Fernanda T. Bianchi

Disclosure of HIV Status and Psychological Well-Being Among Latino Gay and Bisexual Men

This study examined disclosure of HIV-positive serostatus by 301 Latino gay and bisexual men to members of their social networks and the mental health consequences of such disclosure. The sample was recruited from clinics, hospitals, and community agencies in New York City, Washington, DC, and Boston. Proportions disclosing differed depending on the target, with 85% having disclosed to closest friend, 78% to male main partner, 37% to mother, and 23% to father. Although there were differences depending on the target, disclosure was related to greater quality of social support, greater self-esteem, and lower levels of depression. Moreover, findings indicated that social support mediated the relationship between disclosure of serostatus and both self-esteem and depression. Thus, disclosure resulted in greater social support, which in turn had positive effects on psychological well-being. Findings demonstrate that generally Latino gay men are selective in choosing people to whom they disclose their serostatus and that disclosure tends to be associated with positive outcomes.

Social support and psychosocial competence : explaining the adaptation to college of ethnically diverse students

Examined relationships among social support, psychosocial competence, and adaptation to college in a sample of 357 African American, Asian American, Latino, and white college students. Social support and active coping were significant predictors of adaptation to college, whereas locus of control was not. However, there was an interaction between ethnicity and locus of control indicating that although internal African American, Latino, and white students had higher adaptation-to-college scores than external students, the opposite was true for Asian Americans. The relationships among social support, internality, and active coping were also explored. Satisfaction with social support and internality were positively related to active coping, but locus of control and social support were unrelated. Active coping and internality were significantly related to each other for all groups except for African Americans. Although most relationships were the same across groups, these findings call attention to the role of ethnicity as a moderator of college adjustment processes.

Predictors of Unprotected Anal Intercourse Among HIV-Positive Latino Gay and Bisexual Men

This study examined sexual behaviors in a sample of 155 HIV-positive Latino gay and bisexual men. Nearly half the sample had engaged in unprotected anal intercourse in the past 12 months; unprotected anal intercourse was more likely when the partner was also HIV-positive. Separate regression models predicted the number of receptive and insertive partners for unprotected anal intercourse. Participants reported both more unprotected insertive and receptive partners if they had sex under the influence of alcohol or drugs. Older participants and those with lower levels of Latino acculturation reported having more partners with whom they took the receptive role during unprotected anal intercourse, whereas those with higher levels of depression reported having more partners with whom they took the insertive role. Hierarchical set logistic regression revealed that the dyadic variable of seroconcordance added to the prediction of unprotected anal sex with the most recent male partner, beyond the individual characteristics. Results show the importance of examining both individual and dyadic characteristics in the study of sexual behavior.

The sexual experiences of Latino men who have sex with men who migrated to a gay epicentre in the USA

Key informant interviews, in‐depth interviews and focus groups were conducted to examine ways in which social context influenced the behavior of Brazilian, Colombian and Dominican men who have sex with men. First, we investigated how the social context in the home country affected motivation for migration. Findings suggest that Latino men who have sex with men frequently reported coming to the USA to escape homo‐negativity and to achieve greater sexual freedom. The study also examined how the social context encountered in the early years after migration shaped sexual behavior and risk. A majority of the participants reported easy access to sex partners and frequent sexual encounters. The anonymity of living in a gay epicentre such as New York City, often without social connections from the past, was experienced as liberating and conducive to sexual exploration. Moreover, sex in public venues, such as parks and sex cabins, was readily available to those who do not speak English. The tendency to engage in high levels of sexual activity during the early period after arrival in New York City was particularly evident among younger men. Implications for future programme development are discussed alongside prevention efforts targeting migrants during this critical period.

Unprotected Anal Intercourse Among Immigrant Latino MSM: The Role of Characteristics of the Person and the Sexual Encounter

Theoretical models of sexual risk-taking have traditionally focused on personal characteristics, but conceptual approaches emphasizing the social and situational context have also been proposed. This study examined the impact of characteristics of the person and of the sexual encounter on unprotected anal intercourse (UAI) among 482 immigrant Latino MSM. Analyses included logistic regression and hierarchical linear modeling. The personal characteristic of self-efficacy for safer sex was negatively associated with UAI over the previous three months, at the most recent encounter, and over multiple encounters reported by each participant. In addition, a cross-level interaction of self-efficacy at the person-level and sexual desire at the encounter-level showed that increased sexual desire was associated with greater likelihood of UAI for those with low self-efficacy, but not those with high self-efficacy. Likelihood of UAI was also linked to the situational characteristics of closeness to the partner, seroconcordance, and concern about STIs in the encounter.

COPING AS A MEDIATOR OF THE IMPACT OF SOCIOCULTURAL FACTORS ON HEALTH BEHAVIOR AMONG HIV-POSITIVE LATINO GAY MEN

In a sample of 140 HIV-positive immigrant Latino gay men, we tested a mediational model of the impact of sociocultural factors (i.e., poverty, discrimination, and U.S. acculturation) on active engagement of health-promoting behaviors (i.e., practicing good health habits). The role of coping as a mediator was examined. We proposed that the experience of social discrimination, together with acculturation, has a negative influence on active coping, which in turn would impact health behaviors. Regression analyses supported the role of coping as a mediator between sociocultural factors (specifically discrimination based on race or ethnicity and acculturation to the U.S.) and health-promoting behaviors. Findings from this study contribute to explaining the way in which sociocultural factors impact health among those who are HIV-positive and most vulnerable in our society.

The pleasure principle: the effect of perceived pleasure loss associated with condoms on unprotected anal intercourse among immigrant Latino men who have sex with men.

Sexual pleasure has been identified as an important consideration in decision-making surrounding condom use. We examined the impact of perceived pleasure loss associated with condom use on recent history of insertive and receptive unprotected anal intercourse (UAI) among Latino men who have sex with men (MSM) living in the United States. A total of 482 Dominican, Colombian, and Brazilian immigrant MSM were surveyed regarding sexual attitudes and practices via computer-assisted self-interviewing technology with audio enhancement (ACASI). Participants rated the pleasure they derived from protected and unprotected anal intercourse in each position (insertive and receptive) and also reported their HIV status, relationship status, and recent sexual history. Men who had engaged in both positions, with and without condoms (n=268), perceived a greater pleasure loss associated with condoms during anal intercourse in the insertive versus receptive position. Logistic regression analyses controlling for HIV status, relationship status, and age revealed that men who perceived greater pleasure loss from condoms were more likely to have engaged in UAI over the past 3 months (n[insertive]=297; n[receptive]=284). Findings indicate that the pleasure loss associated with condoms may be a key deterrent for their use in either sex position among Latino MSM. Therefore, pleasure needs to be prioritized in the development of condoms and other sexual safety measures as well as in the promotion of their use.

Predictors of Disclosure of Human Immunovirus-Positive Serostatus Among Latino Gay Men

To test a theoretical approach to disclosure of human immunovirus (HIV) status, 301 HIV-positive Latino gay men were interviewed using Audio-CASI (Computer Assisted Self-Interview technology with Audio enhancement). Consequence theory and social influence theory were combined to create a model of antecedents of disclosure. Results provided support for both theories. Perceived positive consequences were associated with greater disclosure to casual partners, families, and friends, whereas perceived negative consequences were associated with less disclosure to friends and family members. Social influence of peer behavioral norms was predictive of disclosure to all three target groups. Gay community social influence produced different effects on disclosure of HIV-positive status: a negative association for casual partners, a positive association for close friends, and no relationship for family members. Time since diagnosis was also predictive of disclosure.

Sex in public and private settings among Latino MSM

Abstract Latino men who have sex with men (MSM) constitute a group at high risk for HIV. Recent approaches to understanding sexual risk have emphasized the role that contextual factors can play in shaping behavior. This study examined sexual behavior of Latino MSM in private and public settings. First, a within-person comparison of behaviors performed in sexual encounters that occurred in public and private settings was conducted. Unprotected anal intercourse (UAI) and other sexual behaviors involving anal stimulation were more common in private settings; group sex was more likely in public settings. Second, a between-person analysis compared sexual behaviors of MSM who went to three different types of public sex settings during the past six months. The types were: (1) commercial sex venues (CSVs), which were defined as businesses with the function of providing a space where MSM can go to have sexual encounters, such as gay bathhouses; (2) commercial sex environments (CSEs), which were defined as businesses with another apparent function, but in which MSM sometimes have sexual encounters, such as gay bars or pornographic movie houses; and (3) public sex environments (PSEs), which were defined as free public areas where MSM can go to find partners for anonymous sex, such as parks or public restrooms. Results indicated that anal sexual behavior was most likely to occur in CSVs and least likely in PSEs, but the probability of UAI was not found to differ among the three types of settings. Behavioral differences were discussed in terms of structural conditions related to privacy and safety, and psychological factors related to intimacy.

Racial Identity and Self-Esteem Among Black Brazilian Men: Race Matters in Brazil Too!

The contribution of J. E. Helmss (1990) people of color racial identity model to the collective and individual self-esteem of Black Brazilian men (N = 203) was explored. The relationships between racial identity attitudes and other racial constructs such as skin color, racial group self-designation, and racial mistrust were also examined. Hierarchical regression analyses revealed that the set of racial identity attitudes (conformity, dissonance, resistance, and internalization) was significant in predicting self-esteem (collective and individual). Results from a multivariate analysis of variance showed an effect for skin color on racial attitudes. In addition, racial identity was significantly related to mistrust of Whites by Black Brazilian men. The implications of these findings are discussed in the context of racial relations in Brazil.