"Being dealt with as a whole person." Care seeking and adherence: the benefits of culturally competent care

The purpose of this study is to characterize the relationship between identity and health care experiences (including antiretroviral therapy utilization) among HIV-positive sexual minority males. This qualitative study used grounded theory with data collection occurring through focus groups and interviews. A questionnaire was used to complete a demographic profile. The study included 47 HIV positive participants from three minorities: gay men, bisexual men and transgendered persons, gender identifying as female and or living as women. Sessions elicited information on: (1) general experiences with health care, (2) experiences with HIV antiretroviral therapies and issues surrounding access, and (3) adherence to these therapies and identity in relation to health care. These textual data revealed three themes: (1) the importance of sexual identity and its social and cultural context, (2) the differences in the health concerns between the sexual minorities and (3) a wide spectrum of experiences with the health care system that provide information surrounding the access to and adequacy of health care. Successful health care providers are aware of different issues that may play a role in the provision of health care to these sexual minorities. Providers awareness of sexual and social identity and the related different cultural values, beliefs and custom enhance care seeking and therapeutic adherence. For sexual minorities, primary care remains the most important entry point into the health care system. Cultural competence of care providers can foster patient's care seeking and adherence to treamtment.HIV Sexual minority health Sexual identity Social identity

Incidence of and Risk Factors for Sexual Orientation–Related Physical Assault Among Young Men Who Have Sex With Men

Objectives. We sought to determine incidence of, prevalence of, and risk factors for sexual orientation–related physical assault in young men who have sex with men (MSM)

Association between Childhood Physical Abuse, Unprotected Receptive Anal Intercourse and HIV Infection among Young Men Who Have Sex with Men in Vancouver, Canada

Introduction The association between childhood sexual abuse and HIV risk among men who have sex with men (MSM) is well established. However, no studies have examined the potential impact of other forms of childhood maltreatment on HIV incidence in this population. Methods We explored the impact of child physical abuse (CPA) on HIV seroconversion in a cohort of gay/bisexual men aged 15 to 30 in Vancouver, Canada. Cox proportional hazard models were used, controlling for confounders. Results Among 287 participants, 211 (73.5%) reported experiencing CPA before the age of 17, and 42 (14.6%) reporting URAI in the past year. After a median of 6.6 years follow-up, 16 (5.8%) participants HIV-seroconverted. In multivariate analysis, CPA was significantly associated with HIV seroconversion (adjusted hazard ratio [AHR] = 4.89, 95% confidence interval (CI): 1.65–14.48), after controlling for potential confounders. Conclusion Our study uncovered a link between childhood physical violence and HIV incidence. Results highlight an urgent need for screening of young gay and bisexual men for histories of violence, and social and structural supports to prevent HIV transmission in this population

Bivariable and multivariable analysis of factors associated with time to HIV seroconversion among young HIV-negative gay and bisexual men in Vancouver, Canada (n = 287).

<p>Bivariable and multivariable analysis of factors associated with time to HIV seroconversion among young HIV-negative gay and bisexual men in Vancouver, Canada (n = 287).</p

Types of childhood physical abuse reported by young HIV-negative gay and bisexual men in Vancouver, Canada (n = 287).

<p>Types of childhood physical abuse reported by young HIV-negative gay and bisexual men in Vancouver, Canada (n = 287).</p

Bivariable analysis of factors associated with childhood physical abuse (CPA) among young HIV-negative gay and bisexual men in Vancouver, Canada (n = 287).

<p>Bivariable analysis of factors associated with childhood physical abuse (CPA) among young HIV-negative gay and bisexual men in Vancouver, Canada (n = 287).</p