National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand
Date
2020
Authors
Lachowsky, Nathan J.
Saxton, Peter J. W.
Dickson, Nigel Patrick
Hughes, Anthony J.
Summerlee, Alastair J. S.
Dewey, Cate E.
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ Open
Abstract
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.
Description
Keywords
Citation
Lachowsky, N. J., Saxton. P. J. W., Dickson, N. P., Hughes, A. J., Summerlee, A. J. S., & Dewey, C. E. (2020). “National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand.” BMJ Open,10, e039896. DOI: https://doi.org/10.1136/bmjopen-2020-039896