Disparities in access to primary care, a key site for HIV prevention services, among gay and bisexual men in the United States.
Disparities in access to primary care, a key site for HIV prevention services, among gay and bisexual men in the United States.
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美国男性同性恋和双性恋者在获得初级保健（艾滋病毒预防服务的关键场所）方面存在差异。
DOI：
10.1080/09540121.2023.2189223
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发表时间：
2023
期刊：
影响因子：
1.7
通讯作者：
Kimmel,AprilD
中科院分区：
文献类型：
--
作者：
Kiernan,JessicaS;Kimmel,AprilD
美国艾滋病毒诊断不成比例地影响非西班牙裔黑人（NHB）和西班牙裔同性恋和双性恋男性。利用国家健康访谈调查（2013-2018）的数据，我们研究了同性恋和双性恋男性的种族和民族以及初级保健服务，这是一种艾滋病毒预防资源。解释变量为NHB、西班牙裔或非西班牙裔白色（NHW）。结果是初级保健特定的日常护理场所（潜在的访问）和看普通医生<12个月（实现访问）。我们使用多变量逻辑回归，调整个人社会人口特征，健康状况和护理障碍。在敏感性分析中，我们检查了一般访问（任何地点/医生）和亚组（1）NHB（2）有通常的护理地点。样本包括1，858名成年男性、同性恋和双性恋男性（未加权）。近三分之一的人自称是NHB或西班牙裔。与NHW男性相比，NHB和西班牙裔男性更年轻，家庭收入更低，护理障碍更多（p< 0.05）。NHB和西班牙裔男性比NHW男性有更低的实现访问（aOR 0.7058，p = 0.030）。仅NHB（与NHW相比）的潜在访问率较低，并且在任何常规护理场所中，NHB和西班牙裔男性与NHW男性相比。NHB或西班牙裔，而不是NHW，同性恋和双性恋男子的初级保健获得率较低，可能会减少艾滋病毒预防的获得。
U.S. HIV diagnoses disproportionately affect Non-Hispanic Black (NHB) and Hispanic gay and bisexual men. Using data from the National Health Interview Survey (2013-2018), we examined race and ethnicity and primary care access, an HIV prevention resource, among gay and bisexual men. The explanatory variable was NHB, Hispanic or Non-Hispanic White (NHW). Outcomes were primary care-specific usual place of care (potential access) and saw general doctor <12 months (realized access). We used multivariable logistic regression, adjusting for individual sociodemographic characteristics, health status, and care barriers. In sensitivity analysis, we examined general access (any place/doctor) and subgroups (1) NHB (2) has usual place of care. The sample included 1,858 adult, gay and bisexual men (unweighted). Nearly one-third self-identified as NHB or Hispanic. Compared to NHW men, NHB and Hispanic men were younger, with lower household income, and more care barriers (p< 0.05). NHB and Hispanic men had lower realized access (aOR 0.7058,p= 0.030) than NHW men. Potential access was lower for NHB only (versus NHW) and, among those with any usual place of care, NHB and Hispanic men versus NHW men. Lower primary care access for NHB or Hispanic, rather than NHW, gay and bisexual men, may reduce HIV prevention access.