Background Understanding the relationships between demographic, healthcare-related and psychosocial factors with STI vulnerability will provide information that can guide development of STI prevention efforts tailored to the lived realities of YMSM.
Methods Between 2009–2011, n=600 YMSM were enrolled at age 18 in a prospective cohort study examining psychosocial and physical health during semi-annual visits conducted over a 36-month period. Reports of recent STIs were collected by self-report and a composite outcome variable was created: self-report of any STI (CT, GC, and/or syphilis) in the prior 90 days (hereafter called STI diagnoses). Bivariate analysis was conducted to examine relationships between STI diagnoses and 3 domains of covariates: demographic factors, psychosocial factors, and healthcare system related factors. Generalized estimating equations (GEE) with link logit was used to model factors from each domain associated with STI diagnoses.
Results Over the course of the study period, these 597 participants contributed a total of 2,765 visits and self-reported n=205 STI diagnoses (composite variable detailed above). Increased age was associated with increased likelihood of STI diagnoses (aOR=1.22 per year, 95% CI 1.04–1.43) after adjustment for SES, race, #insertive/receptive anal intercourse acts, type of healthcare obtained (private clinic, public clinic, VA), and insurance status. Black/African YMSM were more likely to self-report an STI (aOR=2.90, 95% CI 1.50–5.61), compared to White (non-hispanic) peers (adjusted for age, SES, #sex acts, clinic type, and insurance). Participants receiving healthcare at public clinics (aOR= 1.89, 95% CI 1.30–2.77) and VA facilities (aOR= 4.13 95% CI 2.24–7.60) were more likely to report STI diagnoses than those attending private clinics (adjusted for age, race, SES, #sex acts, insurance). Depression score, gay-related stigma, internalized homophobia were not associated with STI diagnoses.
Conclusion Older black/african YMSM were more likely to self-report an STI, perhaps because they participant in a different core mixing group of sexual contacts than other participants.
Disclosure No significant relationships.
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