ITM Latino Talk APHA 2004 Nov 4

Tailoring Prevention with Positives Interventions to Male Latinos who have Sex with Men and Women (MSMW): Differences in Sexual Disclosure Experiences Between HIV+ MSMW Latinos and HIV+ MSMW Non-Latinos: 

Tailoring Prevention with Positives Interventions to Male Latinos who have Sex with Men and Women (MSMW): Differences in Sexual Disclosure Experiences Between HIV+ MSMW Latinos and HIV+ MSMW Non-Latinos By Matt G. Mutchler, Ph.D., Miguel Chion, M.D., M.P.H., Leo Colemon, M.A., andamp; Mark A. Schuster, M.D., Ph.D. American Public Health Association, 2004 Funded by the Universitywide AIDS Research Program

Background: 

Background Illness disclosure and physician-patient interactions HIV/AIDS poses a unique problem of disclosure to sexual partners I will provide sociological analyses of how HIV + MSMW Latinos differ in their safer sex communication, disclosure, and HIV risk patterns compared to non-Latinos

Background---cont.: 

Background---cont. HIV prevention interventions are increasingly targeting people living with HIV/AIDS (PLWA) Most public health studies and interventions group MSMW with gay men Yet, MSMW report different patterns of communication, disclosure, and HIV risk compared to gay men Latino MSMW report higher rates of HIV/AIDS and unique HIV prevention needs

Relevant ITM Study Aims: 

Relevant ITM Study Aims Test hypothesis that there are significant differences in communication, HIV risk and disclosure patterns between HIV+ MSMW Latinos and non-Latinos Discuss implications of these differences for HIV prevention policies and planning

Study Design: 

Study Design Convenience sample; cross-sectional design 150 HIV+ MSMW 50 African American, 50 Latino (25 English speaking andamp; 25 Spanish speaking), andamp; 50 white All participants reported sex with men and women in the previous 5 years Data collected at 8 AIDS service organizations in Los Angeles County (LAC) from August, 2002 through July, 2004

Survey Domains:: 

Survey Domains: Demographic including sexual orientation scales Health status Sexual contexts Sexual risk behaviors Condom use and disclosure attitudes and beliefs HIV medication adherence Substance use HIV status disclosure Stigma/discrimination

Survey Limitations: 

Survey Limitations Based on self reported information The findings may not be generalizable to populations outside the sample

Statistical Analyses: 

Statistical Analyses Univariate analyses performed to provide descriptive statistics and check for irregularities. Bivariate analyses to assess associations between key variables (independent sample t-tests and Chi-square).

Demographic Information: 

Demographic Information Average age=40 28.7% have children 40.7% high school or less education 40.7% earn less than poverty level 16.8% homeless in last 3 months 53.3% ever in the correctional system

Sexual Identities: 

Sexual Identities

Sexual Orientation Klein Scale (0-6): 

Sexual Orientation Klein Scale (0-6)

HIV/AIDS Status: 

HIV/AIDS Status

Latino HIV+ MSMW (P<.05): 

Latino HIV+ MSMW (Pandlt;.05)

Latino HIV+ MSMW (P<.05): 

Latino HIV+ MSMW (Pandlt;.05)

Latino HIV+ MSMW (P<.05): 

Latino HIV+ MSMW (Pandlt;.05)

Latino HIV+ MSMW (P<.05): 

Latino HIV+ MSMW (Pandlt;.05)

Latino HIV+ MSMW (P<.05): 

Latino HIV+ MSMW (Pandlt;.05)

Summary: 

HIV+ MSMW self-report a range of sexual identities HIV+ MSMW Latinos report sexual risk behaviors with male and female primary partners Latinos reported different communication, disclosure, and HIV risk patterns compared to non-Latinos Summary

Recommendations: 

Recommendations HIV prevention interventions should be tailored to specific sub-populations by race/ethnicity and by partner variables (e.g., gender) Community participation is an important vehicle of dissemination for Latinos Such programs need to target behaviors and cognitive beliefs/attitudes/perceptions

Next Steps: 

Next Steps Examine associations among disclosure, risk and partner variables (HIV status, primary/casual, race/ethnicity, gender); stigma; and cognitive beliefs/attitudes/perceptions Explore differences among Latinos (language, partner variables) and Latinos vs. white and African American Test for moderators and mediators

Acknowledgments & Contact Information: 

Acknowledgments andamp; Contact Information I would like to acknowledge the research andamp; evaluation core (REC) at APLA and the UCLA Center for Adolescent Health Promotion/RAND Please contact Dr. Matt G. Mutchler 611 S. Kingsley Dr. Los Angeles, CA 90005 213.201.1522 mmutchler@apla.org