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Sexual orientation disclosure in health care: a systematic review

Sexual orientation disclosure in health care: a systematic review
Sexual orientation disclosure in health care: a systematic review
Background: many men who have sex with men (MSM) in China are “in the closet.” The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals.

Methods: a nationwide cross-sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio-demographic information, sexual behaviours, HIV/STI testing history, and self-reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider.

Results: a total of 1819 men started the survey and 1424 (78.3%) completed it. Among the 1424 participants, 62.2% (886/ 1424) reported overall disclosure, and 16.3% (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56% higher among MSM who used smartphone-based, sex-seeking applications [adjusted odds ratio (aOR) = 1.56, 95% CI: 1.25–2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95% CI: 2.50–4.51 for HIV, and aOR = 4.92, 95% CI: 3.47–6.96 for STIs, respectively) or self-reported as living with HIV (aOR = 1.59, 95% CI: 0.93–2.72).

Conclusion: over 80% of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.

0960-1643
e187-e196
Brooks, Hannah
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Llewellyn, Carrie D.
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Nadarzynski, Tom
218d69a1-d1be-46f4-bead-23071bd4f270
Pelloso, Fernando Castilho
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De Souza Guilherme, Felipe
ec0f8f72-cc6d-4af5-b0db-ca4fa2560a1f
Pollard, Alex
2e7c65e8-af16-4fd6-ab54-8b51f2c1a0d3
Jones, Christina J.
69dd533c-9a3b-413d-9381-1de9c621743d
Brooks, Hannah
514ac04f-3b88-4adc-ae02-7ebf67a4ae55
Llewellyn, Carrie D.
1db5dffa-4401-42b0-a54f-ed428ac14839
Nadarzynski, Tom
218d69a1-d1be-46f4-bead-23071bd4f270
Pelloso, Fernando Castilho
915769a1-2ddc-47ea-b6e8-1aaf3151a6e8
De Souza Guilherme, Felipe
ec0f8f72-cc6d-4af5-b0db-ca4fa2560a1f
Pollard, Alex
2e7c65e8-af16-4fd6-ab54-8b51f2c1a0d3
Jones, Christina J.
69dd533c-9a3b-413d-9381-1de9c621743d

Brooks, Hannah, Llewellyn, Carrie D., Nadarzynski, Tom, Pelloso, Fernando Castilho, De Souza Guilherme, Felipe, Pollard, Alex and Jones, Christina J. (2018) Sexual orientation disclosure in health care: a systematic review. British Journal of General Practice, 68 (668), e187-e196. (doi:10.3399/bjgp18X694841).

Record type: Article

Abstract

Background: many men who have sex with men (MSM) in China are “in the closet.” The low rate of disclosure may impact sexual behaviours, testing for HIV and other sexually transmitted infections (STIs), and diseases transmission. This study examines factors associated with overall sexual orientation disclosure and disclosure to healthcare professionals.

Methods: a nationwide cross-sectional online survey was conducted from September 2014 to October 2014 in China. Participants completed questions covering socio-demographic information, sexual behaviours, HIV/STI testing history, and self-reported HIV status. We defined healthcare professional disclosure as disclosing to a doctor or other medical provider.

Results: a total of 1819 men started the survey and 1424 (78.3%) completed it. Among the 1424 participants, 62.2% (886/ 1424) reported overall disclosure, and 16.3% (232/1424) disclosed to healthcare professionals. In multivariate analyses, the odds of sexual orientation disclosure were 56% higher among MSM who used smartphone-based, sex-seeking applications [adjusted odds ratio (aOR) = 1.56, 95% CI: 1.25–2.95], but were lower among MSM reporting sex while drunk or recreational drug use. The odds of disclosure to a healthcare professional were greater among MSM who had ever tested for HIV or STIs (aOR = 3.36, 95% CI: 2.50–4.51 for HIV, and aOR = 4.92, 95% CI: 3.47–6.96 for STIs, respectively) or self-reported as living with HIV (aOR = 1.59, 95% CI: 0.93–2.72).

Conclusion: over 80% of MSM had not disclosed their sexual orientation to health professionals. This low level of disclosure likely represents a major obstacle to serving the unique needs of MSM in clinical settings. Further research and interventions to facilitate MSM sexual orientation disclosure, especially to health professionals, are urgently needed.

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Llewellyn_2017_SO disclosure BJGP - FINAL - Accepted Manuscript
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More information

Accepted/In Press date: 10 July 2017
e-pub ahead of print date: 29 January 2018
Published date: 1 March 2018

Identifiers

Local EPrints ID: 412605
URI: http://eprints.soton.ac.uk/id/eprint/412605
ISSN: 0960-1643
PURE UUID: faf48a5b-f81a-4c3e-a247-3a432e651b85

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Date deposited: 24 Jul 2017 16:32
Last modified: 30 Jan 2020 05:06

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Contributors

Author: Hannah Brooks
Author: Carrie D. Llewellyn
Author: Tom Nadarzynski
Author: Fernando Castilho Pelloso
Author: Felipe De Souza Guilherme
Author: Alex Pollard
Author: Christina J. Jones

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