Abstract
Introduction
Adolescent sexual minority males (ASMM) experience higher rates of HIV and other sexually transmitted infections (STIs) relative to their heterosexual peers. Primary care clinicians (PCCs) are well positioned to discuss sexual health and STI prevention with adolescent males; however, ASMM report they are rarely asked about their sexual health, especially with respect to attraction and identity. This study sought to determine variables associated with disclosure of male attraction (“being out”) to a PCC.
Methods
ASMM (N = 206; 14 to 17 years in the USA) completed an online sexual health survey in 2017. We assessed socio-demographics, sexuality, being out to a guardian, and being out to a PCC, and calculated proportions and associations among the variables using univariable (Fisher exact) and multivariable (Firth logistic regression) analyses.
Results
Only 20% (n = 41) of ASMM were out to their PCC even though 53% (n = 109) were out to a parent or guardian. ASMM who were out to a parent or guardian were seven times more likely to be out to their PCC (adjusted odds ratio = 6.69, 95% confidential interval 2.69 to 16.60). No other variables were associated with being out to a PCC.
Conclusions
Among ASMM, the only predictor of outness to a PCC in this study was outness to a parent or guardian, yet only half were out to a parent or guardian.
Policy Implications
PCCs should proactively and routinely inquire about sexual health and screen adolescent males for same sex attraction and sexual minority identity in order to provide optimal health care.
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Acknowledgements
We thank the participants, our youth advisory board, and our research assistant.
Funding
Funding for this study came from the National Institute of Mental Health (K23 MH109346, PI: Nelson and K23MH123335, PI: Rusley).
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We certify that all authors made substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data. We also certify that all authors either drafted or critically revised the manuscript for intellectual content, approved the version to be published, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All authors contributed to the study conception and design. Conception, study design, and data collection were performed by Dr. Nelson. Analyses and interpretation were performed by Drs. Nelson and Rusley. The first draft of the manuscript was written by Dr. Rusley, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Rusley, J., Carey, M.P. & Nelson, K.M. Disclosure of Male Attraction to Primary Care Clinicians by Adolescent Sexual Minority Males. Sex Res Soc Policy 19, 321–327 (2022). https://doi.org/10.1007/s13178-021-00544-3
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DOI: https://doi.org/10.1007/s13178-021-00544-3