Same-Sex Attraction Disclosure to Health Care Providers Among New York City Men Who Have Sex With MenImplications for HIV Testing Approaches

Abstract

While it is estimated that only between 2.8% and 10.0% of the male population is gay or bisexual,^1-3 men who have sex with men (MSM) bear a disproportionate burden of adverse health outcomes. Compared with heterosexual men, MSM are significantly more likely to abuse drugs and alcohol,^4-6 smoke cigarettes,^7,8 suffer from depression and other mental disorders,^9-11 attempt suicide,^11-14 and become infected with a sexually transmitted disease (STD) or human immunodeficiency virus (HIV).^15-17Among men in New York City (NYC), New York, in 2005, 51.5% of new HIV diagnoses were among MSM,¹⁸ representing 37.4% of all new HIV diagnoses in NYC. Nationally, these figures are 66.8% and 49.1%, respectively.¹⁹ Furthermore, it is estimated that 25% of individuals infected with HIV are unaware of their infections.²⁰ This proportion among high-risk MSM younger than 30 years is estimated to be 48%.²¹ Men who have sex with men who are unaware of their HIV infections are reported to more likely be nonwhite, have a history of an STD, have a greater number of lifetime sexual partners, and be tested for HIV less frequently than HIV-negative MSM.²²