title: Relationship Factors Associated with Sexual Risk Behavior and High-Risk Alcohol Consumption Among Latino Men Who Have Sex with Men: Challenges and Opportunities to Intervene on HIV Risk.
abstract: The HIV epidemic continues to be a major public health concern, affecting communities with varying prevention and treatment needs. In the U.S., Latino men who have sex with men (MSM) bear a disproportionate burden of HIV incidence. While recent studies have highlighted the relevance of relationship factors for HIV transmission among MSM generally, the unique needs and experiences of Latino MSM have received relatively little attention. Consequently, associations between relationship factors and HIV risk among Latino MSM remain unknown. This mixed-method study examined relationship status and dynamics and potential HIV-related risk behaviors among Latino MSM. Quantitative analyses with 240 Latino MSM investigated associations between relationship status and engagement in condomless anal intercourse (CAI). Focus groups with 20 Latino male couples and 10 health service providers explored the impact of relationship dynamics on sexual behaviors, as well as opportunities to intervene on HIV risk. The majority of participants were predominantly Spanish speaking, most screened positive for high-risk alcohol consumption in the past month, more than half engaged in CAI in the past 3 months, and a majority reported multiple sexual partners in this period. Among participants in same-sex relationships (n = 175), approximately half reported multiple partners in the previous 3 months and more than two-thirds reported CAI in this time period. Being in a same-sex relationship was positively associated with high-risk alcohol consumption and being age 30 or older and negatively associated with having multiple partners. Moreover, being in a same-sex relationship significantly increased the likelihood that participants would report engaging in CAI. Qualitative analyses identified themes related to relationship dynamics and sexual behavior, as well as opportunities to intervene on HIV risk. Despite the challenges encountered by Latino male couples, most participants expressed commitment to and support for their partners. As such, prevention efforts involving Latino male couples must address relationship dynamics and the role they play in sexual health, including safer sex practices.
authors.affiliation: School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, 19122, USA. omar.martinez@temple.edu.
authors.forename: Omar
authors.initials: O
authors.lastname: Martinez
authors.affiliation: School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, 19122, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Muñoz-Laboy
authors.affiliation: School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, 19122, USA.
authors.forename: Ethan C
authors.initials: EC
authors.lastname: Levine
authors.affiliation: Center for HIV Education Studies and Training, The City University of New York, New York, NY, USA.
authors.forename: Tyrel
authors.initials: T
authors.lastname: Starks
authors.affiliation: HIV Center for Clinical and Behavioral Studies, Columbia University, New York, NY, USA.
authors.forename: Curtis
authors.initials: C
authors.lastname: Dolezal
authors.affiliation: School of Public Health, Indiana University-Bloomington, Bloomington, IN, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Dodge
authors.affiliation: School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, 19122, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Icard
authors.affiliation: School of Social Work, University of Texas-El Paso, El Paso, TX, USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Moya
authors.affiliation: School of Social Work, University of Texas-El Paso, El Paso, TX, USA.
authors.forename: Silvia
authors.initials: S
authors.lastname: Chavez-Baray
authors.affiliation: Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Rhodes
authors.affiliation: Department of Public Health, Nova Southeastern University, Fort Lauderdale, FL, USA.
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006630:Hispanic or Latino / Q000523:psychology / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012309:Risk-Taking; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data
keywords: Alcohol consumption; Latino MSM; Relationship dynamics; Sexual orientation; Sexual risk behaviors