HIV prevention services received at health care and HIV test providers by young men who have sex with men: an examination of racial disparities

Abstract

We investigated whether there were racial/ethnic differences among young men who have sex with men (MSM) in their use of, perceived importance of, receipt of, and satisfaction with HIV prevention services received at health care providers (HCP) and HIV test providers (HTP) that explain racial disparities in HIV prevalence. Young men, aged 23 to 29 years, were interviewed and tested for HIV at randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to five U.S. cities that enrolled 50 or more black or Hispanic MSM. Among the 2,424 MSM enrolled, 1,522 (63%) reported using a HCP, and 1,268 (52%) reported having had an HIV test in the year prior to our interview. No racial/ethnic differences were found in using a HCP or testing for HIV. Compared with white MSM, black and Hispanic MSM were more likely to believe that HIV prevention services are important [respectively, AOR, 95% confidence interval (CI): 3.0, 1.97 to 4.51 and AOR, 95% CI: 2.7, 1.89 to 3.79], and were more likely to receive prevention services at their HCP (AOR, 95% CI: 2.5, 1.72 to 3.71 and AOR, 95% CI: 1.7, 1.18 to 2.41) and as likely to receive counseling services at their HTP. Blacks were more likely to be satisfied with the prevention services received at their HCP (AOR, 95% CI: 1.7, 1.14 to 2.65). Compared to white MSM, black and Hispanic MSM had equal or greater use of, perceived importance of, receipt of, and satisfaction with HIV prevention services. Differential experience with HIV prevention services does not explain the higher HIV prevalence among black and Hispanic MSM.