"Actually, that's one of the reasons I stopped getting tested often, because I didn't want to be judged:" Sexual Healthcare and STI Testing Experiences Among U.S. Men Who Have Sex With Men.

BACKGROUND: Men who have sex with men (MSM) havea high need for sexual healthcare, but often report experiences of stigma and discrimination in sexual healthcare-seeking interactions. This qualitative analysis describes experiences of MSM seeking sexual healthcare, as well as barriers and facilitators to engaging in sexual healthcare. METHODS: Data were collected from June to September 2024 as part of a cross-sectional, mixed methods study exploring the acceptability and use of doxycycline post-exposure prophylaxis (doxy-PEP). One-on-one, semi-structured interviews were conducted (via Zoom) followed by a brief online quantitative survey. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. RESULTS: Participants had a median age of 35 (IQR = 30-38), and most had at least a four-year college degree (59%). Fifty-two percent identified as White, 24% identified as Latino, 10% identified as Black/African American, and 14% identified as another race or ethnicity. Participants described positive sexual healthcare experiences including LGBTQ-focused care and personable staff. Concerns with seeking sexual healthcare were prevalent, including lack of provider knowledge, interpersonal staff concerns, and judgment. Participants described how free testing and accessible services served as facilitators to STI testing, whereas insurance complexities and unreliable transportation were identified as barriers. CONCLUSION: Improving culturally sensitive and relevant healthcare for MSM may improve engagement and provide increased opportunities for HIV and STI prevention.