The complex pattern of associations with heavy and/or problematic substance use among urban MSM suggests that heavy and/or problematic substance use is grounded in multiple levels: the individual, the interpersonal and the socio-cultural.

OBJECTIVES: This study assessed the relation between experiences of social discrimination (homophobia, racism, and financial hardship) and symptoms of psychologic distress (anxiety, depression, and suicidal ideation) among self-identified gay and bisexual Latino men in the United States. METHODS: Data were collected from a probability sample of 912 men (self-identified as both Latino and nonheterosexual) recruited from the venues and public social spaces identified as both Latino and gay in the cities of Miami, Los Angeles, and New York. RESULTS: The study showed high prevalence rates of psychologic symptoms of distress in the population of gay Latino men during the 6 months before the interview, including suicidal ideation (17% prevalence), anxiety (44%), and depressed mood (80%). In both univariate and multivariate analyses, experiences of social discrimination were strong predictors of psychologic symptoms. CONCLUSIONS: The mental health difficulties experienced by many gay and bisexual Latino men in the United States are directly related to a social context of oppression that leads to social alienation, low self-esteem, and symptoms of psychologic distress.

Based on data from a probability sample of 912 Latino gay men in 3 U.S. cities, a multivariate model of sexual risk was tested, including experiences of homophobia, racism, and poverty as predictors. Participants reported multiple instances of verbal and physical abuse, rude mistreatment, and discrimination on account of their sexual orientation and their race or ethnicity. Many reported experiences of poverty, such as inability to pay for basic necessities of food or shelter. Men who reported more instances of social discrimination and financial hardship were more psychologically distressed and more likely to participate in "difficult" sexual situations, as predicted. Participation in difficult sexual situations mediates the effects of social oppression and psychological distress on sexual risk behavior.

Epidemiologists have shown how birth outcomes are generally robust for immigrant Latina mothers, despite often situated in poor households, advanced by their strong prenatal and nutritional practices. But little is known about (1) how

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The social and sexual lives of many Latino gay men have been impacted by three socially oppressive forces-homophobia, poverty, and racismthat, acting in an unfortunate synchrony, tend to produce devastating experiences of social alienation and personal shame. Although many men have responded to the oppression with creative acts of personal agency, ranging from committed social activism to acts of personal heroism, others have been deeply troubled and debilitated by financial hardship, family rejection, and discriminatory practices that prevent their fair participation in professional life and in the gay community.Because a relationship between social discrimination and poor health outcomes has been well documented (Krieger, 1999;Williams, Neighbors, &. Jackson, 2003), it is expected that the experience of triple oppression

This study examined four types of predictors of sexual risk within a sample of 110 predominantly English-speaking Latino gay/bisexual men residing in the city of San Francisco. More than one fourth of the sample reported at least one instance of unprotected anal intercourse in the last 30 days; one fifth of the sample reported unprotected anal intercourse with a nonmonogamous sexual partner within the same time period. Findings suggest that weak personal intentions for safer sex and low levels of perceived selfefficacy are associated with risky sexual practices. In addition, a history of sexual abuse in childhood, drug use during sexual activity, and frequency of sex in public cruising environments emerged as significant predictors of sexual risk. Multivariate analyses indicated that a four-predictor model (including a young age, low levels of intention/self-efficacy, a high frequency of sex under the influence of drugs, and a high frequency of sex with nonmonogamous partners) is the most parsimonious model to predict sexual risk in this population. A history of childhood sexual abuse correlated positively with all predictors of risk in the model, except age.In five different studies of gay/bisexual men in the United States, Latinos have reported the highest rates of sexual risk behavior, even when compared

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