AIDS and Behavior

, Volume 22, Issue 10, pp 3417–3428 | Cite as

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

  • Celia B. Fisher
  • Adam L. Fried
  • Kathryn Macapagal
  • Brian Mustanski
Original Paper


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.


Adolescent HIV Sexually transmitted infections Healthcare Men who have sex with men MSM Prevention Stigma Mistrust Discrimination Physician Patient–provider communication 



The authors thank Margaret Desmond and Leah Puri for assistance on data analysis and manuscript preparation. They also thank the participants who generously gave their time and from whom the authors learned so much.


The research reported and preparation of this article were supported on a Grant from the National Institute on Minority Health and Health Disparities at the National Institutes of Health under Award Number 1 R01 MD009561 (PIs Celia B. Fisher and Brian Mustanski).

Compliance with Ethical Standards

Conflicts of interest

The authors do not have any conflicts of interest.

Ethical Approval

This human subjects research received Institutional Review Board approval from Fordham University and Northwestern University. Informed consent was obtained from all participants. All procedures performed in this research are in accordance with U.S. regulations and the 1964 Helsinki declaration and later amendments.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Celia B. Fisher
    • 1
  • Adam L. Fried
    • 2
  • Kathryn Macapagal
    • 3
  • Brian Mustanski
    • 3
  1. 1.Center for Ethics Education and Department of PsychologyFordham UniversityBronxUSA
  2. 2.Clinical Psychology ProgramMidwestern UniversityGlendaleUSA
  3. 3.Department of Medical Social SciencesNorthwestern University Feinberg School of MedicineChicagoUSA

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