title: Correlates of Sexual Risk among Recent Gay and Bisexual Immigrants from Western and Eastern Africa to the USA.
abstract: We examined correlates of sexual risk among gay and bisexual men, who recently migrated from western and eastern African countries to the USA and lived in New York City and who are HIV negative or of unknown status. These men migrate from countries where same-sex sexuality is socially rejected and mostly illegal contributing to the motivation to migrate. Their background might predispose these men to engagement in sexual risk practices, while they are not specifically addressed in HIV prevention programming. Participants (N = 62) reported in face-to-face interviews on pre- and postmigration experiences, psychosocial determinants of sexual risk, and current sexual practices. Operationalization of sexual risk was based on the number of men with whom they had condomless receptive and/or insertive anal sex. Over a third of the men reported always having used condoms in the past year; among the other men, sexual risk varied. Multivariate analyses showed that sexual risk was lower among men with a stronger motivation to avoid HIV infection and higher among men who currently engaged in transactional sex. Further analyses indicated that housing instability was independently associated with reduced motivation to avoid HIV infection and with engagement in transactional sex in the USA. In recent western and eastern African gay and bisexual immigrants to the USA, structural factors, including housing instability, are strongly associated with sexual risk.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA. tgs2001@cumc.columbia.edu.
authors.forename: Theo
authors.identifier: 0000-0002-4986-1739
authors.initials: T
authors.lastname: Sandfort
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
authors.forename: C
authors.initials: C
authors.lastname: Anyamele
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
authors.forename: C
authors.initials: C
authors.lastname: Dolezal
mesh_terms: D000328:Adult; D000351:Africa, Eastern; D000354:Africa, Western; D001727:Bisexuality / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data*; D018451:Homosexuality, Male / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City; D012307:Risk Factors; D012309:Risk-Taking; D055815:Young Adult
keywords: Gay and bisexual men; Housing instability; Migration; New York City; Sexual risk; West and East Africa