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Sexual Healthcare Preferences among Gay and Bisexual Men: A Qualitative Study in San Francisco, California

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  • Kimberly A Koester
  • Shane P Collins
  • Shannon M Fuller
  • Gabriel R Galindo
  • Steven Gibson
  • Wayne T Steward

Abstract

Background: Research on gay and other men who have sex with men's (G/MSM) preferences for sexual healthcare services focuses largely on HIV testing and to some extent on sexually transmitted infections (STI). This research illustrates the frequency and location of where G/MSM interface with the healthcare system, but it does not speak to why men seek care in those locations. As HIV and STI prevention strategies evolve, evidence about G/MSM's motivations and decision-making can inform future plans to optimize models of HIV/STI prevention and primary care. Methods: We conducted a phenomenological study of gay men's sexual health seeking experiences, which included 32 in-depth interviews with gay and bisexual men. Interviews were transcribed verbatim and entered into Atlas.ti. We conducted a Framework Analysis. Findings: We identified a continuum of sexual healthcare seeking practices and their associated drivers. Men differed in their preferences for separating sexual healthcare from other forms of healthcare (“fragmentation”) versus combining all care into one location (“consolidation”). Fragmentation drivers included: fear of being monitored by insurance companies, a desire to seek non-judgmental providers with expertise in sexual health, a desire for rapid HIV testing, perceiving sexual health services as more convenient than primary care services, and a lack of healthcare coverage. Consolidation drivers included: a comfortable and trusting relationship with a provider, a desire for one provider to oversee overall health and those with access to public or private health insurance. Conclusions: Men in this study were likely to separate sexual healthcare from primary care. Based on this finding, we recommend placing new combination HIV/STI prevention interventions within sexual health clinics. Furthermore, given the evolution of the financing and delivery of healthcare services and in HIV prevention, policymakers and clinicians should consider including more primary care services within sexual healthcare settings.

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  • Kimberly A Koester & Shane P Collins & Shannon M Fuller & Gabriel R Galindo & Steven Gibson & Wayne T Steward, 2013. "Sexual Healthcare Preferences among Gay and Bisexual Men: A Qualitative Study in San Francisco, California," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-11, August.
    • Handle: RePEc:plo:pone00:0071546
    DOI: 10.1371/journal.pone.0071546
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    References listed on IDEAS

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    Cited by:

    1. Martos, Alexander J. & Wilson, Patrick A. & Gordon, Allegra R. & Lightfoot, Marguerita & Meyer, Ilan H., 2018. "“Like finding a unicorn”: Healthcare preferences among lesbian, gay, and bisexual people in the United States," Social Science & Medicine, Elsevier, vol. 208(C), pages 126-133.
    2. Kristen Underhill & Kathleen M Morrow & Christopher M Colleran & Richard Holcomb & Don Operario & Sarah K Calabrese & Omar Galárraga & Kenneth H Mayer, 2014. "Access to Healthcare, HIV/STI Testing, and Preferred Pre-Exposure Prophylaxis Providers among Men Who Have Sex with Men and Men Who Engage in Street-Based Sex Work in the US," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-13, November.

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