Open AccessAdapting Andersen’s Behavioral Model of Health Service Use to Examine Risk Factors for Hypertension Among U.S. MSM
Author(s) -
Sabina Hirshfield,
Martin J. Downing,
Keith J. Horvath,
James A. Swartz,
Mary Ann Chiasson
Publication year - 2016
Publication title -
american journal of men's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.881
H-Index - 34
eISSN - 1557-9891
pISSN - 1557-9883
DOI - 10.1177/1557988316644402
Subject(s) - medicine , men who have sex with men , confidence interval , odds ratio , demography , overweight , logistic regression , depression (economics) , diabetes mellitus , behavioral risk factor surveillance system , gerontology , obesity , population , environmental health , human immunodeficiency virus (hiv) , syphilis , endocrinology , immunology , sociology , economics , macroeconomics
Hypertension affects nearly a third of U.S. adult males and is a leading risk factor for cardiovascular disease, but there is a paucity of hypertension research among men who have sex with men (MSM). Andersen’s model of health service use was adapted to examine factors associated with hypertension among MSM. In 2008, 7,454 U.S. MSM completed an online survey. Overall, 16.5% of the sample reported a lifetime diagnosis of hypertension. In hierarchical logistic regression, Black MSM had increased odds of reporting hypertension (adjusted odds ratio [AOR] = 1.79, 95% confidence interval [CI] [1.24, 2.60]) compared with White MSM, as did men aged 30 years and older (age 30-39: AOR = 2.46, 95% CI [1.84, 3.29]; age 40-49: AOR = 3.76, 95% CI [2.85, 4.97]; age 50+: AOR = 6.40, 95% CI [4.78, 8.58]; Reference: 18-29 years). Health conditions associated with hypertension included diabetes (AOR = 3.62, 95% CI [2.81, 4.68]), heart disease (AOR = 5.19, 95% CI [3.99, 6.75]), depression (AOR = 1.38, 95% CI [1.17, 1.63]), anxiety (AOR = 1.30, 95% CI [1.09, 1.57]), and being overweight (AOR = 2.23, 95% CI [1.91, 2.59]). Having a primary care provider (AOR = 2.19, 95% CI [1.64, 2.93]) and residing in South Atlantic (AOR = 1.39, 95% CI [1.12, 1.74]) or South Central (AOR = 1.59, 95% CI [1.27, 2.00]) regions was also associated with reporting hypertension. Study findings are consistent with those in the literature for the general population. To address health care inequities, the Internet could serve as a potential access point for health screening and referral for care.