Utilization Of Sexual Health Services Research Articles

Understanding Barriers to Sexual Health Service Utilization among Young People in Dang, Nepal: A Qualitative Exploration

This qualitative study explores the barriers to the utilization of sexual health services among young people in District Dang, Nepal. Despite the availability of sexual health resources, many youths face significant obstacles in accessing these services, which impacts their overall sexual health and well-being. Through in-depth interviews and focus group discussions with adolescents and young adults, as well as healthcare providers and community leaders, this research identifies key factors that hinder service utilization. The study reveals a range of barriers, including stigma and social taboos surrounding sexual health, lack of awareness and education, inadequate healthcare infrastructure, and cultural and gender norms that restrict open discussion and access. Additionally, the findings highlight the role of family and peer influences in shaping attitudes towards sexual health services. The insights gained from this study underscore the need for targeted interventions to address these barriers, enhance sexual health education, and improve service delivery mechanisms. By addressing the root causes of non-utilization, stakeholders can better support young people in accessing vital sexual health services, ultimately promoting healthier outcomes and empowering youth in District Dang.

Utilization of sexual and reproductive health services and its correlates among community- based older adults in Chongqing

Objective: To investigate the utilization of sexual health services among community-based older adults in Chongqing and explore its potential correlates. Methods: A cross-sectional survey using multistage sampling among community-based older adults aged ≥50 years was conducted in Chongqing between June 2020 and December 2022. A questionnaire including information on demographic characteristics, general health, sexual health status, and sexual health services utilization was collected. Sexual health and reproductive services utilization was defined as having ever been tested for human immunodeficiency virus (HIV), or having had a male/gynecological reproductive health examination in the past year. Logistic regression was used to examine the correlates of the utilization of sexual health services. Results: A total of 794 community-based older adults participated in the study (482 were male, and 312 were female). The mean age was (62.8±8.2) years. The proportion of HIV testing was 18.0%, and the proportion of reproductive health examination was 10.1% among community-based older adults. The results of multivariate logistic regression analysis showed that the age group of 60-69 years (aOR=0.37, 95%CI: 0.18-0.76), female (aOR=11.34, 95%CI: 5.71-22.52), monthly income ≥5 000 yuan (aOR=3.05, 95%CI: 1.01-9.27), being sexual activity (aOR=4.99, 95%CI: 2.23-11.15) was significantly associated with had a reproductive health examination in the past year. Conclusions: The proportion of sexual health services utilization among older adults was low. Older sexual health education should be further strengthened, the close relationship between older adults should be correctly guided and dealt with, and the sexual health services suitable for the older population should be formulated.

Factors associated with bacterial sexually transmitted infections among people of South Asian ethnicity in England

ObjectivesDespite being the largest ethnic minority group in England, South Asians have historically had low levels of utilisation of sexual health services (SHS) and sexually transmitted infection (STI) diagnoses, although...

Embedding a Dedicated Sexual Health Clinic in a University's Health Services Expands Sexually Transmitted Infection Screening Options.

The primary objectives of this study were to assess utilization of sexual health services at a university's student health and wellness center and to determine whether the presence of a dedicated sexual health clinic (SHC) was associated with different utilization patterns for sexual health services when compared with primary care clinics. This was a retrospective chart review of patients presenting to the University of Alabama at Birmingham's Student Health and Wellness Center for sexual health services between January 2015 and June 2019. Utilization of sexual health services, specifically sexually transmitted infection (STI) testing, was compared between the dedicated SHC and primary care clinics. A total of 3081 cases were included. There were statistically significant differences in the proportion of male individuals and populations more burdened by STI tested for STI in the SHC (i.e., persons who identify as Black and younger female individual). We also observed a higher percentage of positive gonorrhea and chlamydia test results and a greater likelihood of extragenital screening in men who have sex with men in the SHC. The dedicated SHC within the University of Alabama at Birmingham's Student Health and Wellness Center was associated with an increase in STI screenings. There was a significant difference between the demographics of those presenting to the SHC versus primary care clinics, proportionally more diagnoses of gonorrhea and chlamydia, and, for men who have sex with men, more extragenital screenings performed in the SHC. These findings suggest that there may be a benefit of an embedded SHC in college and university health and wellness centers.

Changes in HIV Testing Utilization Among Chinese Men Who Have Sex With Men During the COVID-19 Pandemic in Shenzhen, China: An Observational Prospective Cohort Study.

BackgroundThe Coronavirus Diseases 2019 (COVID-19) directly affects HIV prevention and sexual health services utilization among men who have sex with men (MSM). This study investigated changes in human immunodeficiency virus (HIV) testing utilization among MSM before and after the COVID-19 pandemic received initial control in Shenzhen, China.MethodsThis study was a sub-analysis of a prospective observational cohort study conducted among MSM in Shenzhen, China between August 2020 and May 2021. Participants were recruited through outreaching in gay venues, online recruitment, and peer referral. Participants completed a baseline online survey between August and September 2020 and a follow-up online survey between April and May 2021. This study was based on 412 MSM who reported to be HIV-negative/unknown sero-status at baseline, 297 (72.1%) of them completed the follow-up online survey. Multilevel logistic regression models (level 1: sources of recruitment; level 2: individual participants) were fitted.ResultsWhen comparing follow-up data with baseline data, a significant increase was observed in the uptake of any type of HIV testing (77.9% at Month 6 vs. 59.2% at baseline, p < 0.001). After adjusting for age group, education level, current employment status and monthly personal income, two predisposing factors were associated with higher uptake of HIV testing during the follow-up period. They were: (1) condomless anal intercourse with male non-regular male sex partners at follow-up only (AOR: 5.29, 95%CI: 1.27, 22.01) and (2) sanitizing before and after sex at baseline (AOR: 1.26, 95%CI: 1.02, 1.47). Regarding enabling factors, utilization of HIV testing (AOR: 3.90, 95%CI: 2.27, 6.69) and STI testing (AOR: 2.43, 95%CI: 1.20, 4.93) 6 months prior to the baseline survey was associated with higher uptake of HIV testing during the follow-up period. Having the experience that HIV testing service providers reduced service hours during the follow-up period was also positively associated with the dependent variable (AOR: 3.45, 95%CI: 1.26, 9.41).ConclusionsHIV testing utilization among MSM might rebound to the level before the COVID-19 outbreak after the pandemic received initial control in China. This study offered a comprehensive overview to identify potential reasons that can influence the uptake of HIV testing among Chinese MSM.

Associations in preventive sexual health service utilization and pre-exposure prophylaxis (PrEP) interest among young Black women in the United States, 2018

ABSTRACT Despite declines in HIV prevalence among all U.S. women, HIV remains a serious concern for Black women. PrEP is an effective biomedical intervention and has high acceptability among Black women. Therefore, offering PrEP, in addition to screening and testing for STI/HIV consistently, can reduce HIV risk among this population. We examine the associations of preventive sexual health service utilization (PSHSU) and PrEP interest among young Black women (YBW) (N = 209) in the United States in 2018. YBW, ages 18–25, completed a self-administered questionnaire, assessing sexual risk and prevention behaviors, HIV/STI testing, and PrEP interest. More than half of YBW were aware of PrEP and its benefits. YBW, who received an HIV test within the past three to six months, had higher odds of PrEP interest. The proportion of YBW who reported being interested in PrEP did not differ by PSHSU. Active contraceptive use was associated with PrEP interest. The results suggest YBW engage in preventive sexual health services, including HIV/STI testing, reproductive health, and sexual health behavioral counseling. Additional efforts should be made to normalize PrEP education for heterosexual, cisgender women at student health centers on college and university campuses, and other venues outside of traditional HIV/STI testing facilities.

Disparities in Sexually Transmitted Infection Testing and the Need to Strengthen Comprehensive Sexual Health Services for Trans Women.

Few studies have examined the importance of improving the sexual health delivery system beyond HIV among trans women. We assessed survey data from the National HIV Behavioral Surveillance Transgender Woman (NHBS-Trans) Study in San Francisco to characterize the utilization of sexual health services among HIV-negative trans women and to explore opportunities to improve sexual health services for trans women. Trans women were recruited through respondent-driven sampling from July 2019 to February 2020. The analytic sample was restricted to 116 HIV-negative trans women. We identified trends in data using chi-squared tests to assess significance between sexual risk behavior and the use of preventative sexual health services and built logistic regression models to assess the relationships between sexual risk behaviors and sexually transmitted infection (STI) testing. The majority of sample was trans women of color with most identifying as Latinx (42.2%). Over half were low income (56%), and majority had been homeless in past 12 months (62.9%). The prevalence of condomless receptive anal sex was 52.6% with about two-thirds (62.1%) recently having an STI test. Participants who engaged in recent condomless receptive anal sex had more than fivefold greater odds of having a recent STI test compared to their counterparts who did not (adjusted odds ratio [aOR] 5.60, 95% confidence interval [CI] 1.83-17.11; p=0.003). We also found age- and education-related disparities in STI testing. This study characterized the utilization of sexual health services among HIV-negative trans women and identified important disparities in STI testing. We discuss opportunities to strengthen sexual health care delivery systems.

Bisexual People’s Utilization of Sexual Health Services at an LGBTQ Community Center in Chicago

Bisexual people are at increased risk for sexually transmitted infections (STIs), including HIV. In STI data collection, bisexual people are often miscategorized as or conflated with heterosexual or gay/lesbian people. Such poor data capture practices invisibilize bisexual people and prevent the tailoring of HIV and STI services to cater to bisexual populations. The Center on Halsted (COH) is an LGBTQ community center in Chicago. COH’s HIV & STD Services Department provides HIV testing to people who present for HIV screening services age 12 and older. COH also administers the State of Illinois AIDS, HIV, & STD Hotline. This manuscript reports HIV-related service access patterns of COH clients by sexual identity, with an emphasis on reporting patterns among bisexual and other non-monosexual (e.g., “bi+”) populations in comparison with other sexual minority populations. Among COH’s HIV testing clients who were sexual minorities in fiscal years 2018 and 2019, 15.42% in 2018 and 16.71% in 2019 identified as bisexual, respectively. Among sexual minority hotline callers, approximately one quarter (25.1% in 2018 and 28.8% in 2019) identified as bisexual. Given that bisexual individuals comprise over half of sexual minority populations, these findings indicate that bi + individuals may be under-represented in accessing HIV and STI services at COH. These results provide previously unknown insight into the sexual identities of populations accessing HIV- and STD-related services within a LGBTQ community setting. Funders of HIV and STI surveillance services should change reporting requirements to make visible the HIV services access patterns and outcomes of bisexual populations.

Understanding Access to and Utilisation of Sexual Health Services by South Asian Immigrant Men in Western Countries: A Scoping Review.

South Asian communities comprise one of the fastest growing populations in Western countries. However, the sexual health of immigrant men in particular remains vastly understudied and little is known about how and if men access these services. Four multi-disciplinary electronic databases were searched to between 1998 and 2018. The search yielded 586 articles; 407 duplicate articles were removed, and 376 did not meet the inclusion criteria. A total of 10 articles were included in this review. Herein we report the factors shaping sexual health service access and use, namely: (1) cultural and psychological factors; (2) sexual health service accessibility; (3) personal beliefs and patterns in service use; (4) social perspectives and conflicting values on sexual health. We identify the gaps in research needed for policymakers, formal healthcare providers, and South Asian community stakeholders to develop effective and inclusive sexual health programs for South Asian men in Western countries.

Healthcare Professionals’ Perspectives on The Provision of Sexual and Reproductive Health to Young People in Malaysia

Objective: In Malaysia, sexual health issues among young people encompassing premarital sex, the incidence of STI including HIV/AIDS, unintended pregnancy, unsafe abortion and the practice of baby abandonment. Little is known about the provision of sexual health care for young people since it has not been examined in-depth in a Malaysian context. This study aimed to explore the perspectives of healthcare professionals who deliver sexual health services provision to young people within primary healthcare settings which included schools as part of an outreach programme. Methods: This qualitative study used a self-developed topic guide for in-depth interview with twenty-four healthcare professionals of several government health clinics in Malaysia. The aim was to understand healthcare professionals’ experiences of dealing with young people and their views on current sexual health services provision. The interview data were entered into Nvivo and analysed using thematic analysis. Results: The findings show that healthcare professionals regarded the use of the Adolescent Health Screening Form as a cornerstone for all initial interactions between and young people in health clinics. The findings also highlight the problem with an appointment system that includes lack of consultation times, privacy issues and the requirement of parental consent when dealing with unmarried young people. Conclusion: This study had recognized several facility-based obstacles that restricted sexual health services to young people in Malaysia. Their access to and the utilization of sexual health services are dependent on health care system improvement.

Anticipated HIV stigma among HIV negative men who have sex with men in China: a cross-sectional study

BackgroundAnticipated HIV stigma, i.e., the expectation of adverse experiences from one’s seroconversion, is associated with both negative psychological and behavioral outcomes. We know little about anticipated HIV stigma’s relationship with emerging technologies, such as HIV self-testing (HIVST) and online sex-seeking platforms, that have become popular among populations that are disproportionately affected by HIV/AIDS. This study examined correlates of anticipated HIV stigma among Chinese men who have sex with men (MSM).MethodsIn July 2016, MSM, who were ≥ 16 years old and self-reported as HIV negative or unknown, were recruited from a gay mobile phone application in China. Information regarding socio-demographics, sexual behaviors, sexual health service utilization, and anticipated HIV stigma were collected. Anticipated HIV stigma (i.e., negative attitude toward future stigmatization of HIV seroconversion by others) was measured as the mean score from a 7-item Likert-scale ranging from 1 (low) to 4 (high). Generalized linear models were conducted to examine the factors associated with the anticipated HIV stigma scores.ResultsOverall, 2006 men completed the survey. Most men completed high school (1308/2006, 65.2%) and had an annual personal income of ≤9200 USD (1431/2006, 71.3%). The mean anticipated HIV stigma score for the participants was 2.98 ± 0.64. Using social media to seek sexual partners was associated with higher anticipated HIV stigma (Adjusted β = 0.11, 95% confidence interval (CI): 0.05 to 0.17, p = 0.001). HIV self-testing (Adjusted β = − 0.07, 95%CI: − 0.13 to − 0.01, p = 0.02) and having disclosed one’s sexual orientation to a healthcare provider (Adjusted β = − 0.16, 95%CI: − 0.22 to − 0.96, p < 0.001) were associated with lower anticipated HIV stigma.ConclusionOur data suggested that anticipated HIV stigma is still common among Chinese MSM not living with HIV. Tailored anti-HIV stigma campaigns on social media are especially needed, and the promotion of HIVST may be a promising approach.

Meeting the Sexual Health Needs of LGBT Youth: Perceptions and Experiences of University Students in KwaZulu-Natal, South Africa

Limited research on access and utilization of sexual health services by sexual minorities has disadvantaged improvements of health systems in terms of providing appropriate treatment and care. Studies demonstrate that LGBTQ persons are more likely to experience health inequities, and are seldom recognized in health research and interventions. Using qualitative methods, this study aimed to shed insights into the utilization of health care services among university LGBT students. In-depth interviews were conducted with 12 LGBT university students aged 18–24 years in KwaZulu-Natal, South Africa. The interviews reveal that LGBT youth are victims of stigmatization, prejudice, and marginalization within the health system. Health providers have limited training in addressing the concerns of the LGBT community. The Internet is an important source of health information for LGBT youth. Students preferred private health services, because they felt health providers are more informed about their health needs and concerns. The findings suggest the importance of incorporating the needs of LGBT youth within youth-friendly initiatives. Future research should investigate the incidence and prevalence of diseases among LGBTQ persons, and take into account the perceptions and attitudes of health providers to understand their views on the provision of sexual health care for LGBTQ youth.

The relationship between depression and sexual health service utilization among men who have sex with men (MSM) in C\xf4te d'Ivoire, West Africa

BackgroundIn Cote D’Ivoire, there has been limited coverage of evidence-based sexual health services specifically supporting men who have sex with men (MSM). To date, there has been limited study of the determinants of engagement in these services including multiple intersecting stigmas and depression.Methods1301 MSM aged 18 years and older, were recruited using respondent-driven sampling in Abidjan, Yamoussoukro, Gagnoa and Bouake, Cote d’Ivoire from January 2015 to October 2015. Inclusion criteria included anal sex with another man in the past 12 months were to complete a structured questionnaire including the Patient Health Questionnaire (PHQ)-9 to screen for depression. Chi-Square tests were used to test difference in healthcare utilization across variables, and multiple logistic regression was used to test the association between depression and health care utilization represented by HIV and sexually transmittable infection testing and treatment.ResultsDepression (aOR:1.40, 95% CI: 1.07–1.84), being aged 25–29 years (aOR:1.84, 95% CI: 1.11–3.03),unemployed (aOR:0.64, 95% CI: 0.42–0.98), being a student (aOR:0.67, 95% CI: 0.48–0.96), being identified as male (aOR:0.44, 95% CI: 0.29–0.67), and identifying as homosexual (aOR:0.74, 95% CI:0.56–0.99) were significantly associated with utilization of sexual health care services in the final multivariable model. Healthcare enacted stigma (aOR: 1.55, 95% CI: 1.03–2.33) was associated with utilizing sexual health care services, but perceived healthcare stigma, social stigma and family stigma were not.ConclusionGiven higher levels of depressive symptomatology among those engaging in sexual health care services, this engagement represents an opportunity for service integration which may have synergistic benefits for both sexual and mental health. Moreover, MSM in Cote D’Ivoire who had engaged in sexual health services were more likely to report having experienced health-care enacted stigma. Taken together, these results reinforce the need for stigma mitigation interventions to support sustained engagement in HIV prevention, treatment and care services as a means of reducing health disparities among MSM in Cote d’Ivoire.

Sexual health service use among university undergraduate students in Nova Scotia

University students are a high-risk population for acquiring sexually transmitted infections (STIs). However, the rates of sexual health service utilization among this population remain low. In this study, we sought to describe the rates and predictors of sexual health service use among undergraduate students at two Nova Scotia universities. An online survey of eight Canadian Maritime universities was conducted to collect information on undergraduate students’ sexual health behaviours ( n = 10,631). We conducted a secondary analysis on a subset of the data collected from sexually active undergraduate students at two Nova Scotia universities ( n = 3,709). The majority of sexually active female students (73%) and 20% of male students accessed sexual health services at least once in their lifetime. Fewer sexually active students (41% females; 25% males) have ever had an STI test. Twenty-two percent of female students and 8% of male students had ever accessed sexual health services at their university health centre. Non-heterosexual students were less likely to access sexual health services on campus than heterosexual students. Among female respondents, those who reported a greater sense of social support were more likely to access sexual health services on campus. Our results illustrate the characteristics of university undergraduate students who do and do not access sexual health services on campus. These findings will be used to inform the design of a qualitative study to further explore the perceived barriers and enablers to sexual health service use at university health centres.

Use of sexual health services at hospitals by cleaning workers in Bogotá D.C. 2016

Introduction: Poverty and social inequalities together with sexually transmitted diseases have a negative impact on women’s health, which is considered to be a public health problem.Objective: To analyze barriers to accessing sexual and reproductive health services in cleaning workers.Materials and methods: A survey was administered to a sample of 37 female cleaning workers at a hospital in Bogotá D.C. A bivariate analysis was performed with chi-square test, as well as a multivariate analysis with binomial logistic regression.Results: Need factors showed greater association with non-use of sexual health services. All married women had accessed the service over the past 12 months, but there were 5.9 less possibilities of using sexual and reproductive health services when there was no awareness about risk behaviors of sexually transmitted diseases.Conclusion: The determining factor for the utilization of sexual health services is the health care need factor. Variables such as perception of risk behaviors and appropriateness of health care significantly influence the use of the service.

Sexual Health Services for Homeless Youth: A Qualitative Analysis of their Experiences

The sexual health problems experienced by homeless youth bring into question their use of available sexual health services. Using a qualitative typological analysis, this study aims to identify sexual health services utilization profiles for homeless youth, and to understand the role of the homeless experience on the utilization of sexual health services. Individual interviews were conducted with 33 homeless youth (17 men, 16 women) between 18 and 25 years of age. Typological analysis identified four profiles: (1) a targeted use of sexual health services to determine one’s serological status following a relational change during the homeless experience; (2) a limited use of sexual health services to manage sexual emergencies that arise during the homeless experience; (3) a regular use of sexual health services to avoid the risks associated with the homeless experience; (4) a frequent use of sexual health services to obtain support when engaging in prostitution during the homeless experience. This study shows that the precarious and unstable conditions within the homeless experience incite youth to utilize sexual health services in different ways. These findings point to the importance of rethinking sexual health services to better adapt them to the different utilization profiles of homeless youth.

Barriers to Utilization of Sexual Health Services among Young People in District Dang Nepal: A Qualitative Study

Background: Sexual behavior of young people is becoming one of the important social and major publichealth concerns in recent years. Despite the large population of young people, their needs receive limited programmatic and policy attention. Youth-friendly sexual and reproductive health services are lacking despite the existence of national guidelines that call for youth-friendly services. The aim of this study was to determine the barriers to utilization of sexual health services among young people of Badi community of Nepal.Materials &amp; Methods: This qualitative study included the young people, 15-24 years of age among the Badi community in district Dang Nepal. We conducted 22 in-depth interviews by using the interview guideline among the young people. Written and verbal informed consent was taken from each research participants before data collection.Results: Fourteen of the participants were males and eight were females. Participants were divided into two age groups: 15-19 and 20-24 and there were eight and fourteen participants from each group respectively. Rural participants were not satisfied with the services provided to them. We observed that discrimination, beliefs of society and feeling of shame towards family norms, lack of information about existing services, poor gender friendly services,lack of privacy and confidentiality and poor availability of the services pose the barriers to utilization of the sexual health services.Conclusions: Communities should be provided with educational programs on sexual health through community based organization and the establishment of youth friendly service centers with easy access to communities in urban as well as in rural areas would encourage young people to use sexual health services more frequently.J MEDICINE JUL 2018; 19 (2) : 79-83

Sexual orientation and sexual health services utilization among women in the United States

Although sexual minority women are at risk of sexually transmitted infections (STIs) and cervical cancer, few nationally representative studies have assessed sexual orientation disparities in sexual health care among women. Using data from the 2011–2013 and 2013–2015 waves of the National Survey of Family Growth, which provide a national probability sample of U.S. women aged 15–44years (N=11,300), we used multivariable logistic regression to examine the associations between sexual behavior and sexual identity (modeled separately) and STI testing in the past year, Pap test use in the last 3years, lifetime HIV testing, and lifetime human papillomavirus (HPV) testing. Women with male and female lifetime sexual partners had higher adjusted odds of being tested for STIs ([odds ratio:] 1.61; [95% confidence interval:] 1.37–1.89), HIV (1.66; 1.29–2.14), and HPV (1.79; 1.41–2.25) and similar adjusted odds of obtaining a Pap test (0.98; 0.76–1.27) than women with only male lifetime sexual partners. Self-identified bisexual women had higher adjusted odds of obtaining an STI (1.43; 1.10–1.86) and HIV (1.69; 1.24–2.30) test but lower adjusted odds of obtaining a Pap test in the last 3years (0.66; 0.47–0.93) than heterosexual-identified women. Women with only female lifetime sexual partners had lower adjusted odds of receiving an STI (0.14; 0.07–0.28) and Pap (0.10; 0.03–0.27) test than women with only male lifetime sexual partners. Results comparing self-identified lesbian and heterosexual women were similar. Health care facilities should monitor and address sexual orientation disparities in women's sexual health care and ensure the provision of high-quality sexual health services to all women.

Patterns and Disparities in Sexual Health Service Utilization among Adolescent Males: A Report From a National Teen Pregnancy Prevention Initiative

Male adolescents have higher rates of risky sexual behaviors compared to females, including earlier age of first sexual intercourse, higher rates of sexual experience, unprotected intercourse, and sex while high on drugs and/or alcohol. However, compared to females, male adolescents are less likely to receive routine primary care, disease screenings, sexual health counseling, and pregnancy prevention service. Although gender disparities in sexual and reproductive healthcare (SRH) have been well documented, there has been little research on racial/ethnic disparities in adolescent male utilization of SRH services. The current report aims to address this gap in research using data from a national initiative to reduce teen pregnancy in communities with the highest rates. Health center data was collected in 2011 for 59 health centers via a Clinical Partner Needs Assessment (CPNA). CPNA data included information describing health center practice setting, number of unduplicated adolescents clients, and utilization of SRH services by adolescent clients, stratified by age, gender, race and ethnicity. Basic descriptive statistics were calculated on the proportion of adolescent male SRH visits, and disaggregated by age, race, and ethnicity. Patterns in utilization of services were compared across age, race, and ethnic categories to identify disparities. All data was analyzed using Stata statistical analytic software. Out of the 59 partner health centers, only 37 (63%) reported valid data. Collectively, these 37 health centers reported serving 27,683 adolescent clients, of which 19,917 (72%) were female and 7,766 (28%) were male. Among all the male client-visits, 19.9% were SRH visits whereas among all the female client-visits, 55.3% were SRH visits. The proportion of adolescent males accessing SRH care services varies considerably across race/ethnic groups. Hispanic males have the lowest proportion of SRH visits compared to the other racial/ethnic groups (6.7%). In contrast, black males have the highest proportion of SRH visits (39.3%). The frequency of visits per client varies substantially among racial/ethnic groups as well. On average, Hispanic male adolescents have the highest frequency of visit per client (2.4) whereas black males have the lowest frequency of visits per client (1.7). Analysis of data point to persistent disparities in access of SRH utilization for adolescent clients, with adolescent males significantly less likely to access SRH services as compared to their female peers. Among adolescent males, black males have the lowest frequency of visits per client. While Hispanic male adolescents visit health centers in a more recurrent manner compared to other racial/ethnic groups, they are less likely to receive SRH services compared to their non-Hispanic peers. Despite efforts to achieve health equity in teen pregnancy prevention efforts, considerable work needs to be done to address disparities in provision of SRH services for male adolescents. Future efforts should focus on addressing barriers to sexual and reproductive healthcare for black and Hispanic adolescent males in particular.

P1-S2.21 Integrating public health into the sex worker community in Indianapolis

BackgroundSyphilis is a significant disease from a public health perspective both historically and as a result of the serious consequences of infection. While studies have explored the epidemiology of syphilis...