Sexual Health and Socioeconomic-Related Factors Among HIV-Positive Men Who Have Sex with Men in Puerto Rico

Abstract

Most of the research among HIV-positive populations has been approached from behavioral risk models. This is particularly true for those otherwise socially vulnerable groups like men who have sex with men (MSM). As a response to this pattern, we examined data from an ongoing health promotion research being conducted in Puerto Rico (PR). The study is limited to HIV-positive MSM and consists of the participation in a survey interview that includes domains used to assess indicators of socio-economic-related factors (age, educational level, employment, religion, and partnership status) and sexual health (sexual satisfaction, condom use, and sexual health knowledge (SHK)). Participants reported a relatively high level(75 %) of sexual satisfaction and inconsistent condom use (50.9 % reported always using a condom). A deficient (61 %) SHK was also reported. In multivariate analyses, a higher educational level was associated with higher sexual satisfaction (aβ = 3.223; 95 % CI 0.291–6.156) and higher levels of SHK (aβ=1.328; 95 % CI 0.358–2.297), while unemployment was associated with less condom use (aOR 0.314; 95 % CI 0.122–0.810). Not having a primary sexual partner was associated with less sexual satisfaction (aβ= −3.871; 95 % CI −7.534–0.208) and more condom use (aOR 4.292; 95 % CI 1.310–14.068). Findings support the notion that men of a disadvantaged socioeconomic position may have a poorer sexual health status; with a lower level of education and unemployment leading this disparity. Findings also evidence that partnership status may have a role in the sexual health of HIV-positive MSM. To our knowledge, this is the first comprehensive analysis of sexual health and socio-economic indicators among Hispanic/Latino HIV-positive MSM in PR and in the Caribbean. Findings provide valuable information to address the sexual health needs of an underserved population.

Sexual (Dis)satisfaction and Its Contributors Among People Living with HIV Infection in Sweden

“…Not being involved in an intimate relationship was for women and men associated with the experience that their sex life had changed in a negative way and had indirectly a negative effect on sexual satisfaction. We do not know, based on our data, whether being single was of an intentional or circumstantial character, but irrespective of which one, our result supports other studies (Rodriguez-Diaz et al, 2015 ; Rojas Castro et al, 2010 ) albeit in an indirect way. One possible explanation of the finding is that there was a yearning for an intimate relationship, but HIV-related concerns such as disclosure put up barriers for fulfilling this wish and consequently PLHIV were sexually unsatisfied.…”

“…The assessment of sexual satisfaction among PLHIV varies across studies; in some studies, it is measured in terms of sexual dysfunctions as diagnosed in the International Classification of Diseases (ICD10) and DSM-IV-TR, in others by a Likert-scale question based on self-declared satisfaction with sex (Kaida et al, 2015), or by using scales which assess various dimensions of sexual life such as sexual sensations, sexual presence, sexual exchange, emotional connection, and sexual activity (Rodriguez-Diaz, Jovet-Toledo, Ortiz-Sanchez, Rodriguez-Santiago, & Vargas-Molina, 2015). del Mar Sánchez-Fuentes, Santos-Iglesias, and Sierra (2014) point out that used instruments are, with two exceptions (Lawrance & Byers, 1995; Stulhofer, Busko, & Brouillard, 2010), not based on theoretical conceptualizations of sexual satisfaction.…”

“…However, the association between stigma and sexual satisfaction is not fully understood (Bouhnik, Preau, Schiltz, Obadia, & Spire, 2008). Other psychosocial factors linked to sexual dissatisfaction include unemployment (Rojas Castro et al, 2010; Wilson et al, 2010), not having a steady relationship (Rodriguez-Diaz et al, 2015; Rojas Castro et al, 2010), low self-efficacy and social exclusion (Lazar et al, 2014), and feelings of loneliness (Rojas Castro et al, 2010; Wilson et al, 2010). Depression and anxiety were also found to be associated with sexual dissatisfaction in men living with HIV (De Ryck et al, 2012) and with sexual functioning among women living with HIV (Florence et al, 2004).…”

Sexual health knowledge and stigma in a community sample of HIV-positive gay, bisexual, and other men who have sex with men in Puerto Rico

“…Socio-demographic characteristics such as age, education level, employment status, sexual orientation, AIDS diagnosis and years living with HIV were assessed using questions developed by the research team and previously used among similar populations (Jovet-Toledo, Clatts, Rodríguez-Díaz, Vargas-Molina, & Goldsamt, 2014; Rodríguez-Díaz, Collazo, Dodge, Román-Rivera, Candelaria-Rosa, Colón-Colón, & Herbenick, 2014; Rodríguez-Díaz, Jovet-Toledo, Ortíz-Sánchez, Rodríguez-Santiago, & Vargas-Molina, 2015). …”

Can socio-economic differences explain low expectation of health services among HIV patients compared to non-HIV counterparts?

“…Patients’ expectations are affected not only by age [ 20 , 21 ] and sex, but also by occupation [ 22 , 23 ], education [ 23 ], and income-conventional indicators of socio-economic status (SES). Although different socio-economic indicators have comparable effects on patients’ expectations, a convincing causal relationship between SES indicators and patients’ expectation towards quality of HIV/AIDS healthcare remains to be established.…”