Acculturation, sexual behavior, and alcohol use among Latinas

Examining the Measurement Invariance of the Revised Sociosexual Orientation Inventory Among Hispanic and Non-Hispanic White College Women in the U.S

The Revised Sociosexual Orientation Inventory (SOI-R) is a widely used measure in research, yet the invariance of this measure has not been established in English speaking Non-Hispanic White (NHW) and Hispanic/Latine populations. This study examined whether the SOI-R, a measure developed in Germany, was invariant between US Hispanic/Latina (N = 208) and NHW (N = 190) undergraduate women. Confirmatory factor analysis (CFA) was used to assess model fit in the Hispanic/Latina and NHW samples and fit of increasingly restrictive models was used to test configural, metric, scalar, and residual invariance of the models in both samples. CFA results revealed that data from both the Hispanic/Latina and NHW groups fit the model adequately in this sample, which consisted of highly acculturated Hispanic/Latina college women. Tests of measurement invariance found that the SOI-R was invariant across Hispanic/Latina and NHW college women. However, questions about the development of the SOI-R and the underlying assumptions made during the course of its development might be considered prior to the use of the measure in research, and further invariance testing should be conducted in future work with less acculturated Hispanic/Latine populations.

A Critical Review and Meta-Analysis of the Associations Between Acculturation and Alcohol Use Outcomes Among Hispanic Americans

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.

Effects of Acculturation and Psychopathology on Sexual Behavior and Substance Use of Suicidal Hispanic Adolescents

Two theoretical constructs of acculturation (high vs. low and biculturalism) were compared across adolescent risk behaviors among a seldom-studied group of Hispanic adolescents, 70% of whom were from the Dominican Republic. The sample consisted of 116 consecutively referred suicidal adolescentfemales who were assessed on diagnostic, acculturative, and risk behavior instruments. Hierarchical regressions were carried out separately for sexual behavior and substance use. Biculturalism (OR = 1.18, p < .01) and substance use (OR = 1.47, p <.01) were uniquely associated with sexual intercourse. High acculturation (R2 = .37, p <.001) and psychopathology as a block (R2 = .12, p <.01) were associated with greater use of substances (cigarettes, alcohol, and marijuana). Results suggest that acculturative status is an important indicator of high-risk activity and may vary across behavioral contexts. This is the first known report of an association between biculturalism and sexual behavior in Hispanic adolescent girls.

Alcohol use among Latino migrant workers in South Florida

BACKGROUND

A significant segment of the Latino migrant worker population in the United States is at high risk for alcohol abuse and related risk behaviors. Information about the prevalence of alcohol use and abuse and its association with sociodemographic and psychological variables is needed for designing effective intervention prevention strategies.

METHODS

Cross-sectional data were drawn from a baseline assessment that was part of a randomized controlled trial of 278 Latino migrant workers (LMWs) conducted between 2008 and 2010.

RESULTS

About one-third (32%) of participants engaged in heavy drinking in the past 30 days prior to baseline interview. More females than males reported no alcohol use in the past 30 days (53.5% vs. 20.5%). On the other hand, more males reported drinking every day or nearly (25.2% vs. 7.1%). Five factors-gender, country of origin, relationship status, living arrangements, and acculturation-were significantly associated with frequency of alcohol consumption. Multivariate analyses indicated that gender, country of origin, education attainment, relationship status, living arrangement, living with children, length of stay in the US, religious beliefs, acculturation, and depression were associated with frequent heavy drinking, alcohol abuse/dependence, and unprotected sex under the influence of alcohol.

CONCLUSIONS

There is significant variation in alcohol use among Latino migrant workers. Although a substantial proportion of this population abstains from alcohol, an equally substantial proportion report levels of alcohol use that pose significant risk. More research is needed to better understand drinking patterns in this community in order to design prevention strategies specifically tailored for this population.

Condom use among immigrant Latino sexual minorities: multilevel analysis after respondent-driven sampling

This study explored correlates of condom use within a respondent-driven sample of 190 Spanish-speaking immigrant Latino sexual minorities, including gay and bisexual men, other men who have sex with men (MSM), and transgender person, in North Carolina. Five analytic approaches for modeling data collected using respondent-driven sampling (RDS) were compared. Across most approaches, knowledge of HIV and sexually transmitted infections (STIs) and increased condom use self-efficacy predicted consistent condom use and increased homophobia predicted decreased consistent condom use. The same correlates were not significant in all analyses but were consistent in most. Clustering due to recruitment chains was low, while clustering due to recruiter was substantial. This highlights the importance accounting for clustering when analyzing RDS data.

Acculturation and HIV-related sexual behaviours among international migrants: a systematic review and meta-analysis

This review examines the global literature regarding the relationship between acculturation and HIV-related sexual behaviours among international migrants. Seventy-nine articles published in English-language journals prior to July 2012 met the criteria for inclusion. We conducted a systematic review and subset meta-analysis of correlations between acculturation and five types of sexual behaviours including condom use, multiple partnerships, early sexual initiation, sexually transmitted diseases (STDs) and other unsafe sexual practices. Immigrants high in mainstream acculturation were more likely to have multiple partnerships, early sexual initiation, STDs and unsafe sex (rs ranged from 0.10 to 0.16), but acculturation was not associated with condom use (r = 0.02). Gender moderated the relationships between acculturation and multiple partnerships, STDs and unsafe sex. The relationship between acculturation and unsafe sex also varied across ethnicity. These findings suggest that acculturation may serve as a risk factor towards immigrants' HIV-related sexual health. We offered a theoretical framework and suggested applying cross-cultural and longitudinal designs in future research on acculturation and health behaviours.

Latina adolescent suicide ideations and attempts: associations with connectedness to parents, peers, and teachers

Associations between suicidal behavior and social-ecological variables were examined among 1,618 Latina high school students (mean age = 15) from the nationally representative Add Health sample (68% were U.S.-born). Ideations were associated with having a suicidal friend, lower perceived father support, and overall parental caring. Attempts were associated with having a suicidal friend, and lower perceived teacher and parental support. Peer and mother relationship variables were not predictors of ideations or attempts. The protective role of father and teacher support has not previously been emphasized in the literature. Strengthening connections to parents and teachers may reduce suicidal behavior in adolescent Latinas.

Defining and measuring acculturation: a systematic review of public health studies with Hispanic populations in the United States

In this systematic review we sought to identify how the public health literature focusing on Hispanic populations in the United States defined and measured the concept of acculturation. A review of 134 studies found considerable variation in the definition and measurement of this construct. The ten acculturation scales used provided little theoretical orientation. It was unclear the extent to which acculturative changes in attitudes, beliefs and behaviors were captured by current measurement tools, as these primarily measure linguistic elements. We suggest future research should refine existing tools, determine their validity and usefulness across ethnic and subethnic groups, and identify which aspects of acculturation these scales and indices reliably measure. Recommendations for use of acculturation instruments in public health practice with Hispanic populations are included.

HIV prevention with Mexican migrants: review, critique, and recommendations

Charged with the task of reviewing the research outcome literature on HIV prevention with Mexican migrants in the United States, the following broad observations and conclusion were made: (1) there is little research on this specialized topic of concern; (2) the research that exists reflects an overly individualistic behavioral science approach designed to reduce individual risk factors, with little regard for structural and environmental factors that influence HIV risk; and (3) there is a compelling need to develop better theoretic frameworks for understanding the complex and dynamic social and cultural processes influencing sexual behavior among Mexican migrants so as to better inform HIV prevention efforts with this unique and diverse Latino(a) population.

Sociodemographic differences in access to care among Hispanic patients who are HIV infected in the United States

This study evaluated associations between sociodemographic factors and access to care, use of highly active antiretroviral therapy, and patients' ratings of care among Hispanic patients who are HIV infected; we used data from the HIV Cost and Services Utilization Study. Gender, insurance, mode of exposure, and geographic region were associated with access to medical care. Researchers and policymakers should consider sociodemographic factors among Hispanic patients who are HIV positive when designing and prioritizing interventions to improve access to care.

Condom use among Latino college students

Recent reports indicate that Latinos, the largest racial/ethnic minority group in the United States, are disproportionately affected by HIV and AIDS. College health professionals, therefore, should understand current sexual behaviors and risk factors among Latino youth. The authors assessed students' condom use at their most recent sexual encounter by using data from those students who reported oral, vaginal, or anal sex during the last 30 days. Fewer than half of recently sexually active Latino students had used condoms during their last oral (4.9%), vaginal (41.3%), or anal (27.8%) sexual encounter. Predictors of condom use varied according to the type of sexual activity. Findings from this exploratory study offer current information about condom use and sexual behaviors among Latino college students and suggest that prevention interventions and messages should be tailored to students' gender and types of sexual activity.

Determinants of coping responses among Mexican American adolescents

This study examined relationships among perceived stress, self-esteem, acculturation, and gender with the coping response of 472 Mexican American adolescents aged 14 to 16 years. Subjects were drawn from a predominantly Mexican American population located in the Lower Rio Grande Valley region of Texas. Data were collected through a self-report instrument consisting of perceived stress, acculturative status, self-esteem, and coping strategy scales. Subjects reported relatively high perceived stress levels, low acculturation, and moderate self-esteem scores with no significant gender differences. Analysis revealed self-esteem as most predictive of a more effective overall coping response. Results suggest Mexican American adolescents possessing high self-esteem are less likely to encounter damage to their sense of self when confronted with stressors, thus allowing for productive coping.

Challenges and strategies for conducting intervention research with culturally diverse populations

Conducting intervention research with culturally diverse, underserved, and often hard to reach populations in naturalistic or field settings presents investigators with a number of practical challenges. This article describes four special challenges and strategies for dealing with them that clients, service providers, and researchers experienced in conducting a prevention intervention to reduce substance use and sexual risky behaviors with low-income Latina young women. The challenges are (a) building community partnerships; (b) developing interventions that are acceptable and relevant; (c) promoting successful recruitment, participation, and retention of participants; and (d) developing a diverse, cohesive, and committed research team and effective managerial information support systems.

Acculturation and interrelationships between problem and health-promoting behaviors among Latino adolescents

PURPOSE

To examine: (a) the effects of acculturation on a healthy lifestyle including problem behaviors (substance use and sex acts) and health-promoting behaviors (e.g., seat belt use, vitamin intake, hours of sleep per night) and (b) the interrelationships among problem and health-promoting behaviors among Latino adolescents.

METHODS

Face-to-face interviews were conducted with Latino adolescents (n = 609) with questions covering the following areas: acculturation, sociodemographics, problem behaviors, and health-promoting behaviors. The participants ranged in age from 11 to 19 (mean = 15) years. Bivariate correlations and factor analyses were used to examine the relationship between problem and health-promoting behaviors. A combination of one-way analyses of variance (ANOVAs), Chi-square tests, and Student's t-tests were used to analyze the effects of acculturation on problem and health-promoting behaviors.

RESULTS

Higher levels of acculturation were associated with an increased likelihood of exhibiting problem behaviors and a decreased likelihood of exhibiting certain health-promoting behaviors. Foreign-born Latinos were significantly less likely to engage in problem behaviors. Problem behaviors were likely to co-occur; however, the co-occurrence of health-promoting behaviors was not evident. The results also revealed the co-occurrence of problem behaviors with selected health-promoting behaviors.

CONCLUSIONS

Among Latino adolescents, there seems to be evidence that problem behaviors and certain health-promoting behaviors do co-occur. To the extent that "healthy lifestyles" are conceptualized as the presence of health-promoting behaviors and the absence of problem behaviors, less acculturated Latino adolescents seem to fare better than those that are more acculturated. Interventions to promote "healthy lifestyles" among Latino adolescents should be tailored to take into consideration the effect of acculturation.

Predictors of risk for sexually transmitted diseases in ninth grade urban high school students

This study examined risk factors associated with acquisition of sexually transmitted diseases (STDs) including HIV in adolescents, using the AIDS Risk Reduction Model. The study participants were 985 students who were 54% female, ethnically/racially diverse, had a mean age of 14.7 years, and were mostly 9th graders (74%). Logistic regression was used to predict sexual experience. Linear regression was used to predict risky sexual behaviors and condom use within the previous month. The results indicate that demographic factors are associated with being sexually experienced, but few demographics are associated with specific STD-related risk behaviors. STD and AIDS knowledge are not associated with any risk behaviors. Use of alcohol and drugs is associated significantly with being sexually experienced and sexual risk. The results also indicate that peer affiliation, perceptions of peer norms, perceptions of risk, perceptions of self-efficacy, and social support are associated with STD-related risk among sexually experienced youth.

Competence and drug use: theoretical frameworks, empirical evidence and measurement

Statistics show that use of harmful substances (alcohol, cigarettes, marijuana, cocaine) among women of childbearing age is widespread and serious. Numerous theoretical models and empirical studies have attempted to explain the complex factors that lead individuals to use drugs. The Social Stress Model of Substance Abuse [1] is one model developed to explain parameters that influence drug use. According to the model, the likelihood of an individual engaging in drug use is seen as a function of the stress level and the extent to which it is offset by stress modifiers such as social networks, social competencies, and resources. The variables of the denominator are viewed as interacting with each other to buffer the impact of stress [1]. This article focuses on one of the constructs in this model: that of competence. It presents a summary of theoretical and conceptual formulations for the construct of competence, a review of empirical evidence for the association of competence with drug use, and describes the preliminary development of a multi-scale instrument designed to assess drug protective competence among low-income Hispanic childbearing women. Based upon theoretical and empirical studies, eight domains of drug protective competence were identified and conceptually defined. Using subscales from existing instruments with psychometric evidence for their validity and reliability, a multi-scale instrument was developed to assess drug protective competence. Hypothesis testing was used to assess construct validity. Four drug protective competence domains (social influence, sociability, self-worth, and control/responsibility) were found to be statistically associated with drug use behaviors. Although not statistically significant, expected trends were observed between drug use and the other four domains of drug protective competence (intimacy, nurturance, goal directedness, and spiritual directedness). Study limitations and suggestions for further psychometric testing of the instrument are described.

Personality differences between endometrial and cervical cancer patients in relation to sexual behavior

Possible differences in personality were investigated in a sample of endometrial (n = 30) and cervical (n = 30) cancer patients and related to sexual behavior. The assessments were based on the Karolinska Scales of Personality (KSP) and semistructured interviews. The endometrial group reported both a higher age at sexual debut and a lower number of sexual partners whereas the corresponding figures for the cervical group were within the range of representative data from the general population. Strikingly, numerous significant correlations between personality characteristics and behavioral aspects appeared in the cervical group. In a discriminant analysis between the two cancer groups, verbal aggression, number of sexual partners, irritability, use of alcohol, age at sexual debut, impulsivity and social desirability appeared to be the most powerful variables. In view of the similarity of cervical cancer women in terms of personality and sexual behavior to normative data the elaboration of adequate and large-scale preventive measures aimed at young age groups is warranted.

HIV risk factors, condom use, and HIV antibody testing among heterosexual Hispanics: the National AIDS Behavioral Surveys (NABS)

The rate of HIV infection and AIDS cases among heterosexual Hispanics is increasing. Data from a national probability survey of HIV-related risk factors among 4,390 heterosexual Hispanics in the 1990-1991 National AIDS Behavioral Surveys reveal that 164% of respondents reported an HIV risk factor; of these, 35.3% had been tested for HIVl Multiple sex partners and risky main sexual partner were the major risk factors. Men and middle-income Hispanics reported a higher prevalence of HIV testing. Half of those at highest riskfor HIV infection had neither been tested for HlV antibody nor had used condoms to protect themselves. The results suggest that HIV infection poses a great threat, particularly among certain heterosexual Hispanic subgroups where condom use and HIV testing is relatively low, illustrating the extreme need for developing new HIV prevention strategies among specific Hispanic risk groups.