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Out of the Closet, Into the Clinic: Opportunities for Expanding MSM-Competent Services in China

Watson, Julia, BA1,2,3; Tang, Weiming, PhD1,2,3,4; Pan, Stephen, PhD2,5; Wu, Dan, PhD1,2,3; Zhao, Peipei, MS1,2,6; Cao, Bolin, PhD2,7; Liu, Chuncheng, BA1,2,8; Bien, Cedric, MD1,2; Huang, Wenting, MS1,2; Luo, Zhenzhou, MS6,*; Tucker, Joseph D., MD1,2,3,9*

doi: 10.1097/OLQ.0000000000000808
Original Study: PDF Only

Background Despite the high HIV burden among men who have sex with men (MSM), there is little research on health services provided to MSM in China and other low- and middle-income countries. Discrimination and inadequate services may discourage MSM from seeking healthcare services. This study examined essential services provided to MSM and healthcare discrimination among MSM in China.

Methods A nationwide cross-sectional online survey was conducted among MSM who saw a physician in the last 24 months in China. The survey included items on sociodemographic information, HIV testing, experiences from the last physician encounter, and history of perceived healthcare discrimination. We defined MSM-competent physicians as physicians who asked their patient about having sex with other men, asked about anal sex, and either asked about or recommended HIV testing at the most recent visit.

Results Among the 503 participants, 35.0% (176/503) saw an MSM-competent physician. In multivariate analyses, respondents who saw an MSM-competent physician were more likely to be younger (AOR, 0.87; CI, 0.81-0.94), have a primary care physician (AOR, 3.24; CI, 1.85-5.67), and be living with HIV (AOR, 2.01; CI, 1.13-3.56). 61.2% (308/503) of MSM had ever experienced healthcare discrimination.

Conclusions Our data suggest that there is variability in the extent to which physicians are meeting the needs of MSM in China. There is an urgent need to evaluate and expand MSM-competent services in China.

1 University of North Carolina Project-China, Guangzhou, China

2 SESH (Social Entrepreneurship to Spur Health) Team, Guangzhou, China

3 School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA

4 Dermatology Hospital of Southern Medical University, Guangzhou, China

5 Xi’an Jiaotong-Liverpool University, Suzhou, China

6 Shenzhen Nanshan Center for Chronic Diseases Control, Shenzhen, China

7 College of Mass Communication, Shenzhen University, Shenzhen, China

8 Department of Sociology, University of California, San Diego, La Jolla, USA

9 Infectious and Tropical Diseases Faculty, London School of Hygiene and Tropical Medicine, London, UK

Correspondence to: Zhenzhou Luo, MS, Shenzhen Nanshan Center for Chronic Diseases Control, Shenzhen, China, Address: Nanshan Block Huaming Road 7, Shenzhen, 518052, China. Phone: +86-755-26521124. Email: 15289376@qq.com; Joseph D. Tucker, MS, PhD, University of North Carolina Project-China, Guangzhou, China, Address: No. 2 Lujing Road, Guangzhou, 510095, China. Phone: +86-20-83755802. Email: jdtucker@med.unc.edu

Source of Funding:

This work was supported by the National Institutes of Health [National Institute of Allergy and Infectious Diseases 1R01AI114310]; UNC-South China STD Research Training Centre [Fogarty International Centre 1D43TW009532]; UNC Center for AIDS Research [National Institute of Allergy and Infectious Diseases 5P30AI050410]; and the Bill & Melinda Gates Foundation to the MeSH Consortium (BMGF-OPP1120138).

The listed grant funders played no role in any step of this study. The authors declare no competing interests.

Short Summary

A study of MSM who saw a physician in the last two years in China found that only a small proportion of MSM saw an MSM-competent physician. MSM who saw an MSM-competent physician were more likely to be younger, have a primary care physician, and living with HIV than those who did not. A high proportion of Chinese MSM had ever experienced healthcare discrimination.

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