7. Abortion Conflict as a Predictor of Lifetime Abortion and Multiple Abortions in the Context of Intimate Partner Violence and Reproductive Coercion

Abstract

analytic sample included 77 sexually experienced males to date. Patients reported on SRHC receipt by doctor assessed here with 4 composite scores summed across items within each domain: sexual history taking (practices, partner number and gender, protection, past STD andHIV test, sexual identity, plans for children); counseling (reducing STD/HIV risk, correct condom use); materials provided (condoms, lubrication); and screening tests (HIV, urine-based STD). Higher scores represent greater quality of service receipt. Patient characteristics assessed included: age; race/ethnicity; sexual attraction; visit reason (annual, STD, other); time since last visit (first visit, <2 years, 2 years); and doctor’s gender. Multivariate Poisson regression analyses examined associations between patient characteristics with each SRHC composite score accounting for clinics in cluster design. This study was IRB approved. Results: Mean (SD) participant age was 20.0 (2.5); 83% were non-Hispanic Black and 8% Hispanic (29% completed Spanish ACASI). Patients were diverse in reports of sexual attraction (77% to females, 16% males, 4% both, 4% not sure); visit reason (88% annual/STDrelated, 12% other); and time since last visit (36% first visit, 56% <2 years, 8% 2 years). 25% were seen by male doctor. Although some patients reported SRHC receipt (all sexual history questions asked (21%), topics counseled (43%), materials provided (31%), tests performed (48%), respectively),many reported suboptimal SRHC receipt (no sexual history questions asked (9%), topics counseled (21%), materials provided (43%), tests performed (21%), respectively), and only 7% received all SRHC. After controlling for patient characteristics, higher sexual history taking receipt was associated with patients being non-Hispanic Black and white (vs. Hispanic) (aRR [95% CI]1⁄41.60 [1.17-2.19] & 1.70 [1.20-2.41], respectively); attracted to both sexes (vs. females only) (1.24 [1.06-1.44]); and seen for annual/ STD visit (vs. other) (2.04 [1.40-2.95]). Counseling receipt was associated with patients being attracted to females only and males only (vs. both sexes) (1.98 [1.26-3.11] & 2.41 [1.36-4.28], respectively); and 2 years since last visit (vs. <2 years) (1.36 [1.08-1.70]). Material receipt was associated with patients being seen by male doctor (vs. female) (1.66 [1.32-2.08]). STD/HIV screening receipt was associated with patients being attracted to females only and males only (vs. both sexes) (2.18 [1.71-2.76] & 2.84 [2.02-3.99], respectively); and seen for annual/STD visit (vs. other) (2.36 [1.21-4.61]). Conclusions: Study findings confirm suboptimal delivery of SRHC to all males and highlights disparities of SRHC delivery among male sub-populations (Hispanics & males attracted to both sexes). Future workneeds to improveproviders’deliveryofqualitySRHCtoallmales. Sources of Support: CDC1H25PS003796 (Secretary’s Minority AIDS Initiative Fund).