed and tested for HIV at randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to five U.S. cities that enrolled 50 or more black or Hispanic MSM. Among the 2,424 MSM enrolled, 1,522 (63%) reported using a HCP, and 1,268 (52%) reported having had an HIV test in the year prior to our interview. No racial/ethnic differences were found in using a HCP or testing for HIV. Compared with white MSM, black and Hispanic MSM were more likely to believe that HIV prevention services are important [respectively, AOR, 95% confidence interval (CI): 3.0, 1.97 to 4.51 and AOR, 95% CI: 2.7, 1.89 to 3.79], and were more likely to receive prevention services at their HCP (AOR, 95% CI: 2.5, 1.72 to 3.71 and AOR, 95% CI: 1.7, 1.18 to 2.41) and as likely to receive counseling services at their HTP. Blacks were more likely to be satisfied with the prevention services received at their HCP (AOR, 95% CI: 1.7, 1.14 to 2.65). Compared to white MSM, black and Hispanic MSM had equal or greater use of, perceived importance of, receipt of, and satisfaction with HIV prevention services. Differential experience with HIV prevention services does not explain the higher HIV prevalence among black and Hispanic MSM.

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Acknowledgments

We are grateful to the young men who volunteered for this research project and to the dedicated staff who contributed to its success. We are especially grateful to the YMS coordinators: John Hylton and Karen Yen (Baltimore); Santiago Pedraza and Douglas Shehan (Dallas); Trista Bingham and Denise Johnson (Los Angeles); Henry Artiguez (Miami); Vincent Guilin (New York City); and Tom Perdue (Seattle). We appreciate and acknowledge the dedicated effort of laboratory and data management staff in all cities.

The following organizations participated in the Young Men’s Survey: Baltimore: Johns Hopkins School of Hygiene and Public Health, Baltimore City Health Department, Maryland Department of Health and Mental Hygiene; Dallas: University of Texas Southwestern Medical Center at Dallas, Texas Department of Health; Los Angeles: Los Angeles County Department of Health Services; Miami: Health Crisis Network, University of Miami, Florida Department of Health; New York City: New York Blood Center, New York City Department of Health; San Francisco: San Francisco Department of Public Health; Seattle: Public Health—Seattle and King County, HIV/AIDS.

The members of the Young Men’s Survey Group are Baltimore: David D. Celentano, ScD; John B. Hylton, MHS; Frank Sifakis, Ph.D.; Dallas: Anne C. Freeman, MSPH; Douglas Shehan; Santiago Pedraza; Los Angeles: Trista Bingham, MPH, MS.; Denise Johnson, MPH; Bobby Gatson; Miami: Marlene LaLota, MPH; Tom Liberti; New York City: Vincent Guilin; Beryl A. Koblin, PhD; Lucia V. Torian, PhD; San Francisco: William McFarland MD, PhD; Kyung-Hee Choi, Ph.D.; Seattle: Thomas Perdue, MPH; Hanne Thiede, DVM, MPH; St. Louis: Gina M. Secura, PhD; CDC: Bradford N. Bartholow PhD; Stephanie Behel, MPH; Robert S. Janssen, MD; Duncan A. MacKellar, MA, MPH; Linda A. Valleroy, PhD.

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Correspondence to Stephanie K. Behel.

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A complete list of the members of the Young Men’s Survey Study Group and cooperating organizations appears at the end of this article.

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Behel, S.K., MacKellar, D.A., Valleroy, L.A. et al. HIV Prevention Services Received at Health Care and HIV Test Providers by Young Men who Have Sex with Men: An Examination of Racial Disparities. J Urban Health 85, 727–743 (2008). https://doi.org/10.1007/s11524-008-9303-x

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