National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand
Objectives To assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity.Design Repeated cross-sectional.Setting Behavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand.Participants Eli...
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e039896.full |
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| author | Cate E Dewey Nathan J Lachowsky Peter J W Saxton Nigel Patrick Dickson Anthony J Hughes Alastair J S Summerlee |
| author_facet | Cate E Dewey Nathan J Lachowsky Peter J W Saxton Nigel Patrick Dickson Anthony J Hughes Alastair J S Summerlee |
| author_sort | Cate E Dewey |
| collection | DOAJ |
| description | Objectives To assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity.Design Repeated cross-sectional.Setting Behavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand.Participants Eligible participants were self-identified men aged 16 years or older who reported sex with another man in the past 5 years. We classified 10 525 participants’ ethnicities: Asian (n=1003, 9.8%), Māori (Indigenous people of Aotearoa New Zealand, n=1058, 10.3%), Pacific (n=424, 4.1%) and European (n=7867, 76.8%).Outcome measures The sexual health outcomes examined were >20 recent (past 6 months) male sexual partners, past-year sexually transmitted infection (STI) testing, past-year STI diagnosis, lifetime and past-year HIV testing, lifetime HIV-positive diagnosis and any recent (past 6 months) condomless anal intercourse with casual or regular partners.Results When disaggregated, Indigenous and ethnic minority groups reported sexual health trends that diverged from the European MSM and each other. For example, Asian MSM increased lifetime HIV testing (adjusted OR, AOR=1.31 per survey cycle, 95% CI 1.17 to 1.47) and recent HIV testing (AOR=1.14, 95% CI 1.02 to 1.28) with no changes among Māori MSM or Pacific MSM. Condomless anal intercourse with casual partners increased among Māori MSM (AOR=1.13, 95% CI 1.01 to 1.28) with no changes for Asian or Pacific MSM. Condomless anal intercourse with regular partners decreased among Pacific MSM (AOR=0.83, 95% CI 0.69 to 0.99) with no changes for Asian or Māori MSM.Conclusions Population-level trends were driven by European MSM, masking important differences for Indigenous and ethnic minority sub-groups. Surveillance data disaggregated by ethnicity highlight inequities in sexual health service access and prevention uptake. Future research should collect, analyse and report disaggregated data by ethnicity to advance health equity. |
| format | Article |
| id | doaj-art-2ffc935e8a4e417ab3fcfe7f63536e0b |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2ffc935e8a4e417ab3fcfe7f63536e0b2025-08-20T01:53:37ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-039896National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New ZealandCate E Dewey0Nathan J Lachowsky1Peter J W Saxton2Nigel Patrick Dickson3Anthony J Hughes4Alastair J S Summerlee5Population Medicine, University of Guelph, Guelph, Ontario, CanadaSchool of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, CanadaSocial and Community Health, The University of Auckland, Auckland, Auckland, New ZealandDepartment of Preventive and Social Medicine, University of Otago, Dunedin, New ZealandNew Zealand AIDS Foundation, Auckland, New ZealandBiomedical Science, University of Guelph, Guelph, Ontario, CanadaObjectives To assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity.Design Repeated cross-sectional.Setting Behavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand.Participants Eligible participants were self-identified men aged 16 years or older who reported sex with another man in the past 5 years. We classified 10 525 participants’ ethnicities: Asian (n=1003, 9.8%), Māori (Indigenous people of Aotearoa New Zealand, n=1058, 10.3%), Pacific (n=424, 4.1%) and European (n=7867, 76.8%).Outcome measures The sexual health outcomes examined were >20 recent (past 6 months) male sexual partners, past-year sexually transmitted infection (STI) testing, past-year STI diagnosis, lifetime and past-year HIV testing, lifetime HIV-positive diagnosis and any recent (past 6 months) condomless anal intercourse with casual or regular partners.Results When disaggregated, Indigenous and ethnic minority groups reported sexual health trends that diverged from the European MSM and each other. For example, Asian MSM increased lifetime HIV testing (adjusted OR, AOR=1.31 per survey cycle, 95% CI 1.17 to 1.47) and recent HIV testing (AOR=1.14, 95% CI 1.02 to 1.28) with no changes among Māori MSM or Pacific MSM. Condomless anal intercourse with casual partners increased among Māori MSM (AOR=1.13, 95% CI 1.01 to 1.28) with no changes for Asian or Pacific MSM. Condomless anal intercourse with regular partners decreased among Pacific MSM (AOR=0.83, 95% CI 0.69 to 0.99) with no changes for Asian or Māori MSM.Conclusions Population-level trends were driven by European MSM, masking important differences for Indigenous and ethnic minority sub-groups. Surveillance data disaggregated by ethnicity highlight inequities in sexual health service access and prevention uptake. Future research should collect, analyse and report disaggregated data by ethnicity to advance health equity.https://bmjopen.bmj.com/content/10/11/e039896.full |
| spellingShingle | Cate E Dewey Nathan J Lachowsky Peter J W Saxton Nigel Patrick Dickson Anthony J Hughes Alastair J S Summerlee National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand BMJ Open |
| title | National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand |
| title_full | National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand |
| title_fullStr | National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand |
| title_full_unstemmed | National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand |
| title_short | National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand |
| title_sort | national trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity repeated cross sectional behavioural surveillance in new zealand |
| url | https://bmjopen.bmj.com/content/10/11/e039896.full |
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