Health Care Communication and HIV Prevention for Sexual Minority Men

Effective health care communication underpins HIV prevention efforts among sexual minority men worldwide. This population faces unique barriers including stigma, discrimination and legal constraints that undermine trust in health services and discourage disclosure of sexual orientation or same‐sex behaviour. Disclosure to health care providers facilitates risk assessment, tailored counselling, uptake of preventative measures such as pre‐exposure prophylaxis (PrEP) and voluntary counselling and testing (VCT), as well as linkage to antiretroviral therapy (ART) and peer support. Yet many men conceal their sexual identity due to fears of judgement, breaches of confidentiality or negative prior experiences, leading to missed opportunities for early diagnosis and intervention. Recent interventions leverage digital platforms, community‐based peer educators and provider training to improve patient–provider dialogue, destigmatise care environments and enhance awareness of emerging biomedical prevention strategies such as PrEP and Undetectable = Untransmittable (U=U). Simultaneously, structural factors such as police harassment, discriminatory laws and lack of rights protections continue to drive health care avoidance and suboptimal engagement. Addressing these multifaceted challenges requires integrated approaches that combine policy reform, provider sensitisation, community empowerment and innovative delivery models to support open communication channels, reinforce trust and ultimately reduce HIV incidence among sexual minority men on a global scale.

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Health Care Communication and HIV Prevention for Sexual Minority Men publication trend

The graph below shows the total number of articles in health care communication and hiv prevention for sexual minority men across all publications each year (not limited to Nature Index journals).

Technical terms

Sexual minority men: Men whose sexual orientation or behaviour includes attraction to, or sex with, other men, encompassing gay, bisexual and other non-heterosexual identities.

Pre-exposure prophylaxis (PrEP): A biomedical prevention strategy involving daily antiretroviral medication taken by HIV-negative individuals to reduce the risk of acquiring HIV.

Antiretroviral therapy (ART): Medication regimen used to treat people living with HIV, which also reduces the likelihood of onward transmission when viral load is suppressed.

Undetectable = Untransmittable (U=U): The principle that individuals living with HIV who maintain an undetectable viral load cannot sexually transmit the virus to others.

Voluntary counselling and testing (VCT): A service offering confidential HIV testing combined with risk-reduction counselling.

Disclosure: The act of revealing one’s sexual orientation or same-sex behaviour to health care providers.

Stigma: Social disapproval or discrimination directed at individuals based on characteristics such as sexual orientation or HIV status.

References

1. Same-sex behavior disclosure to health care providers associated with greater awareness of pre-exposure prophylaxis. BMC Public Health (2021).
2. Associations between police harassment and distrust in and reduced access to healthcare among Black sexual minority men: A longitudinal analysis of HPTN 061.. PLOS ONE (2023).
3. Patient sexuality disclosure experience and associations with clinical sexual health outcomes among HIV-negative men who have sex with men in Mexico. Preventive Medicine (2022).