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J Int AIDS Soc. 2017 Feb 6;20(1):21416. doi: 10.7448/IAS.20.1.21416.

Disclosure of sexual orientation to health professionals in China: results from an online cross-sectional study.

Author information

1
University of North Carolina at Chapel Hill Project-China, Guangzhou, China.
2
SESH Study Group of University of North Carolina at Chapel Hill, Guangzhou, China.
3
Department of STI Control, Guangdong Center for Skin Diseases and STI Control, Guangzhou, China.
4
Department of Infectious Diseases, School of Medicine of University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
5
Department of Biostatistics of University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
6
Danlan Gongyi, Beijing, China.
7
School of Public Health, Shandong University, Jinan, China.
8
School of Medicine, University of California, San Francisco, San Francisco, CA, USA.

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.

KEYWORDS:

China; disclosure; healthcare professional; men who have sex with men (MSM); sexual behaviours; sexual orientation

PMID:
28361498
PMCID:
PMC5467583
DOI:
10.7448/IAS.20.1.21416
[Indexed for MEDLINE]
Free PMC Article

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