Preferences for models of sexual health service delivery among gay, bisexual and other men who have sex with men in Australia: a discrete choice experiment

IF 4.9 1区医学 Q2 IMMUNOLOGY

Journal of the International AIDS Society Pub Date : 2025-07-07 DOI:10.1002/jia2.26482

Jason J. Ong, Doug Fraser, Christopher Bourne, Andrew Grulich, Benjamin R. Bavinton

{"title":"Preferences for models of sexual health service delivery among gay, bisexual and other men who have sex with men in Australia: a discrete choice experiment","authors":"Jason J. Ong, Doug Fraser, Christopher Bourne, Andrew Grulich, Benjamin R. Bavinton","doi":"10.1002/jia2.26482","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Gay, bisexual and other men who have sex with men are disproportionately affected by HIV and other sexually transmitted infections (STIs). This study explores preferences for different models of sexual health services among gay, bisexual and other men who have sex with men in Australia, using discrete choice experiments (DCEs).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A cross-sectional online survey was conducted from November 2022 to February 2023, targeting three groups: (1) gay, bisexual and other men who have sex with men living with HIV; (2) pre-exposure prophylaxis (PrEP) users; and (3) non-PrEP users. Participants were recruited through paid advertisements, sexual health clinics and community networks. The survey included demographic questions, sexual behaviour inquiries and three tailored DCEs to quantify preferences for service delivery attributes such as cost, type of clinic, appointment type, appointment frequency, extra services and where samples are taken for HIV/STI testing. We used latent class analyses to identify subgroups of people with similar preferences.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>We recruited 1422 participants. The median age was 41 (interquartile range [IQR]: 32–54) for gay, bisexual and other men who have sex with men living with HIV (<i>N</i> = 396), 35 (IQR: 29–45) for PrEP users (<i>N</i> = 436) and 33 (IQR: 26–44) for non-PrEP users (<i>N</i> = 590). In our latent class analyses, gay, bisexual and other men who have sex with men living with HIV preferred sexual health services to be delivered via sexual health clinics (46.2%), general practitioners (GP) with expertise in lesbian, gay, bisexual, trans, queer and others (LGBTQ+) health (33.0%) or were happy to go anywhere and to pay (20.7%). PrEP users preferred either PrEP-only clinics or GP with expertise in LGBTQ+ health (75.2%) and GP with expertise in LGBTQ+ health only (24.8%). Non-PrEP users preferred GP with expertise in LGBTQ+ health (44.7%) or any free service (22.8%); some did not want to test (22.2%) or were unsure of their preferences (10.2%).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>To align service models with client needs, investment in specialist sexual health clinics and LGBTQ+ competent GPs is important, though this may depend on local resources and infrastructure. Future research should focus on addressing financial barriers, evaluating telehealth and digital health interventions, and understanding testing reluctance among non-PrEP users.</p>\n </section>\n </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"28 S3","pages":""},"PeriodicalIF":4.9000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jia2.26482","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the International AIDS Society","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jia2.26482","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Gay, bisexual and other men who have sex with men are disproportionately affected by HIV and other sexually transmitted infections (STIs). This study explores preferences for different models of sexual health services among gay, bisexual and other men who have sex with men in Australia, using discrete choice experiments (DCEs).

Methods

A cross-sectional online survey was conducted from November 2022 to February 2023, targeting three groups: (1) gay, bisexual and other men who have sex with men living with HIV; (2) pre-exposure prophylaxis (PrEP) users; and (3) non-PrEP users. Participants were recruited through paid advertisements, sexual health clinics and community networks. The survey included demographic questions, sexual behaviour inquiries and three tailored DCEs to quantify preferences for service delivery attributes such as cost, type of clinic, appointment type, appointment frequency, extra services and where samples are taken for HIV/STI testing. We used latent class analyses to identify subgroups of people with similar preferences.

Results

We recruited 1422 participants. The median age was 41 (interquartile range [IQR]: 32–54) for gay, bisexual and other men who have sex with men living with HIV (N = 396), 35 (IQR: 29–45) for PrEP users (N = 436) and 33 (IQR: 26–44) for non-PrEP users (N = 590). In our latent class analyses, gay, bisexual and other men who have sex with men living with HIV preferred sexual health services to be delivered via sexual health clinics (46.2%), general practitioners (GP) with expertise in lesbian, gay, bisexual, trans, queer and others (LGBTQ+) health (33.0%) or were happy to go anywhere and to pay (20.7%). PrEP users preferred either PrEP-only clinics or GP with expertise in LGBTQ+ health (75.2%) and GP with expertise in LGBTQ+ health only (24.8%). Non-PrEP users preferred GP with expertise in LGBTQ+ health (44.7%) or any free service (22.8%); some did not want to test (22.2%) or were unsure of their preferences (10.2%).

Conclusions

To align service models with client needs, investment in specialist sexual health clinics and LGBTQ+ competent GPs is important, though this may depend on local resources and infrastructure. Future research should focus on addressing financial barriers, evaluating telehealth and digital health interventions, and understanding testing reluctance among non-PrEP users.

Abstract Image

查看原文本刊更多论文

澳大利亚同性恋、双性恋和其他男男性行为者对性健康服务提供模式的偏好：一项离散选择实验

男同性恋、双性恋和其他男男性行为者受到艾滋病毒和其他性传播感染（STIs）的影响不成比例。本研究利用离散选择实验（DCEs）探讨了澳大利亚同性恋、双性恋和其他男男性行为者对不同模式的性健康服务的偏好。方法于2022年11月至2023年2月进行横断面在线调查，针对三种人群：(1)男同性恋、双性恋和其他与艾滋病毒感染者发生性关系的男性；(2)暴露前预防（PrEP）使用者；(3)非prep使用者。参与者是通过付费广告、性健康诊所和社区网络招募的。该调查包括人口统计问题、性行为问题和三个定制的DCEs，以量化对服务提供属性的偏好，如成本、诊所类型、预约类型、预约频率、额外服务以及在何处采集样本进行艾滋病毒/性传播感染检测。我们使用潜在类别分析来识别具有相似偏好的人的亚组。结果我们招募了1422名参与者。男同性恋、双性恋和其他与艾滋病毒携带者发生性关系的男性（N = 396）的中位年龄为41岁（四分位数间距[IQR]: 32-54）， PrEP使用者（N = 436）的中位年龄为35岁（IQR: 29-45），非PrEP使用者（N = 590）的中位年龄为33岁（IQR: 26-44）。在我们的潜在阶层分析中，男同性恋、双性恋和其他与感染艾滋病毒的男性发生性关系的男性更倾向于通过性健康诊所提供性健康服务（46.2%），在女同性恋、男同性恋、双性恋、变性人、酷儿和其他（LGBTQ+）健康方面具有专业知识的全科医生（GP）（33.0%），或者愿意去任何地方并支付费用（20.7%）。PrEP使用者更倾向于仅提供PrEP的诊所或具有LGBTQ+健康专业知识的全科医生（75.2%）和仅具有LGBTQ+健康专业知识的全科医生（24.8%）。非prep用户更喜欢有LGBTQ+健康专业知识的全科医生（44.7%）或任何免费服务（22.8%）；有些人不想测试（22.2%）或不确定他们的偏好（10.2%）。结论：为了使服务模式与客户需求保持一致，投资专门的性健康诊所和LGBTQ+合格的全科医生是很重要的，尽管这可能取决于当地的资源和基础设施。未来的研究应侧重于解决财务障碍，评估远程医疗和数字卫生干预措施，以及了解非prep用户不愿进行检测的情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of the International AIDS Society IMMUNOLOGY-INFECTIOUS DISEASES

CiteScore

8.60

自引率

10.00%

发文量

186

审稿时长

>12 weeks

期刊介绍： The Journal of the International AIDS Society (JIAS) is a peer-reviewed and Open Access journal for the generation and dissemination of evidence from a wide range of disciplines: basic and biomedical sciences; behavioural sciences; epidemiology; clinical sciences; health economics and health policy; operations research and implementation sciences; and social sciences and humanities. Submission of HIV research carried out in low- and middle-income countries is strongly encouraged.