Barriers to sexually transmitted infections testing in young men who have sex with men: An integrative review

Sexually transmitted infections (STIs) are an increasing public health problem that affects all populations regardless of race or gender. Despite general increased prevalence, specifically young men who have sex with men (YMSM), between the ages of 15-26, are a high risk group accounting for 53% of all new cases. National and provincial guidelines recommend increased STI testing in YMSM in comparison to their female and non-MSM counterparts to reduce overall STI rates and prevent potential negative health outcomes. Although these guidelines exist, testing in this population remains low. This integrative literature review explores the barriers experienced by YMSM when accessing STI testing and informs strategies whereby Nurse Practitioners could optimize sexual health care in this population. A systematic search of the literature identified 11 key articles. These were analyzed using the Critical Appraisal Skills Programme tools, the Mixed Methods Appraisal Tool, and Scale for the Assessment of Narrative Review Articles. Three key themes emerged from the literature and are explored in detail: personal barriers, system-level barriers, and healthcare provider barriers. Recommendations based on the above themes with respect to facilitating sexual health education in YMSM and related practice improvement in NPs are identified. Normalization of sexual health through a life course approach and areas for further research are also highlighted.