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      Patient–Provider Communication Barriers and Facilitators to HIV and STI Preventive Services for Adolescent MSM

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          Abstract

          Adolescent males who have sex with males (AMSM) are at increased risk of contracting HIV/AIDS and other sexually transmitted infections (STIs). Healthcare providers are a critical source of HIV/STI prevention, yet little is known about AMSM patient-provider sexual health communications and services. To explore this issue, we surveyed a national sample of 198 AMSM 14-17 years. Four online psychometrically validated scales indicated over half the youth avoided communicating their sexual orientation and sexual health concerns to providers due to fear of heterosexist bias, concern their sexual health information would be disclosed to parents, and a general belief that sexual minority youth do not receive equitable treatment in health care settings. Youth who reported their physicians had initiated discussion about their sexual orientation were significantly more likely to have received HIV/STI preventive services and testing. Discussion includes the importance of medical training that meets the unique sexual health needs of AMSM.

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          The role of stigma and medical mistrust in the routine health care engagement of black men who have sex with men.

          Objectives: We assessed how health care-related stigma, global medical mistrust, and personal trust in one's health care provider relate to engaging in medical care among Black men who have sex with men (MSM).
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            Development of the Perceived Risk of HIV Scale

            Past studies have used various methods to assess perceived risk of HIV infection; however, few have included multiple items covering different dimensions of risk perception or have examined the characteristics of individual items. This study describes the use of Item Response Theory (IRT) to develop a short measure of perceived risk of HIV infection scale (PRHS). An item pool was administered by trained interviewers to 771 participants. Participants also completed the risk behavior assessment (RBA) which includes items measuring risky sexual behaviors, and 652 participants completed HIV testing. The final measure consisted of 8 items, including items assessing likelihood estimates, intuitive judgments and salience of risk. Higher scores on the PRHS were positively associated with a greater number of sex partners, episodes of unprotected sex and having sex while high. Participants who tested positive for HIV reported higher perceived risk. The PRHS demonstrated good reliability and concurrent criterion-related validity. Compared to single item measures of risk perception, the PRHS is more robust by examining multiple dimensions of perceived risk. Possible uses of the measure and directions for future research are discussed.
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              Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors Among Students in Grades 9–12 — United States and Selected Sites, 2015

              Sexual identity and sex of sexual contacts can both be used to identify sexual minority youth. Significant health disparities exist between sexual minority and nonsexual minority youth. However, not enough is known about health-related behaviors that contribute to negative health outcomes among sexual minority youth and how the prevalence of these health-related behaviors compare with the prevalence of health-related behaviors among nonsexual minorities.
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                Author and article information

                Journal
                AIDS and Behavior
                AIDS Behav
                Springer Science and Business Media LLC
                1090-7165
                1573-3254
                October 2018
                March 15 2018
                October 2018
                : 22
                : 10
                : 3417-3428
                Article
                10.1007/s10461-018-2081-x
                6139078
                29546468
                34e787d6-84e0-48c5-be4d-4051b9a740eb
                © 2018

                http://www.springer.com/tdm

                http://www.springer.com/tdm

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