Factors Influencing Access to Sexual Health Care Among Behaviorally Bisexual Men in Vientiane, Laos: A Qualitative Exploration

Anna L Bowring; Nakhornphet Pasomsouk; Peter Higgs; Vanphanom Sychareun; Margaret Hellard; Robert Power

doi:10.1177/1010539515612909

Factors Influencing Access to Sexual Health Care Among Behaviorally Bisexual Men in Vientiane, Laos: A Qualitative Exploration

Asia Pac J Public Health. 2015 Nov;27(8):820-34. doi: 10.1177/1010539515612909.

Authors

Anna L Bowring¹, Nakhornphet Pasomsouk², Peter Higgs³, Vanphanom Sychareun⁴, Margaret Hellard⁵, Robert Power⁶

Affiliations

¹ Burnet Institute, Melbourne, Victoria, Australia School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia annab@burnet.edu.au.
² Burnet Institute, Vientiane, Lao PDR.
³ Burnet Institute, Melbourne, Victoria, Australia Faculty of Health Sciences, National Drug Research Institute, Curtin University, Fitzroy, Melbourne, Victoria, Australia.
⁴ Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Lao PDR.
⁵ Burnet Institute, Melbourne, Victoria, Australia School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁶ Burnet Institute, Melbourne, Victoria, Australia School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

PMID: 26543164
DOI: 10.1177/1010539515612909

Abstract

In Laos, men who have sex with men (MSM) are disproportionately affected by HIV, and bisexual behavior among men is common. We conducted a qualitative study to explore access and influences on sexual health care seeking among bisexual men in Vientiane. In 2013, behaviorally bisexual men were recruited from bars, clubs and dormitories for 5 focus group discussions and 11 in-depth interviews. Participants (aged 18-35 years) commonly reported high-risk sexual behaviors, yet most had never been tested for HIV, and none reported testing for sexually transmitted infections. Common barriers to testing were low perception of risk, expectation of symptoms, fear of HIV, shyness, perceived stigma, confidentiality concerns, and waiting times. Many men were unaware of available services. Most clinics cannot provide comprehensive HIV and sexually transmitted infection services. Strategies are needed to generate demand for testing, improve the capacity of sexual health care providers, and promote available services among behaviorally bisexual men in Vientiane.

Keywords: HIV testing; Laos; bisexuality; health care utilization; men who have sex with men; sexually transmitted infection testing.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Bisexuality / psychology*
Bisexuality / statistics & numerical data
Focus Groups
HIV Infections / diagnosis
Health Knowledge, Attitudes, Practice
Health Services Accessibility*
Humans
Laos
Male
Mass Screening / statistics & numerical data
Patient Acceptance of Health Care / psychology*
Patient Acceptance of Health Care / statistics & numerical data
Qualitative Research
Reproductive Health*
Risk-Taking
Sexual Behavior / psychology
Sexually Transmitted Diseases / diagnosis
Young Adult