Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors

Daniel Siconolfi; Emma G. Thomas; Emily K. Chen; Sabina A. Haberlen; M. Reuel Friedman; Deanna Ware; Steven Meanley; Mark Brennan-Ing; Andre L. Brown; James E. Egan; Robert Bolan; Valentina Stosor; Michael Plankey

doi:10.1177/08982643231177725

Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors

Daniel Siconolfi^*, Emma G. Thomas, Emily K. Chen, Sabina A. Haberlen, M. Reuel Friedman, Deanna Ware, Steven Meanley, Mark Brennan-Ing, Andre L. Brown, James E. Egan, Robert Bolan, Valentina Stosor, Michael Plankey

^*Corresponding author for this work

Medicine, Infectious Diseases Division

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Objectives: Advance care planning (ACP) specifies decision-making surrogates and preferences for serious illness or end-of-life medical care. ACP research has largely neglected sexual minority men (SMM), a population that experiences disparities in health care and health status. Methods: We examined formal and informal ACP among SMM ages 40+ in the Multicenter AIDS Cohort Study (N = 1,071). Results: For informal ACP (50%), younger SMM and men with past cardiovascular events had greater odds of planning; single men had lower odds of planning. For formal ACP (39%), SMM with greater socioeconomic status had greater odds of planning; SMM who were younger, of racial/ethnic minority identities, who were single or in a relationship without legal protections, and who lacked a primary care home had lower odds of planning. Discussion: Findings warrant further exploration of both informal and formal planning. More equitable, culturally-humble engagement of SMM may facilitate access, uptake, and person-centered planning.

Original language	English (US)
Pages (from-to)	147-160
Number of pages	14
Journal	Journal of aging and health
Volume	36
Issue number	3-4
DOIs	https://doi.org/10.1177/08982643231177725
State	Published - Mar 2024

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Institute on Aging (R03AG067871) and National Institute on Minority Health and Health Disparities (R01MD010680). The authors gratefully acknowledge the contributions of the study participants and dedication of the staff at the MWCCS sites. This study was funded by the National Institute on Aging (R03AG067871) and the National Institute on Minority Health and Health Disparities (R01MD010680). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. MWCCS (Principal Investigators): Atlanta CRS (Ighovwerha Ofotokun, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (Kathryn Anastos and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Golub), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen and Audrey French), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky), U01-HL146240; Connie Wofsy Women’s HIV Study, Northern California CRS (Bradley Aouizerat, Phyllis Tien, and Jennifer Price), U01-HL146242; Los Angeles CRS (Roger Detels), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146205; Miami CRS (Maria Alcaide, Margaret Fischl, and Deborah Jones), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, Jodie Dionne-Odom, and Deborah Konkle-Parker), U01-HL146192; UNC CRS (Adaora Adimora), U01-HL146194. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Institute On Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004.

Keywords

advance care planning
advance directives
aging
sexual minority men

ASJC Scopus subject areas

Health(social science)
Life-span and Life-course Studies
Sociology and Political Science

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/08982643231177725

Cite this

Siconolfi, D., Thomas, E. G., Chen, E. K., Haberlen, S. A., Friedman, M. R., Ware, D., Meanley, S., Brennan-Ing, M., Brown, A. L., Egan, J. E., Bolan, R., Stosor, V., & Plankey, M. (2024). Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors. Journal of aging and health, 36(3-4), 147-160. https://doi.org/10.1177/08982643231177725

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abstract = "Objectives: Advance care planning (ACP) specifies decision-making surrogates and preferences for serious illness or end-of-life medical care. ACP research has largely neglected sexual minority men (SMM), a population that experiences disparities in health care and health status. Methods: We examined formal and informal ACP among SMM ages 40+ in the Multicenter AIDS Cohort Study (N = 1,071). Results: For informal ACP (50%), younger SMM and men with past cardiovascular events had greater odds of planning; single men had lower odds of planning. For formal ACP (39%), SMM with greater socioeconomic status had greater odds of planning; SMM who were younger, of racial/ethnic minority identities, who were single or in a relationship without legal protections, and who lacked a primary care home had lower odds of planning. Discussion: Findings warrant further exploration of both informal and formal planning. More equitable, culturally-humble engagement of SMM may facilitate access, uptake, and person-centered planning.",

keywords = "advance care planning, advance directives, aging, sexual minority men",

author = "Daniel Siconolfi and Thomas, {Emma G.} and Chen, {Emily K.} and Haberlen, {Sabina A.} and Friedman, {M. Reuel} and Deanna Ware and Steven Meanley and Mark Brennan-Ing and Brown, {Andre L.} and Egan, {James E.} and Robert Bolan and Valentina Stosor and Michael Plankey",

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year = "2024",

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doi = "10.1177/08982643231177725",

language = "English (US)",

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Siconolfi, D, Thomas, EG, Chen, EK, Haberlen, SA, Friedman, MR, Ware, D, Meanley, S, Brennan-Ing, M, Brown, AL, Egan, JE, Bolan, R, Stosor, V & Plankey, M 2024, 'Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors', Journal of aging and health, vol. 36, no. 3-4, pp. 147-160. https://doi.org/10.1177/08982643231177725

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AU - Siconolfi, Daniel

AU - Thomas, Emma G.

AU - Chen, Emily K.

AU - Haberlen, Sabina A.

AU - Friedman, M. Reuel

AU - Ware, Deanna

AU - Meanley, Steven

AU - Brennan-Ing, Mark

AU - Brown, Andre L.

AU - Egan, James E.

AU - Bolan, Robert

AU - Stosor, Valentina

AU - Plankey, Michael

PY - 2024/3

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N2 - Objectives: Advance care planning (ACP) specifies decision-making surrogates and preferences for serious illness or end-of-life medical care. ACP research has largely neglected sexual minority men (SMM), a population that experiences disparities in health care and health status. Methods: We examined formal and informal ACP among SMM ages 40+ in the Multicenter AIDS Cohort Study (N = 1,071). Results: For informal ACP (50%), younger SMM and men with past cardiovascular events had greater odds of planning; single men had lower odds of planning. For formal ACP (39%), SMM with greater socioeconomic status had greater odds of planning; SMM who were younger, of racial/ethnic minority identities, who were single or in a relationship without legal protections, and who lacked a primary care home had lower odds of planning. Discussion: Findings warrant further exploration of both informal and formal planning. More equitable, culturally-humble engagement of SMM may facilitate access, uptake, and person-centered planning.

AB - Objectives: Advance care planning (ACP) specifies decision-making surrogates and preferences for serious illness or end-of-life medical care. ACP research has largely neglected sexual minority men (SMM), a population that experiences disparities in health care and health status. Methods: We examined formal and informal ACP among SMM ages 40+ in the Multicenter AIDS Cohort Study (N = 1,071). Results: For informal ACP (50%), younger SMM and men with past cardiovascular events had greater odds of planning; single men had lower odds of planning. For formal ACP (39%), SMM with greater socioeconomic status had greater odds of planning; SMM who were younger, of racial/ethnic minority identities, who were single or in a relationship without legal protections, and who lacked a primary care home had lower odds of planning. Discussion: Findings warrant further exploration of both informal and formal planning. More equitable, culturally-humble engagement of SMM may facilitate access, uptake, and person-centered planning.

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Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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