Substance Use and Sexual Risk Behavior: Understanding their Association among Four Ethnic Groups of Latino Men Who Have Sex With Men

Dolezal, Curtis; Carballo‐Diéguez, Alex; Nieves-Rosa, Luis; Díaz, Francisco Javier

doi:10.1016/s0899-3289(00)00030-4

Cited by 98 publications

(68 citation statements)

References 30 publications

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“…These findings are consistent with other work linking heavy drinking among MSM to sexual risk behavior. 29,[33][34][35] Thus, the findings of this study support multiple pathways linking stigma-related stress to alcohol use. Internalization of negative societal attitudes (indicated by a high level of IH) and concealment of one's sexual orientation (indicated by having a female partner) were found to be associated with at least weekly binge drinking, indicating a reliance on alcohol consumption as a maladaptive coping and emotion regulation strategy.…”

Section: Discussionsupporting

confidence: 67%

Binge Drinking among Men Who Have Sex with Men and Transgender Women in San Salvador: Correlates and Sexual Health Implications

2015

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High rates of heavy alcohol use among men who have sex with men (MSM) and transgender women (TW) have been linked to increased vulnerability for HIV and poor mental health. While theories explaining elevated drinking levels among sexual minorities have been forwarded, few investigations have assessed the potential pathways using empirical data, particularly with an explicit focus on self-stigma and among MSM and TW in low-and middle-income countries. This study examined the relationship between stigma-related stress (specifically, self-stigma and concealment of one's sexual orientation) and binge drinking in a sample of MSM and TW (n=670) in San Salvador, El Salvador, recruited using respondent-driven sampling. Levels of alcohol consumption among participants were high: only 39 % of the sample did not drink alcohol or did not binge drink, while 34 % engaged in binge drinking at least weekly. Among MSM, high self-stigma was associated with binge drinking at least weekly (adjusted relative risk ratio (aRRR)=2.1, pG0.05). No such relationship was found with less than weekly binge drinking. Among both MSM and TW, having a female partner was associated with binge drinking less than weekly (aRRR=3.3, pG0.05) and binge drinking at least weekly (aRRR=3.4, pG0.05), while disclosure of sexual orientation to multiple types of people was associated with binge drinking less than weekly (aRRR=2.9 for disclosure to one-two types of people, pG0.01; aRRR=4.0 for disclosure to three-nine types of people, pG0.01). No such relationship was found with at least weekly binge drinking. Binge drinking at least weekly was marginally associated with a number of sexual health outcomes, including high number of lifetime partners (adjusted odds ratio (aOR)=1.7, pG0.10), inconsistent condom use with a non-regular partner (aOR=0.5, pG0.10), and decreased intention to test for HIV in the next 12 months (aOR=0.6, pG0.10). With the exception of inconsistent condom use with a non-regular partner (aOR=0.4, pG0.05), binge drinking less than weekly was not associated with increased sexual risk behavior and was actually associated with increased intention to test for HIV in the next 12 months (aOR=2.8, pG0.01). These findings support multiple pathways linking stigma-related stress to alcohol use. Specifically, those with high self-stigma and identity concealment may be using alcohol as a maladaptive coping and emotion regulation strategy, while those who have disclosed their sexual orientation to multiple types of people may be more engaged with the sexual minority community, likely in bars and other venues where permissive norms for alcohol use prevail. That this frequency of binge drinking does not appear to be associated with increased sexual risk behavior (and may even be associated with increased intention to test for HIV in the next 12 months) lends further support to the suggestion that these individuals with healthy concepts of the self (as indicated by high levels of disclosure and low levels of risky sexual behavior) may engage in b...

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Section: Discussionsupporting

confidence: 67%

Binge Drinking among Men Who Have Sex with Men and Transgender Women in San Salvador: Correlates and Sexual Health Implications

2015

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“…Ross [12] [20]. Dolezal in a recent study of homosexually active Latino men found a positive association between measures of selfworth and sexual risk taking [21], and Robins [22,23] found that gay men who reported unprotected anal intercourse had lower levels of psychological distress than their peers. Similarly, Rubb's group found that homosexually active men whose responses indicated depressed ideation were less likely to report having engaged in receptive or insertive unprotected anal intercourse [24].…”

Section: Discussionmentioning

confidence: 99%

Depressive disorders and unprotected casual anal sex among Australian homosexually active men in primary care

et al. 2003

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ObjectiveTo examine the relationship between depressive disorders and unprotected anal intercourse with casual partners, among homosexually active men attending for primary care. MethodsThe first 460 homosexually active men enrolling in an Australian integrated primary care programme were screened for current depressive disorders using the Primary Care Evaluation of Mental Disorders (PRIME-MD) and completed questionnaires on their sexual behaviour in the prior 6 months. One hundred and sixty-two (35%) were HIV positive, 283 (62%) were HIV negative and 15 (3%) were untested. ResultsThe prevalence of major depressive episode (MDE), as measured by the PRIME-MD, on enrolment was 28% (129/460), while the prevalence of dysthymic disorder (DD) was 26% (121/460). These include 84 men (18%) who met the criteria for both disorders ('double depression'). Men with DD alone, however, were significantly more likely than men with neither disorder to report having had unprotected anal intercourse with a casual partner (11/38 [29%] vs. 43/292 [15%]; OR: 2.36 [95%CI: 1.09-5.10]; P 5 0.035). ConclusionsDepressive disorders were highly prevalent in this cohort and independent of HIV status. MDE was associated with reduced sexual activity. Among men without MDE, the presence of DD was independently associated with an increased likelihood of reporting unsafe anal sex with a casual partner in the prior 6 months.Keywords: homosexual men, neuropsychological, prevention of sexual transmission, psychiatry, psychosocial, risk factors, sexual behaviour Received: 30 September 2002, accepted 20 February 2003 Introduction Depressive disorders are highly prevalent in people with HIV infection [1][2][3][4][5]. Clinical wisdom is that this high prevalence results from the psychosocial stress of HIV diagnosis and disease together, perhaps, with direct neurochemical effects of the virus. A number of studies, however, identify levels of depressive disorder among uninfected members of the communities particularly affected by HIV that are similarly high [6][7][8][9][10]. Ciesla and Roberts, in a recent metaanalysis of 10 studies, concluded that HIV infection did appear to be an independent risk factor for major depression, but not for dysthymic disorder (DD) [11].The relationship between depression and HIV risk behaviour among gay men has been addressed in many studies, but the results have been conflicting. Ross [12] [20]. Dolezal in a recent study of homosexually active Latino men found a positive association between measures of selfworth and sexual risk taking [21], and Robins [22,23] found that gay men who reported unprotected anal intercourse had lower levels of psychological distress than their peers. Similarly, Rubb's group found that homosexually active men whose responses indicated depressed ideation were less likely to report having engaged in receptive or insertive unprotected anal intercourse [24].While these results appear conflicting, it seems that no previous study has differentiated between the two common patterns of depression seen c...

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“…Several studies have documented that Latino immigrant men are much more likely to have contracted HIV from sex with other men (despite a strong cultural bias against homosexuality) than the overall male U.S. population (15,16,24). Harawa et al found that overall HIV prevalence was identical for immigrant versus U.S.-born clients, at 1.8% and 1.6%, respectively (45).…”

Section: Responsible Sexual Behaviormentioning

confidence: 99%

Assuring the Health of Immigrants: What the Leading Health Indicators Tell Us

Kandula

Kersey

Lurie

2004

Annu. Rev. Public Health

206

135

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Over the past 20 years, the United States has experienced one of the largest waves of immigration in its history. Understanding the health status and needs of immigrants is important because of their growing numbers and their contribution to the health of the nation, but it is challenging because of gaps in national databases, the heterogeneity of immigrant populations, and uncertainty about how migration affects health. Healthy People 2010 outlines the nation's public health objectives for the current decade. It includes ten leading health indicators (LHIs) chosen because of their importance as public health issues, their ability to motivate action, and the availability of data to measure their progress. In this paper, we discuss the health of immigrants from the perspective of these LHIs, as they provide a framework for anticipating some of the future health needs of immigrants and help define priority areas for research and action. INTRODUCTIONOver the past 20 years, the United States has experienced one of the largest waves of immigration in its history. Understanding the health status and needs of immigrants is important because of their growing numbers and their contribution to the health of the nation, but it is challenging because of gaps in national databases, the heterogeneity of immigrant populations, and uncertainty about how migration affects health. The health status and health needs of immigrants are poorly understood. Until recently, most health research did not collect data on nativity and immigration status. When immigration status was collected, many studies grouped all Asians or Latinos together, despite marked differences within subgroups with respect to culture, socioeconomic status, health status, and patterns of immigration.The effect of immigration on health is controversial. Some studies have shown that immigrants enjoy superior health compared to the U.S. born, despite higher 358KANDULA KERSEY LURIE rates of poverty and poorer access to health care (1,23,100,102). Others find that some groups experience much higher rates of disease and poor health than previously suspected (36,101,112). As immigrants adopt traditional American health behaviors over time, their health status begins to converge with that of the general U.S. population (20,63,66,90,96,101,112). Yet the literature on how acculturation affects health is often difficult to interpret because there are few validated and consistent measures of acculturation (57). Data on immigrant health status are also often difficult to interpret because of uncertain impact of selection biases [e.g., immigrants to the United States may represent the most healthy and motivated individuals, thus able to make the long journey to the United States (1, 34); they live healthier lifestyles, with fewer risk-taking behaviors and better diets (57); and they return to their native country prior to dying and therefore are not counted in U.S. death records or vital statistics (57)]. Healthy People 2010 outlines the nation's public health objecti...

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Substance Use and Sexual Risk Behavior: Understanding their Association among Four Ethnic Groups of Latino Men Who Have Sex With Men

Cited by 98 publications

References 30 publications

Binge Drinking among Men Who Have Sex with Men and Transgender Women in San Salvador: Correlates and Sexual Health Implications

Binge Drinking among Men Who Have Sex with Men and Transgender Women in San Salvador: Correlates and Sexual Health Implications

Depressive disorders and unprotected casual anal sex among Australian homosexually active men in primary care

Assuring the Health of Immigrants: What the Leading Health Indicators Tell Us

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