Cover: Advance Care Planning Among Sexual Minority Men

Advance Care Planning Among Sexual Minority Men

Sociodemographic, Health Care, and Health Status Predictors

Published in: Journal of Aging and Health (2023). doi: 10.1177/08982643231177725

Posted on Jun 21, 2023

by Daniel Siconolfi, Emma Thomas, Emily K. Chen, Sabina A. Haberlen, M. Reuel Friedman, Deanna Ware, Steven Meanley, Michael Brennan, Andre L. Brown, James E. Egan, et al.


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.


We examined formal and informal ACP among SMM ages 40+ in the Multicenter AIDS Cohort Study (N=1,071).


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.


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.

Research conducted by

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.