A community-based rapid assessment of HIV behavioural risk disparities within a large sample of gay men in southeastern USA: A comparison of African American, Latino and white men

Abstract

Because the southeastern USA is experiencing a disproportionate HIV infection rate compared to other regions of the country, we explored HIV behavioural risk disparities by race/ethnicity among self-identifying gay men. Conceived and implemented as a community-based participatory research (CBPR) study, this rapid assessment collected demographic and HIV risk-behaviour data from men in five gay bars in the northwestern part of the state of North Carolina, using an assessment available in English and Spanish. Of 719 participants, 34.8% reported inconsistent condom use during anal intercourse in the past three months, 11.4% reported ever having had a sexually transmitted disease (STD), 3.6% reported being HIV-seropositive and 26% reported illicit drug use during the past 30 days. Compared to white participants, African American/black and Hispanic/Latino participants were more likely to report inconsistent condom use during anal intercourse with multiple partners during the past three months. African American/black participants were more likely to report illicit drug use during the past 30 days. Hispanic/Latino participants were more likely to have never been tested for HIV. Rates of HIV risk behaviours among gay men remain high and racial/ethnic differences indicate the need for targeted and tailored prevention strategies.

Predictors of Unprotected Sex among Young Sexually Active African American, Hispanic, and White MSM: The Importance of Ethnicity and Culture

“…Unfortunately, we did not link reports of unprotected sex with partner type; therefore, we are unable to determine if unprotected sex was with their primary partner or a casual partner. Nonetheless, our findings could suggest that prevention messages are not effectively reaching African American youth and conveying the importance of protecting oneself, even within a long-term relationship (Rhodes et al 2006). The finding that having been kicked out of home because of sexual orientation was correlated with unprotected sex only among African Americans could be reflective of the importance of a sense of community and belonging within the African American community, especially with respect to family (Williams et al 2004;Jiminez 2003;Stokes and Peterson 1998;Whitehead 1997;Billingsley and Caldwell 1991).…”

“…Cultural variations in attitudes towards and practices of condom use have been demonstrated among adult MSM (Harawa et al 2004;Rhodes et al 2006). A number of factors have been associated with inconsistent condom use among African American and Hispanic MSM; however, ethnic differences in the predictors of unprotected sex have been reported.…”

“…For instance, from 1999 to 2004 in states with HIV name reporting the number of new HIV infections among MSM aged 13-24 increased 48% (Rangel et al 2006). YMSM who are also African American or Hispanic are at elevated risk for HIV infection above their non-minority peers (Hall et al 2007;Harawa et al 2004;Rhodes et al 2006). Results from the Young Men's Survey (a multisite HIV prevalence study) revealed that while White YMSM ages 15-22 had an overall HIV prevalence of 3.3%, African American and Hispanic YMSM had much higher rates, with 6.9% of Hispanics and 14.1% of African Americans testing positive for HIV (Valleroy et al 2000).…”

How Do the Sexual Behaviors of Foreign-Born Hispanic Men Who Have Sex With Men Differ by Relationship Status?

“…Fewer studies, however, have focused on Hispanic MSM. Rhodes, Yee, and Hergenrather (2006) conducted a study that surveyed African American, Caucasian, and Hispanic MSM. The researchers found that Hispanic MSM were more likely to report inconsistent condom usage during anal intercourse and were less likely than the other groups of MSM to be tested for HIV infection.…”

Latinos and HIV/AIDS: Examining Factors Related to Disparity and Identifying Opportunities for Psychosocial Intervention Research

“…Such community-based approaches may be successful in reaching Latinos who are otherwise unlikely to access conventional services. For example, one group has examined the feasibility of reaching Latino men at risk for HIV through Latino soccer leagues in North Carolina (Rhodes et al 2006). Overall, these inventive strategies and the use of culturally sensitive case management, community health workers, and patient navigators (Vargas and Cunningham 2006), hold promise to improve HIV-positive Latinos' access to care.…”