Héctor Carrillo

HIV prevention with Mexican migrants: review, critique, and recommendations.

Summary:Charged with the task of reviewing the research outcome literature on HIV prevention with Mexican migrants in the United States, the following broad observations and conclusion were made: (1) there is little research on this specialized topic of concern; (2) the research that exists reflects an overly individualistic behavioral science approach designed to reduce individual risk factors, with little regard for structural and environmental factors that influence HIV risk; and (3) there is a compelling need to develop better theoretic frameworks for understanding the complex and dynamic social and cultural processes influencing sexual behavior among Mexican migrants so as to better inform HIV prevention efforts with this unique and diverse Latino(a) population.

AIDS and Condom-Related Knowledge, Beliefs, and Behaviors in Mexican Migrant Laborers

AIDS and condom-related knowledge, beliefs, and behaviors were assessed in Mexican migrant laborers. The sample consisted of 55 men and 32 women who were administered a modified version of the Hispanic Condom Questionnaire. Results indicated that respondents were knowledgeable about actual modes of HIVtransmission butthata third to half of the sample believed they could contract AIDS from unlikely sources such as mosquito bites, public bathrooms, and kissing on the mouth. Knowledge of proper condom use was problematic, and frequency of condom use during the past year was no higher than half of the time. Concern about contracting AIDS was generally low but was highestfor migrants that were younger andfor those with multiple sex partners. Although respondents reportedfew negative beliefs about the consequences of condom use, most believed that women would be seen as promiscuous for carrying condoms.

Hombres Sanos: Evaluation of a Social Marketing Campaign for Heterosexually Identified Latino Men Who Have Sex With Men and Women

OBJECTIVES We evaluated the effectiveness of Hombres Sanos [Healthy Men] a social marketing campaign to increase condom use and HIV testing among heterosexually identified Latino men, especially among heterosexually identified Latino men who have sex with men and women (MSMW). METHODS Hombres Sanos was implemented in northern San Diego County, California, from June 2006 through December 2006. Every other month we conducted cross-sectional surveys with independent samples of heterosexually identified Latino men before (n = 626), during (n = 752), and after (n = 385) the campaign. Respondents were randomly selected from 12 targeted community venues to complete an anonymous, self-administered survey on sexual practices and testing for HIV and other sexually transmitted infections. About 5.6% of respondents (n = 98) were heterosexually identified Latino MSMW. RESULTS The intervention was associated with reduced rates of recent unprotected sex with both females and males among heterosexually identified Latino MSMW. The campaign was also associated with increases in perception of HIV risk, knowledge of testing locations, and condom carrying among heterosexual Latinos. CONCLUSIONS Social marketing represents a promising approach for abating HIV transmission among heterosexually identified Latinos, particularly for heterosexually identified Latino MSMW. Given the scarcity of evidence-based HIV prevention interventions for these populations, this prevention strategy warrants further investigation.

Border crossings and shifting sexualities among Mexican gay immigrant men: Beyond monolithic conceptions

This article describes patterns of interpretation and practice of same-sex desires pre- and post-migration among self-identified gay and bisexual Mexican immigrant men to the USA. Drawing on in-depth interviews with 80 such men, we argue that, contrary to stereotypes, their pre-migration interpretations and practices are considerably diverse and not solely informed by highly gendered understandings and styles of sexual interaction between men. After migration, some shift their interpretations and practices considerably, while others retain those that informed their sexualities pre-migration, either adapting them to their new sexual contexts or resisting any changes. These findings, which reveal the complexity and diversity of sexual interpretations among immigrant gay and bisexual men, pose a challenge to proposed systems of classifying same-sex desires as well as to conventional understandings of the impact of international migration on gay sexuality.

Immigrant sexual citizenship: intersectional templates among Mexican gay immigrants to the USA

Existing literature on sexual citizenship has emphasized the sexuality-related claims of de jure citizens of nation-states, generally ignoring immigrants. Conversely, the literature on immigration rarely attends to the salience of sexual issues in understanding the social incorporation of migrants. This article seeks to fill the gap by theorizing and analyzing immigrant sexual citizenship. While some scholars of sexual citizenship have focused on the rights and recognition granted formally by the nation-state and others have stressed more diffuse, cultural perceptions of community and local belonging, we argue that the lived experiences of immigrant sexual citizenship call for multiscalar scrutiny of templates and practices of citizenship that bridge national policies with local connections. Analysis of ethnographic data from a study of 76 Mexican gay and bisexual male immigrants to San Diego, California, reveals the specific citizenship templates that these men encounter as they negotiate their intersecting social statuses as gay/bisexual and as immigrants (legal or undocumented); these include an ‘asylum’ template, a ‘rights’ template, and a ‘local attachments’ template. However, the complications of their intersecting identities constrain their capacity to claim immigrant sexual citizenship. The study underscores the importance of both intersectional and multiscalar approaches in research on citizenship as social practice.

Rethinking Sexual Initiation: Pathways to Identity Formation Among Gay and Bisexual Mexican Male Youth

The topic of same-sex sexual initiation has generally remained understudied in the literature on sexual identity formation among sexual minority youth. This article analyzes the narratives of same-sex sexual initiation provided by 76 gay and bisexual Mexican immigrant men who participated in interviews for the Trayectos Study, an ethnographic study of sexuality and HIV risk. These participants were raised in a variety of locations throughout Mexico, where they also realized their same-sex attraction and initiated their sexual lives with men. We argue that Mexican male same-sex sexuality is characterized by three distinct patterns of sexual initiation—one heavily-based on gender roles, one based on homosociality, and one based on object choice—which inform the men’s interpretations regarding sexual roles, partner preferences, and sexual behaviors. We analyzed the social factors and forms of cultural/sexual socialization that lead sexual minority youth specifically to each of these three patterns of sexual initiation. Our findings confirm the importance of studying same-sex sexual initiation as a topic in its own right, particularly as a tool to gain a greater understanding of the diversity of same-sex sexual experiences and sexual identities within and among ethnic/cultural groups.

From MSM to heteroflexibilities: Non-exclusive straight male identities and their implications for HIV prevention and health promotion

ABSTRACT This article examines the logics of self-identification among men who have same-sex desires and behaviours and consider themselves to be straight. We draw from interviews conducted in the USA with 100 straight-identified men who have same-sex desires and 40 partners of such men. Our data allow us to reject two misconceptions. One is the idea that these men are actually gay or bisexual but refuse to accept those identities. We argue instead that these men see themselves as straight and therefore it is important to understand what specifically they mean by that. The second misconception links straight-identified men who have same-sex desires and behaviours to the racialised discourse of the so-called down low (or ‘DL’) in the USA. While the DL typically is depicted as involving African American and Latino men, most of our participants are White. Moving beyond these misconceptions, we propose that health educators must acknowledge flexibilities in the definition of heterosexuality and use an expanded definition as a starting point to envision, together with these men, how to more effectively engage them in HIV prevention and health promotion.

‘Straight with a pinch of bi’: The construction of heterosexuality as an elastic category among adult US men:

The sexualities of men who have same-sex desires yet identify as straight have attracted significant attention in recent years. We present findings from interviews with 100 such men, whom we recruited while they were seeking sex with men online, and examine the logics that allow them to maintain an identity as straight. Our sample is somewhat unique in that it included men across a wide age range (from 18 to 70), and also because many of our participants are white adult US men who are married or in stable relationships with women. Based on their patterns of sexual interpretation, we discuss how these men make their same-sex desires and behaviours consistent with a primary self-identification as straight. We argue that, in the process of maintaining identities as straight men, they change the definition of heterosexuality, in effect turning it into a considerably elastic category that is perceived as fully compatible with having and enacting same-sex desires.

Another Crack in the Mirror: The Politics of AIDS Prevention in Mexico:

Beginning in the mid-1980s, nongovernmental groups and the government in Mexico launched efforts to combat AIDS by addressing the population openly and directly. The content and tone of AIDS prevention messages in Mexico have been strongly influenced by models developed in the United States, even when the social conditions of Mexico are strikingly different. However, the local organization of AIDS prevention efforts in Mexico has differed sharply from efforts in large U.S. cities in terms of the distribution of funds and the role played by civil society in the creation of programs. Based on the premise that social and political forces may strongly influence the success, or failure, of health education interventions, this article analyzes the emergence of AIDS prevention in the Mexican context. The epidemiological characteristics of AIDS in Mexico, the governmental response to the epidemic, the role of nongovernmental groups, the availability of funds, the opposition of the political right, and the adoption of models imported from the United States are all considered to be important factors that shape current efforts. The article highlights possible directions for future development of AIDS prevention in Mexico.

Policy perspectives on public health for Mexican migrants in California.

This analysis focuses on public policies that affect primary HIV prevention and access to HIV care for Mexican migrants residing in California. Policy or structural level interventions, as opposed to behavioral or psychologic interventions, help to shape the environment in which people live. We use a conceptual model for policy analysis in public health to understand better the challenges faced by Mexican migrants. We assess potential policy level interventions that may serve as barriers to or facilitators of primary HIV prevention and care for Mexican migrants. Among potential barriers, we discuss restrictions on public health services based on legal immigration status, limits placed on affirmative action in education, and laws limiting travel and immigration. Under potential facilitators, we discuss community and migrant health centers, language access laws, and the use of community-based groups to provide prevention and treatment outreach. We also report on the limited research evaluating the implications of these public policies and ways to organize for more responsive public policies.