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Lee JJ, Aguirre J, Munguia L, Robles G, Ramirez Hernandez K, Ramirez JI, Leyva Vera CA, Duran MC. Engagement of Latino immigrant men who have sex with men for HIV prevention through eHealth: preferences across social media platforms. ETHNICITY & HEALTH 2022; 27:1684-1697. [PMID: 34152248 PMCID: PMC8688577 DOI: 10.1080/13557858.2021.1943322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/08/2021] [Indexed: 05/12/2023]
Abstract
OBJECTIVE eHealth has growing potential to enhance access to HIV prevention for hard to reach populations, including young Latino immigrant men who have sex with men (MSM) in the United States. We examined the feasibility and acceptability of using eHealth tools, specifically social media platforms, to facilitate HIV testing and pre-exposure prophylaxis (PrEP) uptake among this population. DESIGN We utilized a community sensitive approach to conduct 30 in-depth interviews and five focus groups with young Latino immigrant MSM in Seattle, WA. Data were analyzed using thematic analysis with both data-driven inductive and a priori deductive approaches. RESULTS Participants were open to receiving HIV information via social media platforms. Participants recommended that social media content be tailored with their language preferences, cultural norms, and beliefs about HIV testing and PrEP in mind. Further, participants emphasized that content avoid stigmatizing HIV or Latino MSM's complex identities. CONCLUSIONS Results have implications for utilizing social media platforms and developing HIV prevention interventions for Latino immigrant MSM. Findings highlight that HIV prevention content should acknowledge how identities as an emerging adult, Latino, immigrant, and MSM, warrant unique consideration.
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Affiliation(s)
- Jane J Lee
- School of Social Work, University of Washington, Seattle, WA, USA
| | | | | | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | | | | | | | - Miriana C Duran
- Department of Health Services, University of Washington, Seattle, WA, USA
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2
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Estrada F, Jones IJ, Rivera D, Ramirez A, Cerezo A. Trauma and Latinx Sexual- and Gender-Minority Immigrants in the U.S. Curr Opin Psychol 2022; 47:101439. [DOI: 10.1016/j.copsyc.2022.101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
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3
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Valdes B, Martinez J, Quidley-Rodriguez N, Salani D, Provencio-Vasquez E, De Santis JP. Interventions for Hispanic/Latino gay, bisexual, and men who have sex with men: Critical appraisal. Public Health Nurs 2021; 39:572-585. [PMID: 34881458 DOI: 10.1111/phn.13022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/25/2021] [Accepted: 11/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Some interventions have been developed and tested to reduce high risk sexual behaviors among Hispanic/Latino gay, bisexual, and men who have sex with men (MSM). The purpose of this paper is to critically appraise published interventions designed to reduce high risk sexual behaviors among Hispanic/Latino gay, bisexual, and MSM. DESIGN/SAMPLE/MEASUREMENT A critical appraisal of published interventions designed to reduce high risk sexual behaviors among Hispanic/Latino gay, bisexual, and MSM was conducted. Using guidelines established by the Johns Hopkins Nursing Evidence-Based Practice Rating Scale published research articles were categorized and evaluated using these guidelines. RESULTS The critical appraisal identified nine intervention studies that met all inclusion criteria. The critical appraisal of these interventions highlighted strengths and weaknesses of these interventions which should be considered when developing future interventions to decrease high risk sexual practices among Hispanic/Latino gay, bisexual, and MSM. CONCLUSION While several interventions have been created to specifically address HIV infection among Hispanic/Latino gay, bisexual, and MSM, these interventions were varied. Suggestions for future intervention development to decrease high risk sexual behaviors among Hispanic/Latino gay, bisexual, and MSM based on the findings of the critical appraisal of the literature are included.
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Affiliation(s)
- Beatriz Valdes
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
| | - Jacob Martinez
- School of Nursing, The University of Texas at El Paso, El Paso, Texas, USA
| | | | - Deborah Salani
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
| | | | - Joseph P De Santis
- University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
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4
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Sharma A, Paredes-Vincent A, Kahle EM. Awareness, Utilization, and Preferences for Traditional and Contemporary HIV Prevention Strategies Among Facebook and Instagram-Using MSM in the United States. J Int Assoc Provid AIDS Care 2021; 20:23259582211024770. [PMID: 34132144 PMCID: PMC8212379 DOI: 10.1177/23259582211024770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
HIV prevention research among men who have sex with men (MSM) has traditionally
focused on individual risk reduction strategies. Our study evaluated awareness,
utilization, and preferences for 10 complementary HIV prevention strategies
among 1,286 MSM recruited via Facebook and Instagram from June-August 2018. Ages
ranged from 18-85 years, and the majority were non-Hispanic white (n = 1,019,
79.24%), college-educated (n = 819, 63.69%), gay-identifying (n = 1,074,
83.51%), and partnered (n = 808, 62.83%). Post-exposure prophylaxis was the
least familiar option, and engaging in sexual activities other than anal sex was
the most utilized option. Progressively older and bisexual-identifying MSM were
less likely, but those with higher educational levels and easy access to local
HIV resources were more likely to be aware of and to be utilizing a greater
number of strategies. Additionally, Hispanic MSM were less likely to be aware
of, and those in a “closed” relationship were less likely to be utilizing a
greater number of strategies. In a subset of 775 multiple strategy users,
pre-exposure prophylaxis, regularly testing for HIV, and limiting the number of
sex partners emerged as the most preferred options. Combination intervention
packages for MSM should be tailored to personal circumstances, including sexual
orientation, relationship characteristics and access to local HIV resources.
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Affiliation(s)
- Akshay Sharma
- Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA.,Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
| | - Ariana Paredes-Vincent
- Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Erin M Kahle
- Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, USA.,Center for Sexuality and Health Disparities, University of Michigan School of Nursing, Ann Arbor, MI, USA
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5
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Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men. AIDS Behav 2021; 25:311-321. [PMID: 32654021 PMCID: PMC7352092 DOI: 10.1007/s10461-020-02969-0] [Citation(s) in RCA: 148] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is an urgent need to measure the impacts of COVID-19 among gay men and other men who have sex with men (MSM). We conducted a cross-sectional survey with a global sample of gay men and other MSM (n = 2732) from April 16, 2020 to May 4, 2020, through a social networking app. We characterized the economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response, and examined whether sub-groups of our study population are disproportionately impacted by COVID-19. Many gay men and other MSM not only reported economic and mental health consequences, but also interruptions to HIV prevention and testing, and HIV care and treatment services. These consequences were significantly greater among people living with HIV, racial/ethnic minorities, immigrants, sex workers, and socio-economically disadvantaged groups. These findings highlight the urgent need to mitigate the negative impacts of COVID-19 among gay men and other MSM.
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6
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Harkness A, Weinstein ER, Mayo D, Rodriguez-Diaz C, Safren SA. Latinx Sexual Minority Men's Behavioral, Psychosocial, and Medical Experiences during COVID-19: Differences across Immigration Statuses. ANNALS OF LGBTQ PUBLIC AND POPULATION HEALTH 2021; 2:104-115. [PMID: 34790911 PMCID: PMC8594873 DOI: 10.1891/lgbtq-2020-0054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Latinx sexual minority men (LSMM) are at the intersection of two communities disproportionately impacted by COVID-19. To develop and deploy appropriate resources to support LSMM, it is important to understand the behavioral, psychosocial, and medical experiences of this population during COVID-19, as well as for LSMM of different immigration statuses. The current study uses the Pandemic Stress Index (PSI) to describe LSMM's self-reported behavioral, psychosocial, and medical experiences during COVID-19. Logistic and linear regressions compared experiences during COVID-19 among LSMM across different immigration statuses (recent, established, and US-born as the reference group). LSMM's responses to the PSI indicated they experienced anxiety (64.4%), depression (59.0%), alcohol/substance use (27.6%), as well as loneliness (50.1%) and sleep problems (60.4%). Overall, over half reported personal financial loss, the odds of which were 2.75 times greater among LSMM who were recent immigrants compared to US-born LSMM (OR = 2.75, 95% CI: 1.30, 5.82). Nearly 8% reported being diagnosed with COVID-19, with the odds four and a half times greater among established immigrants compared to US-born LSMM (OR = 4.52, 95% CI: 1.60, 12.81). The findings have implications for tailored support resources and public health interventions to reach LSMM in general and LSMM with immigration histories.
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Affiliation(s)
| | | | - Daniel Mayo
- University of Miami, Department of Psychology
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7
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Takada S, Gorbach P, Brookmeyer R, Shoptaw S. Associations of social capital resources and experiences of homophobia with HIV transmission risk behavior and HIV care continuum among men who have sex with men in Los Angeles. AIDS Care 2020; 33:663-674. [PMID: 33050712 DOI: 10.1080/09540121.2020.1828798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For men who have sex with men (MSM) in the US, the positive and negative aspects of social capital - access to resources within their social networks and experiences of homophobia - may explain their disproportionate burden of HIV infection. We analyzed data from 379 HIV seronegative and seropositive MSM in Los Angeles, collected between May 2017 and February 2018. Dependent variables were HIV transmission risk behaviors and care continuum outcomes. We used multivariable logistic regression to estimate the association between social capital resources and experiences of homophobia with dependent variables, adjusting for sociodemographics and drug use. Most participants were under age 40 and 41% identified as Black/African American and 36% as Hispanic/Latino. Social capital resources associated with likelihood of new sexually transmitted infections (-5.5% per standard deviation (SD), 95%CI -10.3, 0.7%) and HIV testing (5% per SD, 95%CI 0.8, 9.2%). Experiences of homophobia associated with likelihood of methamphetamine use during sex (10% per SD, 95%CI 7, 14%), receiving (4.3% per SD, 95%CI 1.9, 6.7%) and giving (7.2% per SD, 95%CI 4.5, 9.9%) exchange sex, and missing appointments (7.2% per SD, 95%CI 0.8, 13.6%). Findings that social capital associated with HIV transmission risk behaviors and HIV testing suggest interventions to increase social capital resources would impact the HIV-prevention continuum.
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Affiliation(s)
- Sae Takada
- Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, CA, USA.,VA HSR&D Center for the Study of Healthcare Innovation, Implementation, & Policy, Los Angeles, CA, USA
| | - Pamina Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.,Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Ron Brookmeyer
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Steve Shoptaw
- Department of Family Medicine, University of California, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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8
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Wandschneider L, Batram-Zantvoort S, Razum O, Miani C. Representation of gender in migrant health studies - a systematic review of the social epidemiological literature. Int J Equity Health 2020; 19:181. [PMID: 33054755 PMCID: PMC7556985 DOI: 10.1186/s12939-020-01289-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background Gender as a social construct contributes to determine who migrates and which migration-related risks and opportunities emerge in all phases of the migration trajectory. Simultaneously, migration influences the individual as well as societal definition and perception of gender roles. An explicit gender perspective in migration-related epidemiological research can contribute to adequately analyse and interpret the health of migrants. This systematic review gives a comprehensive overview on how gender has been conceptualised, operationalised and measured in social epidemiologic studies aiming to assess the influence of gender on health among migrants. Methods We searched PubMed, Embase, CINAHL, the Cochrane Library, EconLit and PsycINFO and conducted backward reference searching. Reviewers independently selected studies, extracted data and conducted the quality assessment. Eligible studies actively aimed to understand, identify or explain the influence of gender on migrants’ health, whereby the role of gender can encompass a variety of mechanisms, processes or states of differentiation, discrimination and/or inequality. Results Almost all of the 43 studies were cross-sectional and focussed on health outcomes in the post-migration phase. The most common theme of research was the health of male migrants in the US, and in particular of men who have sex with men (MSM). All studies treated gender as a binary variable (men vs. women), without discussing additional types of gender identities. A minority of studies differentiated clearly between sex and gender. Gender was mostly operationalised through attitudes toward gender roles and gender-based discrimination, experienced at the individual level. Community and societal level gender measures capturing structural gender determinants were underrepresented. Conclusions The intersections of migration and gender suggested synergistic effects on health that only become visible when considering those two social determinants together. Future research needs to embrace a multilevel and non-binary understanding of gender and reflect on the influence of gender in the different phases of the migration journey. Systematic review registration PROSPERO CRD42019124698.
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Affiliation(s)
- Lisa Wandschneider
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany.
| | - Stephanie Batram-Zantvoort
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany
| | - Céline Miani
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany
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9
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Diaz JE, Schrimshaw EW, Tieu HV, Nandi V, Koblin BA, Frye V. Acculturation as a Moderator of HIV Risk Behavior Correlates Among Latino Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2029-2043. [PMID: 31858309 PMCID: PMC7302998 DOI: 10.1007/s10508-019-01604-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 10/16/2019] [Accepted: 12/03/2019] [Indexed: 05/18/2023]
Abstract
Acculturation is associated with increased sexual risk behaviors among heterosexual Latinos, but its influence among Latino gay, bisexual, and other men who have sex with men (MSM) remains less clear. Elements of acculturation may create distinct lived experiences among sexual minority Latinos, moderating how beneficial and adverse influences contribute to their sexual risk behaviors. Latino MSM living in New York City (n = 412) were recruited using a modified time-space venue- and web-based sampling method. Negative binomial regression models estimated associations between indicators of acculturation (i.e., language use, nativity status, ethnic identification), sexual minority stressors (i.e., internalized homophobia, sexual orientation-based discrimination), peer condom use norms, and the number of serodiscordant condomless anal intercourse (SDCAI) encounters. Acculturation indicators were then tested as simultaneous moderators of the influence of each predictor variable on the outcome. The association between internalized homophobia and SDCAI was significant only among English language speakers (aIRR = 3.05 [2.13, 4.37]) and those born outside of the U.S. (foreign-born = 0, aIRR = 0.17 [0.08, 0.36]). Sexual orientation-based discrimination and SDCAI were also positively associated among both English-speaking (aIRR = 1.82 [1.22, 2.72]) and foreign-born men (aIRR = 0.34 [0.14, 0.84]). Stronger ethnic identification also moderated the protective effects of peer condom use norms on SDCAI (aIRR = 0.28 [0.15, 0.52]). Results suggest that different dimensions of acculturation help shape how both stressors and protective factors influence HIV risk among Latino MSM. Future research is needed to examine the mechanisms through which these differences in acculturation may act on sexual risk behaviors among Latino MSM.
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Affiliation(s)
- José E Diaz
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Eric W Schrimshaw
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Hong-Van Tieu
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Vijay Nandi
- Laboratory of Data Analytic Services, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Beryl A Koblin
- Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York, NY, USA
| | - Victoria Frye
- Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, NY, USA
- Laboratory of Social and Behavioral Sciences, Lindsley F. Kimball Research Institute, New York, NY, USA
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10
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Lee J, Cassels S. Immigrant Generational Differences in Social Support and Sexual Risk Behaviors Among Men Who Have Sex With Men in Seattle, Washington. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2020; 32:282-295. [PMID: 32897132 PMCID: PMC8055472 DOI: 10.1521/aeap.2020.32.4.282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Different immigrant generations may encounter distinct sexual opportunities with implications for HIV transmission. Yet, few studies have examined how immigrant generational status is associated with sexual risk behaviors among men who have sex with men (MSM). We explored relationships between immigrant generational status, social support, and sexual risk behaviors among English-speaking MSM using data from surveys conducted in Seattle, Washington, in 2014 (n = 323). We compared the sexual risk behaviors and social support of first-generation, second-generation, and third- and higher-generation MSM, and examined whether immigrant generational status and social support were associated with sexual risk behaviors using logistic regression models. Second-generation MSM reported lower friend social support than first- or third- and higher-generation MSM (p < .05). However, immigrant generational status was not associated with sexual risk behavior outcomes, even after accounting for social support. Results suggest that differences in immigration processes such as acculturation may be more predictive of risk behaviors than generational status alone.
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Affiliation(s)
- Jane Lee
- School of Social Work, University of Washington, Seattle, Washington
| | - Susan Cassels
- Department of Geography, University of California, Santa Barbara, California
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11
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Health Insurance Coverage and Access to Care Among US-Born and Foreign-Born Sexual Minorities. J Immigr Minor Health 2019; 21:540-548. [PMID: 29946865 DOI: 10.1007/s10903-018-0774-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Sexual minorities and immigrants face unique challenges to accessing health care in the United States. This study used data on nonelderly adults (n = 100,667) from the 2013-2016 National Health Interview Survey. Unadjusted prevalence estimates and multivariable logistic regression models (with and without interactions between immigration and sexual minority status) were used to compare health insurance coverage and access to care by immigration and sexual minority status. We did not find any differences in uninsurance, having a usual source of care, and a recent office visit by sexual orientation for US-born and foreign-born adults. However, compared to their heterosexual counterparts, US-born and foreign-born sexual minorities were more likely to have an emergency room visit in the prior year and report financial-related barriers to medical care, dental care, prescription medications, and mental health care. Foreign-born sexual minorities were more likely to have an emergency room visit and unmet mental health care needs due to cost compared to other subpopulations after controlling for sociodemographic characteristics. Broadening the knowledge and scope of research on sexual minority immigrants can inform targeted health policy approaches with the goal of achieving health equity for sexual minority immigrants.
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12
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Painter TM, Song EY, Mullins MM, Mann-Jackson L, Alonzo J, Reboussin BA, Rhodes SD. Social Support and Other Factors Associated with HIV Testing by Hispanic/Latino Gay, Bisexual, and Other Men Who Have Sex with Men in the U.S. South. AIDS Behav 2019; 23:251-265. [PMID: 31102108 PMCID: PMC6800592 DOI: 10.1007/s10461-019-02540-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cognitive-psychosocial and other factors may affect participation in HIV testing, particularly by Hispanic/Latino gay, bisexual, and other men who have sex with men (MSM) in the U.S. South, a region hard-hit by HIV. We used univariate and multivariable logistic regression analyses to examine the association between social support and other cognitive-psychosocial factors; sociodemographic characteristics; risk behaviors; and self-reported HIV testing in a sample of 304 Hispanic/Latino MSM in North Carolina. In the multivariable logistic regression analysis, general and HIV-related social support and HIV-related knowledge were associated with greater odds of testing; speaking only Spanish was associated with reduced odds of testing. Social support and aspects of social connectedness may constitute community-based resources for use in HIV prevention efforts with Hispanic/Latino MSM. However, harnessing these resources for HIV prevention will require a better understanding of how social support relationships and processes shape HIV risks and protective actions by these vulnerable MSM.
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Affiliation(s)
- Thomas M Painter
- Prevention Research Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E-37, Atlanta, GA, 30329, USA.
| | - Eunyoung Y Song
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mary M Mullins
- Prevention Research Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E-37, Atlanta, GA, 30329, USA
| | - Lilli Mann-Jackson
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Beth A Reboussin
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Scott D Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
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13
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Sexual Migration and HIV Risk in a Sample of Brazilian, Colombian and Dominican Immigrant MSM Living in New York City. J Immigr Minor Health 2019; 21:115-122. [PMID: 29497902 DOI: 10.1007/s10903-018-0716-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We examined motivations for migration to the United States (US) among 482 Brazilian, Colombian, and Dominican men who have sex with men (MSM). Participants' most common reason for migration was to improve their financial situation (49%), followed by sexual migration in order to affirm their sexual orientation (40%). Fewer endorsed sexual migration motivated by avoiding persecution due to being gay (13%). We conducted further analyses among 276 participants who migrated after age 15 and were HIV-negative at the time of migration. We hypothesized that sexual migration would be associated with greater likelihood of HIV acquisition post-migration. Hierarchical logistic regression analysis indicated that sexual migration motivated by avoiding persecution due to being gay was associated with increased odds of contracting HIV after arrival in the US whereas sexual migration to lead a gay life was not. Our findings highlight the importance of addressing the negative impact of anti-gay discrimination in countries of origin.
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14
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De Santis JP, Quidley-Rodriguez N, Valdes B, Alves SL, Provencio-Vasquez E. Contemplating Co-Occurring Cultures: A Grounded Theory Study of Sexual Decision Making Among Hispanic Men Who Have Sex With Men. HISPANIC HEALTH CARE INTERNATIONAL 2019; 16:85-98. [PMID: 30157694 DOI: 10.1177/1540415318790554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction HIV infection continues to be a serious health concern globally. Of the 1.2 million people with HIV infection in the United States, men who have sex with men (MSM) account for 57% of cases. Hispanic/Latino individuals accounted for 24% of new HIV diagnoses, with male-to-male sexual contact responsible for the majority of cases. A factor in HIV prevention is the sexual decision-making process. The purpose of this study was to describe the process by which sexual decision making occurs among Hispanic MSM. Method Utilizing a grounded theory approach, 19 in-depth, semistructured interviews were conducted from participants ages 25 to 65 years living in South Florida. After consent, participants completed an in-depth interview. Interviews were audio-recorded and transcribed verbatim. Data were analyzed to identify categories and subcategories. Findings A theory grounded in the data called Contemplating Co-Occurring Cultures (Hispanic, gay, and health cultures) emerged that described the central phenomenon. These co-occurring cultures were the foundation of sexual decision making among participants. Conclusion Clinicians providing care to this population should be aware of the complexity of the sexual decision-making process. Awareness of these factors may provide the opportunity for HIV risk reduction strategies developed specifically for Hispanic MSM.
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Affiliation(s)
- Joseph P De Santis
- 1 University of Miami, Coral Gables, FL, USA.,2 University of Texas at El Paso, TX, USA
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15
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Lui PP, Zamboanga BL. A Critical Review and Meta-Analysis of the Associations Between Acculturation and Alcohol Use Outcomes Among Hispanic Americans. Alcohol Clin Exp Res 2018; 42:1841-1862. [PMID: 30030932 DOI: 10.1111/acer.13845] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 07/16/2018] [Indexed: 12/31/2022]
Abstract
Acculturation has been studied as one key sociocultural determinant that helps explain ethnic disparities in alcohol use outcomes among Hispanic Americans. Primary studies and other systematic reviews have found between-study inconsistencies regarding the extent to which acculturation is associated with alcohol use outcomes among Hispanic Americans. To better examine whether acculturation is distinctly linked to drinker status, drinking frequency, volume, intensity, binge drinking, and hazardous alcohol use/drinking problems, and to identify individual and methodological factors that moderate these associations, we conducted a comprehensive research synthesis. A systematic review was conducted on research pertaining to the associations between acculturation and alcohol use among Hispanics. We included 88 independent study samples (N = 68,282) coded from 68 manuscripts published in 1987 to 2017. Standard and robust variance estimation (RVE) meta-analyses were conducted to calculate the correlations between acculturation and overall alcohol use. We also conducted a series of analyses to examine the weighted mean correlations between acculturation and 6 specific drinking outcomes. We found a statistically significant correlation between acculturation and overall alcohol use (r = 0.09, p < 0.001). Acculturation was associated with drinker status (r = 0.10, p < 0.001), drinking intensity (r = 0.09, p = 0.001), binge drinking (r = 0.05, p = 0.006), and hazardous alcohol use/drinking problems (r = 0.06, p = 0.006), but not drinking frequency (r = 0.02, p = 0.56) or volume (r = 0.01, p = 0.73). Gender, acculturation dimension, acculturation domain, age group, and sampling settings were found to explain between-study variability in some of these associations. Findings show small relations between acculturation and various alcohol use outcomes, but the effects are relatively more robust among Hispanic women, adults, and when studies measured U.S. cultural orientation, linguistic acculturation, and behavioral practices.
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Affiliation(s)
- P Priscilla Lui
- Department of Psychology, Southern Methodist University, Dallas, Texas
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16
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Friedman EE, Dean HD, Duffus WA. Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Public Health Rep 2018; 133:392-412. [PMID: 29874147 DOI: 10.1177/0033354918774788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Social determinants of health (SDHs) are the complex, structural, and societal factors that are responsible for most health inequities. Since 2003, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) has researched how SDHs place communities at risk for communicable diseases and poor adolescent health. We described the frequency and types of SDHs discussed in articles authored by NCHHSTP. METHODS We used the MEDLINE/PubMed search engine to systematically review the frequency and type of SDHs that appeared in peer-reviewed publications available in PubMed from January 1, 2009, through December 31, 2014, with a NCHHSTP affiliation. We chose search terms to identify articles with a focus on the following SDH categories: income and employment, housing and homelessness, education and schooling, stigma or discrimination, social or community context, health and health care, and neighborhood or built environment. We classified articles based on the depth of topic coverage as "substantial" (ie, one of ≤3 foci of the article) or "minimal" (ie, one of ≥4 foci of the article). RESULTS Of 862 articles authored by NCHHSTP, 366 (42%) addressed the SDH factors of interest. Some articles addressed >1 SDH factor (366 articles appeared 568 times across the 7 categories examined), and we examined them for each category that they addressed. Most articles that addressed SDHs (449/568 articles; 79%) had a minimal SDH focus. SDH categories that were most represented in the literature were health and health care (190/568 articles; 33%) and education and schooling (118/568 articles; 21%). CONCLUSIONS This assessment serves as a baseline measurement of inclusion of SDH topics from NCHHSTP authors in the literature and creates a methodology that can be used in future assessments of this topic.
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Affiliation(s)
- Eleanor E Friedman
- 1 Association of Schools and Programs of Public Health/CDC Public Health Fellowship Program, Atlanta, GA, USA.,2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.,3 Chicago Center for HIV Elimination and University of Chicago Department of Medicine, Chicago, IL, USA
| | - Hazel D Dean
- 4 Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wayne A Duffus
- 2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Henny KD, Nanin J, Gaul Z, Murray A, Sutton MY. Gay Identity and HIV Risk for Black and Latino Men Who Have Sex with Men. SEXUALITY & CULTURE 2018; 22:258-270. [PMID: 31371911 PMCID: PMC6671864 DOI: 10.1007/s12119-017-9465-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Strong gay identity among white men who have sex with men (MSM) has been associated with decreased HIV risk, but data for black and Latino MSM (BLMSM) are inconclusive. We examined gay identity and HIV risk among BLMSM to inform social and structural HIV intervention strategies. BLMSM were administered a computerized survey as part of an HIV research study during 2011-2012 conducted in New York City. We used a brief scale of Gay Identity Questionnaire. After data analysis, Stage I (not fully accepting) and Stage II (fully accepting) gay identity were determined based on participant responses. We used logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between gay identity with HIV risk and social determinant factors. Among 111 self-identified BLMSM (median age = 32 years, 68.4% with some college or higher education), 34.2 reported receptive anal sex without condoms in the previous three months. Gay Identity Questionnaire Scale assessment indicated that 22 (19.8%) were Stage I, and 85 (76.6%) were Stage II in this BLMSM sample. Stage II gay identity was more likely seen among BLMSM with high involvement in the gay community (aOR 3.2; CI 1.00, 10.26) and less likely among BLMSM who exchanged sex for food or shelter (aOR 0.15; CI 0.02, 0.98). Fully accepting gay identity may be protective for BLMSM as it relates to transactional sex; these factors warrant further research and consideration as part of HIV prevention strategies.
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Affiliation(s)
- Kirk D. Henny
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA 30329, USA
| | - Jose Nanin
- Community Health Program at Kingsborough Community College, City University York, New York City, NY, USA
| | | | - Ashley Murray
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA 30329, USA
| | - Madeline Y. Sutton
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-45, Atlanta, GA 30329, USA
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Daniel-Ulloa J, Ulibarri M, Baquero B, Sleeth C, Harig H, Rhodes SD. Behavioral HIV Prevention Interventions Among Latinas in the US: A Systematic Review of the Evidence. J Immigr Minor Health 2018; 18:1498-1521. [PMID: 26467788 DOI: 10.1007/s10903-015-0283-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Compared to White women, Latinas are 4 times more likely to contract HIV. In an effort to determine the overall state of the science meant to address this disparity, we reviewed the current HIV prevention intervention literature for U.S. Latinas. We searched 5 online electronic databases from their inception through July, 2014, for HIV prevention interventions including a majority sample of Latinas. Of 1041 articles identified, 20 studies met inclusion criteria. We documented study designs, participant characteristics, outcomes, theories used, and other intervention characteristics. Overall, HIV knowledge and attitudes were the predominant outcome; a small minority of studies included self-reported condom use or STD incidence. Strategies used to address cultural factors specific to Latinas and HIV included; lay health advisors, using ethnographic narratives, or using the Theory of Gender and Power, however few of the interventions adopted these strategies. This study identified several gaps in the intervention literature that need to be addressed. In addition to including more direct measures of decreased HIV risk (ex. condom use), more systematic use of strategies meant to address gender and cultural factors that may place Latinas at increased risk (e.g., gender inequity, traditional gender role norms such as machismo and marianismo, and relationship power dynamics).
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Affiliation(s)
- Jason Daniel-Ulloa
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA. .,University of Iowa, Prevention Research Center, Iowa City, IA, USA. .,Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - M Ulibarri
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - B Baquero
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA.,University of Iowa, Prevention Research Center, Iowa City, IA, USA
| | - C Sleeth
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA.,University of Arizona College of Medicine, Tucson, AZ, USA
| | - H Harig
- University of Iowa, Prevention Research Center, Iowa City, IA, USA
| | - S D Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Murray A, Gaul Z, Sutton MY, Nanin J. "We hide…": Perceptions of HIV Risk Among Black and Latino MSM in New York City. Am J Mens Health 2017; 12:180-188. [PMID: 29161954 PMCID: PMC5818124 DOI: 10.1177/1557988317742231] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Black and Latino men who have sex with men (BLMSM) are disproportionately infected with HIV; they comprised 66% of HIV diagnoses among men who have sex with men (MSM) in the United States in 2015. Risk factors for HIV infection among BLMSM include a high community prevalence of diagnosed and undiagnosed HIV/STDs, and dense sex partner networks. Perceptions of HIV risk among BLMSM were explored to inform HIV prevention efforts. During 2011-2012, semistructured interviews were conducted with BLMSM in New York City. Using computer-assisted thematic analyses (NVivo), transcribed interview responses to questions regarding HIV risk for main themes were examined. Interview data were available for 108 BLMSM: 86% Black, 13% Latino, 26% aged 18-24 years, 59% self-identified as "gay," and 33% self-identified as "bisexual." The main emergent theme was stigma. Subthemes related to stigma included: (a) homophobia in the Black and Latino community, (b) fear of losing support from family and friends, and (c) lack of support leading to low self-esteem. Addressing the stigma felt by BLMSM may be an important strategy to facilitate improved HIV prevention efforts, HIV care and treatment, and to decrease HIV-related disparities.
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Affiliation(s)
- Ashley Murray
- 1 Division of HIV/AIDS Prevention, NCHHSTP, CDC, Atlanta, GA, USA
| | - Zaneta Gaul
- 1 Division of HIV/AIDS Prevention, NCHHSTP, CDC, Atlanta, GA, USA.,2 ICF, Atlanta, GA, USA
| | | | - Jose Nanin
- 3 Kingsborough Community College, CUNY, New York, NY, USA
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20
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Martinez O, Lee JH, Bandiera F, Santamaria EK, Levine EC, Operario D. Sexual and Behavioral Health Disparities Among Sexual Minority Hispanics/Latinos: Findings From the National Health and Nutrition Examination Survey, 2001-2014. Am J Prev Med 2017; 53:225-231. [PMID: 28284748 PMCID: PMC5567737 DOI: 10.1016/j.amepre.2017.01.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/22/2016] [Accepted: 01/23/2017] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Hispanics/Latinos (henceforth, Latinos) are the largest minority group in the U.S. With growing health disparities among this group, the highest burden remains among sexual and gender minority Latinos. Differences regarding sexual orientation have not been fully explored within this group using national representative samples. This study analyzed sexual and behavioral health disparities associated with sexual minority status among Latinos in the U.S. METHODS The study included data from 5,598 Latino adults who participated in the 2001-2014 waves of the National Health and Nutrition Examination Survey. Data analysis was conducted in 2016. Bivariate and multivariable logistic regression analyses examined the prevalence of HIV, sexually transmitted infections, mental health problems, cigarette smoking, and alcohol/illicit drug use among sexual minorities and heterosexual Latino adults. Sexual minorities were defined as "gay, lesbian, and bisexual" (GLB) and "other" non-heterosexual groups. RESULTS GLB Latinos reported higher prevalence of mental health problems and cigarette smoking compared with heterosexuals. After adjusting for covariates, GLB Latinos had greater odds of testing positive for HIV, lifetime diagnosis of sexually transmitted infections, poor mental health outcomes, cigarette smoking (including lifetime and current smoking status), and illicit drug use than heterosexuals. CONCLUSIONS The disproportionate impact of health disparities among Latinos varies significantly by sexual orientation, with GLB individuals facing elevated prevalence. In particular, elevated odds for HIV/sexually transmitted infections, mental health problems, smoking, and illicit substance use were found. Further research, including longitudinal studies to understand the trajectories of risks, is needed to identify intervention opportunities in this population.
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Affiliation(s)
- Omar Martinez
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania.
| | - Ji Hyun Lee
- School of Public Health, Brown University, Providence, Rhode Island
| | - Frank Bandiera
- School of Public Health, University of Texas, Dallas, Texas
| | | | - Ethan C Levine
- School of Social Work, College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Don Operario
- School of Public Health, Brown University, Providence, Rhode Island
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21
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Disparities Within the Disparity-Determining HIV Risk Factors Among Latino Gay and Bisexual Men Attending a Community-Based Clinic in Los Angeles, CA. J Acquir Immune Defic Syndr 2017; 73:237-44. [PMID: 27163174 DOI: 10.1097/qai.0000000000001072] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Latino gay, bisexual, and other men who have sex with men (MSM) in the United States have a 50% greater incidence of HIV when compared with White MSM. Previous studies have analyzed factors contributing to condomless anal intercourse among Latino MSM, but few studies have followed cohorts of HIV-negative Latino MSM to determine circumstances for HIV infection. Informed by Syndemics theory, we examine behavioral, biological, and contextual factors associated with HIV infection for Latino MSM. METHODS Risk assessment and HIV testing data were analyzed for all initially HIV negative, Latino MSM (n = 3111) visiting a community-based clinic in Los Angeles, CA from January 2009 to June 2014. Survival analyses were used to determine characteristics of Latino MSM who became HIV positive during the study time frame. RESULTS Similar to previous studies of MSM, self-reported history of chlamydia, gonorrhea, and/or syphilis (adjusted hazard ratio (aHR): 1.97; CI: 1.28 to 3.04), receptive condomless anal intercourse (aHR: 1.7; CI: 1.16 to 2.49), and methamphetamine use (aHR: 1.99; CI: 1.15 to 3.43) predicted HIV infection. In addition, originating from Central America (aHR: 2.31; CI: 1.41 to 3.79), Latino ethnicity of the last sex partner (aHR: 1.67; CI: 1.16 to 2.39) and experiencing intimate partner violence (IPV) (aHR: 1.73; CI: 1.13 to 2.64) were also associated with HIV infection among Latino MSM. CONCLUSIONS This is the first study to show independent associations between IPV and HIV infection among Latino MSM. This study shows that psychosocial conditions such as IPV fuel HIV incidence among Latino MSM, and psychosocial interventions should be considered to reduce HIV disparities among Latino MSM.
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Factors Associated with Sexual Risk of HIV Transmission Among HIV-Positive Latino Men Who have Sex with Men on the U.S.-México Border. AIDS Behav 2017; 21:923-934. [PMID: 27278549 DOI: 10.1007/s10461-016-1449-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We present results from a cross-sectional, clinic-based survey of border-region Latino men who have sex with men (MSM) and who also are living with HIV in the El Paso-Ciudad Juárez area. Among the 66 participants who reported serodiscordant anal or vaginal intercourse, we examined levels of psychological distress and substance use and the association of these variables with condomless sex. Bivariate analyses indicated that MSM who reported condomless sex with a serodiscordant partner were more likely to report higher scores on measures of anxiety, depression, and trauma. These men were also more likely to report more days of alcohol use to the point of intoxication. In multivariate logistic regression, no variables were independently associated with sexual risk behavior, but symptoms of anxiety trended toward statistical significance. Our study is one of few reports aimed at understanding the HIV epidemic among Latino MSM living with HIV in the El Paso-Ciudad Juárez border region. Although we found no evidence of a relation between our measures of psychological distress and substance use and sexual risk behavior in multivariate analyses, psychological distress and problematic alcohol use were common in the sample and are important targets for intervention in their own right.
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Lewis NM, Wilson K. HIV risk behaviours among immigrant and ethnic minority gay and bisexual men in North America and Europe: A systematic review. Soc Sci Med 2017; 179:115-128. [PMID: 28260636 DOI: 10.1016/j.socscimed.2017.02.033] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 01/19/2017] [Accepted: 02/22/2017] [Indexed: 02/07/2023]
Abstract
HIV surveillance systems show that gay, bisexual, and other men who have sex with men (MSM) bear a disproportionate burden of HIV in North American and European countries. Within the MSM category, HIV prevalence is often elevated among ethnic minority (i.e., Latino, Asian, and Black) MSM, many of whom are also foreign-born immigrants. Little research has focused specifically on foreign-born populations, though studies that provide data on the nativity of their samples offer an opportunity to investigate the potential role of transnational migration in informing HIV risk among ethnic minority MSM. This systematic review of ethnic minority MSM studies where the nativity of the sample is known provides a robust alternative to single studies measuring individual-level predictors of HIV risk behaviour. In this review, HIV prevalence, unprotected sex, drug use, and HIV testing are analysed in relation to the ethnicity, nativity, and location of the samples included. The results, which include high rates of HIV, unprotected sex, and stimulant use in foreign-born Latino samples and high rates of alcohol and club drug use in majority foreign-born Asian Pacific Islander (API) samples, provide baseline evidence for the theory of migration and HIV risk as syndemics within ethnic minority populations in North American and European countries. The findings also suggest that further research on the contextual factors influencing HIV risk among ethnic minority MSM groups and especially immigrants within these groups is needed. These factors include ethnic networks, individual post-migration transitions, and the gay communities and substance use cultures in specific destination cities. Further comparative work may also reveal how risk pathways differ across ethnic groups.
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Affiliation(s)
- Nathaniel M Lewis
- Geography & Environment, University of Southampton, 2508 Shackleton, Highfield Campus, Southampton, SO17 1BJ, UK.
| | - Kathi Wilson
- Department of Geography & Programs in Environment, University of Toronto Mississauga, Canada
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Flórez KR, Derose KP, Breslau J, Griffin BA, Haas AC, Kanouse DE, Stucky BD, Williams MV. Acculturation and Drug Use Stigma Among Latinos and African Americans: An Examination of a Church-Based Sample. J Immigr Minor Health 2017; 17:1607-14. [PMID: 25612923 DOI: 10.1007/s10903-015-0161-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Substance use patterns among Latinos likely reflect changes in attitudes resulting from acculturation, but little is known about Latinos' attitudes regarding drug addiction. We surveyed a church-based sample of Latinos and African Americans (N = 1,235) about attitudes toward drug addiction and socio-demographics. Linear regression models compared Latino subgroups with African-Americans. In adjusted models, Latinos had significantly higher drug addiction stigma scores compared to African Americans across all subgroups (US-born Latinos, β = 0.22, p < .05; foreign-born Latinos with high English proficiency, β = 0.30, p < .05; and foreign-born Latinos with low English proficiency, β = 0.49, p < .001). Additionally, Latinos with low English proficiency had significantly higher mean levels of drug use stigma compared Latinos with high proficiency (both foreign-born and US-born). In this church-affiliated sample, Latinos' drug addiction stigma decreases with acculturation, but remains higher among the most acculturated Latinos compared to African-Americans. These attitudes may pose a barrier to treatment for Latino drug users.
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Affiliation(s)
- Karen R Flórez
- Health Program, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA.
| | - Kathryn Pitkin Derose
- Health Program, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | | | | | | | - David E Kanouse
- Health Program, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | - Brian D Stucky
- Health Program, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
| | - Malcolm V Williams
- Health Program, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407-2138, USA
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Mizuno Y, Purcell DW, Knowlton AR, Wilkinson JD, Gourevitch MN, Knight KR. Syndemic vulnerability, sexual and injection risk behaviors, and HIV continuum of care outcomes in HIV-positive injection drug users. AIDS Behav 2015; 19:684-93. [PMID: 25249392 DOI: 10.1007/s10461-014-0890-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Limited investigations have been conducted on syndemics and HIV continuum of care outcomes. Using baseline data from a multi-site, randomized controlled study of HIV-positive injection drug users (n = 1,052), we examined whether psychosocial factors co-occurred, and whether these factors were additively associated with behavioral and HIV continuum of care outcomes. Experiencing one type of psychosocial problem was significantly (p < 0.05) associated with an increased odds of experiencing another type of problem. Persons with 3 or more psychosocial problems were significantly more likely to report sexual and injection risk behaviors and were less likely to be adherent to HIV medications. Persons with 4 or more problems were less likely to be virally suppressed. Reporting any problems was associated with not currently taking HIV medications. Our findings highlight the association of syndemics not only with risk behaviors, but also with outcomes related to the continuum of care for HIV-positive persons.
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Affiliation(s)
- Yuko Mizuno
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE Mail Stop E37, Atlanta, GA, 30333, USA,
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Martinez O, Wu E, Sandfort T, Shultz AZ, Capote J, Chávez S, Moya E, Dodge B, Morales G, Porras A, Ovejero H. [A couple-based approach: An innovative effort to tackle HIV infection among Latino gay men.]. EHQUIDAD 2014; 1:15-32. [PMID: 25580466 PMCID: PMC4286892 DOI: 10.15257/ehquidad.2014.0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The HIV epidemic is a serious and pervasive health issue in the Latino community. While prevention efforts have helped maintain stability in the overall number of infections among Latinos for more than a decade, this population continues to be affected by HIV at high levels. In particular, Predominantly Spanish-speaking Latino men who have sex with men (MSM) are disproportionately impacted by HIV. Several factors contribute to the HIV epidemic among Predominantly Spanish-speaking Latino MSM including substance use; intimate partner violence; the presence of certain STIs; same-sex relationship dynamics; avoidance of seeking testing counseling and treatment out of fear of discrimination and immigration status; and poverty, migration patterns, and language barriers. In particular, epidemiological behavioral research has identified how relationship dynamics in male couples are associated with sexual risk behavior. Consequently, further research is needed to identify and deliver interventions geared toward couple-based risk reduction among men in same-sex relationships. This paper describes the potential significance that innovative couple-based approaches can have on reducing HIV and AIDS cases among Predominantly Spanish-speaking Latino MSM and their same-sex partners.
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Affiliation(s)
- Omar Martinez
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University
| | - Elwin Wu
- School of Social Work at Columbia University
| | - Theo Sandfort
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University
| | - Andrew Z. Shultz
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University
| | - Jonathan Capote
- Communications and Development Assistant at AID for AIDS International
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