Psychosocial, Behavioral, and Cultural Predictors of Sexual Risk for HIV Infection Among Latino Men Who Have Sex with Men

Abstract

This study sought to replicate and extend an investigation by Diaz et al. (1999) on determinants of HIV risk among Latino gay and bisexual men living in San Francisco who were predominantly English-speaking. Compared to the Diaz et al. study, the current study sample consisted of predominantly Spanish-speaking MSM, who resided outside of HIV/AIDS epicenters and whose countries of origin were primarily Central & South American. The relationships of unprotected anal sex and multiple sexual partners with demographic, developmental, behavioral, cultural and psychosocial variables were examined. Data were collected in a convenience sample of 250 participants (primarily immigrants from El Salvador) residing in Virginia. Most men in the sample had more than one sexual partner in the last 3 months (62%) and more than a third had unprotected anal sex with a casual partner in the same time period. Communication about HIV, sexual attraction, machismo, and experiences of discrimination based on homosexual behavior were predictive of HIV risk behaviors. The findings support an integrative approach to investigating HIV risk among Latino MSM. Implications for prevention programs are discussed.

Lesbian, gay, bisexual, and transgender immigrant acculturation experience

“…In light of multiple difficulties facing LGBT immigrants, including challenges integrating sexual identity within culturally-defined immigrant environments, most LGBT immigrants report being constantly fearful of rejection and feeling bad about themselves, which results in a wide range of mental health issues including depression, suicidal ideation, substance abuse, eating disorders, and high risk sexual behaviours (Acevedo, 2008;Ayala & Diaz, 2001;Bianchi et al, 2004;Breslau et al, 2006;Carballo-Dieguez, 1989;Carballo-Dieguez & Dolezal, 1995;Carballo-Dieguez et al, 1997;Choi et al, 2002;Cochran et al, 2007;Diaz, 1997Diaz, , 1998Diaz et al, 1999;Domanico & Crawford, 2000;Dube & Savin-Williams, 1999;Jarama et al, 2005;Marin, 1996;Mason et al, 1995;RamirezValles et al, 2005;Ramírez et al, 1994;Van Oss-Marin, 2003;Zea et al, 2004;Zwiers, 2009). …”

“…There is evidence that LGBT immigrants belonging to certain racial or ethnic groups are at particularly high risk for HIV/AIDS; cultural variables, according to Yoshikawa and colleagues, play an important role in determining the risk profile of a particular ethnic or racial group. For example, the annual AIDS rate for Latino gay men is on average 3-4 times higher than in Whites (Jarama et al, 2005;Poppen et al, 2004), which can probably be attributed to the fact that Latinos report the highest rates of unprotected anal intercourse compared to any other racial or ethnic group (Diaz et al, 1999). While the prevalence of mental health disorders, which quite often lead to risky sexual behaviours, tends to be lower among Latino immigrants (Cochran et al, 2007), in the case of Latino gay men, high rates of unprotected sex are often attributed to a cultural variable called "machismo" (Jarama et al, 2005).…”

“…For example, the annual AIDS rate for Latino gay men is on average 3-4 times higher than in Whites (Jarama et al, 2005;Poppen et al, 2004), which can probably be attributed to the fact that Latinos report the highest rates of unprotected anal intercourse compared to any other racial or ethnic group (Diaz et al, 1999). While the prevalence of mental health disorders, which quite often lead to risky sexual behaviours, tends to be lower among Latino immigrants (Cochran et al, 2007), in the case of Latino gay men, high rates of unprotected sex are often attributed to a cultural variable called "machismo" (Jarama et al, 2005). The cultural value of machismo reflects strict gender role expectations, characterized by the need for anal penetrative sex in the insertive role, and the frequent use of the sexual encounter as means to prove masculinity.…”

“…Internalized homophobia, typical of LGBT immigrants who are predominately identified with their ethnic community, often prevents immigrants from actually self-identifying as LGBT and therefore keeps them away from participating in broader queer culture, and in turn, from support for safer sex (Jarama et al, 2005). In fact, the majority of immigrant cultures view homosexuality negatively, which decreases the disclosure of information by LGBT immigrants that can be associated with nonheterosexual orientation .…”

“…Most of the studies reviewed employed nonprobability sampling to gather data because of the difficulty in recruiting participants (Diaz, 1998;Jarama et al, 2005). Also, as was discussed earlier, quite often LGBT immigrants represent a hidden population that cannot be enumerated precisely, and therefore it becomes virtually impossible to derive a truly representative sample of the entire population .…”