Background: 

Health care provider assessment of patient sexual behavior and substance use is essential for determining appropriate prevention interventions—including HIV pre-exposure prophylaxis (PrEP)—for sexual minority men (SMM). We sought to explore acceptability and utility of using electronic surveys to conduct health behavior assessments in clinical settings among SMM.

Methods: 

Among a US nationwide sample of SMM (n = 4187; mean age = 38.3 years; 60% white; 82% HIV-negative), we examined associations of demographics, recruitment venue, sexual behavior characteristics, and recent substance use with participants' comfort communicating verbally and through electronic survey with a health care provider about sexual and substance use behavior.

Results: 

On average, SMM had greater comfort communicating through electronic survey vs. verbally. In our fully adjusted analysis, preference favoring electronic surveys more strongly than verbal communication differed by age (β = −0.07, P ≤ 0.001). SMM with a bachelor's degree or more (β = 0.04, P < 0.05), those recruited from nonclinical settings (β = 0.06, P ≤ 0.001), and those without primary care providers (β = 0.04, P < 0.05) favored electronic surveys more strongly in the fully adjusted multivariable model. SMM who reported any recent casual sex partners (β = 0.05, P < 0.01), those never tested for HIV (β = 0.03, P < 0.05), and HIV-negative/unknown men not on PrEP (compared with PrEP users; β = 0.09, P ≤ 0.001) also favored electronic surveys in the fully adjusted model.

Conclusions: 

Reducing communication barriers by incorporating electronic surveys into patient assessments could help identify HIV testing and PrEP needs for SMM most susceptible to HIV acquisition. Nonetheless, no one screening strategy is likely to work for most SMM, and multiple approaches are needed.

中文翻译：

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减少医疗机构中数字问卷的讨论范围：HIV检测和PrEP筛查的颠覆性创新

背景： 

医护人员对患者性行为和药物使用情况的评估对于确定针对性少数男性（SMM）的适当预防干预措施（包括HIV 暴露前预防（PrEP））至关重要。我们试图探索在SMM中使用电子调查在临床环境中进行健康行为评估的可接受性和实用性。

方法： 

在美国全国范围内的SMM样本中（n = 4187；平均年龄= 38.3岁； 60％的白人； 82％的HIV阴性），我们研究了人口统计学，招聘地点，性行为特征以及近期使用毒品与参与者舒适度的关系与医疗保健提供者进行口头交流和电子调查，以了解其性和物质使用行为。

结果： 

平均而言，与通过口头调查相比，SMM通过电子调查进行交流的舒适度更高。在我们的充分调整的分析，偏好有利于电子调查强于年龄（β= -0.07，不同语言的沟通P ≤0.001）。SMM，获程度以上（β= 0.04，P <0.05），那些来自非临床设置（β= 0.06，招募P ≤0.001），而那些没有初级保健提供者（β= 0.04，P <0.05）有利于电子调查在完全调整的多变量模型中更有效。SMM报告了最近有过随意的性伴侣（β= 0.05，P <0.01），从未接受过HIV检测的伴侣（β= 0.03，P <0.05）和HIV阴性/未知的人就不在制备型（用制备的用户相比，β= 0.09，P ≤0.001）也有利于电子调查在充分调整模型。

结论： 

通过将电子调查纳入患者评估中来减少沟通障碍，可以帮助确定最易感染HIV的SMM的HIV检测和PrEP需求。尽管如此，对于大多数SMM，没有一种筛选策略可能适用，并且需要多种方法。