title: 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 socioeconomic 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.
authors.affiliation: School of Public Health, University of Puerto Rico-Medical Sciences Campus, PO Box 365067, San Juan, PR, 00936-5067, USA, carlos.rodriguez64@upr.edu.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Rodríguez-Díaz
authors.forename: Gerardo G
authors.initials: GG
authors.lastname: Jovet-Toledo
authors.forename: Edgardo J
authors.initials: EJ
authors.lastname: Ortiz-Sánchez
authors.forename: Edda I
authors.initials: EI
authors.lastname: Rodríguez-Santiago
authors.forename: Ricardo L
authors.initials: RL
authors.lastname: Vargas-Molina
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology*; D018451:Homosexuality, Male / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011647:Puerto Rico / Q000453:epidemiology; D060728:Reproductive Health; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult