Sexually Transmitted Infections Among Young Men Who Have Sex with Men: Experiences with Diagnosis, Treatment, and Reinfection

Abstract

Despite high rates of sexually transmitted infections (STIs) among young men who have sex with men (YMSM), little is known about their experiences with diagnosis, treatment, and reinfection. To fill this gap, we interviewed 17 YMSM ages 18-29 who participated in an online HIV prevention trial and tested positive for STIs at both the baseline and three-month follow-up assessments. Participants were asked about their reactions to testing positive, experiences with treatment, disclosure to partners, and changes in thinking and behavior. Reactions were diverse, the most common being surprise and concern. Most participants sought treatment, although type of provider varied (e.g., primary care physician, clinic that specialized in gay/bisexual men's health). Providers tended to re-test participants, but some did so at the incorrect anatomical site. Participants who felt comfortable talking to providers about STIs tended to use their regular provider or one who specialized in gay/bisexual men's health. Most participants described changes in their thinking and behavior (e.g., increased condom use, decreased sex partners, questioning their partners' trust). Most participants disclosed to at least one partner, but some did not remember or were not in contact with partners. Experiences were similar the first and second time participants tested positive for STIs during the study with a few exceptions (e.g., more self-blame and comfort talking to providers the second time). In sum, YMSM have diverse experiences with STI diagnosis and treatment. Implications for public policy and STI prevention are discussed.

HIV and STI Testing Preferences for Men Who Have Sex with Men in High-Income Countries: A Scoping Review

“…Despite the appeal of the convenience of self-testing, we found three studies that identified issues with self-testing [ 28 , 29 , 30 ]. One study, conducted in the US, used a series of focus-group discussions with 21 young MSM of colour (aged 18–35 years) to explore the acceptability, preferences and usability of HIV self-test kits [ 29 ].…”

“…Six studies suggested a previous negative experience of the testing process to be an important barrier to HIV/STI testing [ 28 , 31 , 32 , 33 , 34 , 35 ]. Common themes which emerged included feeling embarrassed during previous testing experiences and discomfort about discussing their sexual history.…”

“…One study conducted focus groups with 36 young African American MSM in Alabama, US, found overall negative opinions about self-testing at home due to concerns about accuracy and preferred to be tested by trusted physicians [ 28 ].…”

“…However, if the cost of the fingerpick self-test cost half the price, and tested for other STIs, the preference for the fingerpick self-test increased [ 27 ]. Three studies discussed that the perceived greater accuracy of testing a blood sample compared to other samples was an important consideration in their preferences [ 20 , 28 , 34 ]. One study addressed the importance of wanting control over specimen collection, i.e., collecting their own specimen [ 50 ].…”

“…A study that conducted focus groups with 36 young African American MSM in Alabama, US, found that privacy and confidentiality were important when seeking STI testing [ 28 ]. Participants highlighted that a private doctor’s office was ideal for these reasons, as there was no assumption of being there for STI testing, and medical professionals were obligated to maintain confidentiality.…”