Jesus Ramirez-Valles

From Networks to Populations: The Development and Application of Respondent-Driven Sampling Among IDUs and Latino Gay Men

One of the challenges in studying HIV-risk behaviors among gay men is gathering information from a non-biased sample, as traditional probability sampling methods cannot be applied in gay populations. Respondent-Driven Sampling (RDS) has been proposed as a reliable and bias-free method to recruit “hidden” populations, such as gay men. The aim of this study is to assess the feasibility and effectiveness of RDS to sample Latino gay men and transgender persons. This was carried out when we used RDS to recruit participants into a study that investigated community involvement on HIV/AIDS sexual risk behaviors among Latino gay and bisexual men, and transgender (male-to-female) persons in Chicago and San Francisco. The population coverage of RDS was then compared to simulated time-location sampling (TLS). Recruitment differences were observed across cities, but the samples were comparable. RDS showed broader population coverage than TLS, especially among individuals at high risk for HIV.

Sexual risk behavior among youth: modeling the influence of prosocial activities and socioeconomic factors.

Sexual activity among high-school-aged youths has steadily increased since the 1970s, emerging as a significant public health concern. Yet, patterns of youth sexual risk behavior are shaped by social class, race, and gender. Based on sociological theories of financial deprivation and collective socialization, we develop and test a model of the relationships among neighborhood poverty; family structure and social class position; parental involvement; prosocial activities; race; and gender as they predict youth sexual risk behavior. We employ structural equation modeling to test this model on a cross-sectional sample of 370 sexually active high-school students from a midwestern city; 57 percent (n = 209) are males and 86 percent are African American. We find that family structure indirectly predicts sexual risk behavior through neighborhood poverty, parental involvement, and prosocial activities. In addition, family class position indirectly predicts sexual risk behavior through neighborhood poverty and prosocial activities. We address implications for theory and health promotion.

Resilience Among Urban African American Male Adolescents: A Study of the Protective Effects of Sociopolitical Control on Their Mental Health

Resilience refers to the notion that some people succeed in the face of adversity. In a risk-protective model of resilience, a protective factor interacts with a risk factor to mitigate the occurrence of a negative outcome. This study tested longitudinally the protective effects of sociopolitical control on the link between helplessness and mental health. The study included 172 urban, male, African American adolescents, who were interviewed twice, 6 months apart. Sociopolitical control was defined as the beliefs about ones capabilities and efficacy in social and political systems. Two mental health outcomes were examined—psychological symptoms and self-esteem. Regression analyses to predict psychological symptoms and self-esteem over time were conducted. High levels of sociopolitical control were found to limit the negative consequences of helplessness on mental health. The results suggest that sociopolitical control may help to protect youths from the negative consequences of feelings of helplessness. Implications for prevention strategies are discussed.

HIV Infection, Sexual Risk Behavior, and Substance Use Among Latino Gay and Bisexual Men and Transgender Persons

OBJECTIVES We examined HIV prevalence and the socioeconomic correlates of HIV infection, sexual risk behaviors, and substance use among Latino gay and bisexual men and transgender persons in Chicago and San Francisco. METHODS Data were collected from a sample of 643 individuals (Chicago: n=320; San Francisco: n=323) through respondent-driven sampling and computer-assisted self-administered interviews. RESULTS HIV prevalence in San Francisco (0.325; 95% confidence interval [CI]=0.260, 0.393) was higher than in Chicago (0.112; 95% CI=0.079, 0.163). In San Francisco, HIV prevalence was higher among US-born residents than among those born outside the country; in Chicago, the opposite was true. Heavy use of alcohol was prevalent, especially in Chicago (0.368; 95% CI=0.309, 0.432; San Francisco: 0.154; 95% CI=0.116, 0.192). Drug use and more education were positively correlated and greater age was negatively correlated with unprotected anal intercourse. CONCLUSIONS Heavy alcohol drinking and use of drugs remain a significant public health problem in this population. Drug use was more closely linked to HIV sexual risk behaviors than was heavy drinking.

Gender Differences of Neighborhood and Social Control Processes: A Study of the Timing of First Intercourse among Low-achieving, Urban, African American Youth

This study examines the gender-specific contextual and individual socioeconomic predictors of the timing of first intercourse among low-achieving African American youth. Following financial deprivation and collective socialization theories, the authors test separate models for males and females and include neighborhood poverty and race composition, family social class position, and social control mechanisms such as family structure, parental involvement, and prosocial activities as predictors. The sample comprises 558 African American high school students followed over a 3-year period. For young women, the significant predictors are age, mothers education, time with mother, and involvement in church activities. For young men, the significant factors are school achievement, an interaction between living in an two-parent family and time with father, participation in family decision making, and neighborhood poverty level. Thus, males and females are differently affected by social control processes and neighborhood poverty plays a significant role in young African American mens sexual behaviors.

Social Integration and Health: Community Involvement, Stigmatized Identities, and Sexual Risk in Latino Sexual Minorities

The purpose of this study is to contribute to the conceptual understanding and practical application of social integration theory to health behaviors. We test whether community involvement in AIDS and GLBT organizations moderates the relationship of racial and homosexual stigmata to sexual risk behavior among gay and bisexual men and transgender persons of Latin American origin or descent. We use structural equation modeling to analyze data from a sample of 643 individuals recruited via respondent-driven sampling. Among those not involved in community organizations, homosexual and racial stigmata are related to sexual activity under the influence of alcohol and drugs, which is linked to sexual risk behavior. Among the involved group, the stigmata are not linked to sexual activity under the influence of alcohol and drugs, or to sexual risk behavior. The moderating role of community involvement seems to be more salient in those currently involved than those ever involved.

Confronting Stigma: Community Involvement and Psychological Well-Being Among HIV-Positive Latino Gay Men

Theories of social integration and stress process posit that community involvement may buffer or may compensate the adverse effects of stigma on psychological well-being. In this article, the authors explore this thesis in a stigmatized and seldom studied group of HIV-positive Latino gay men. Specifically, they examine the effects of community involvement in AIDS and gay-related organizations (e.g., volunteerism and activism) and experienced homosexual stigma on three psychological well-being indicators (i.e., self-esteem, depression, and loneliness). The cross-sectional sample includes 155 HIV-positive men living in New York City and Washington, DC. Results suggest that experienced stigma attributed to homosexuality is associated with psychological well-being. Community involvement, however, seems to compensate the association between stigma and depression and loneliness, while buffering the association with self-esteem. Furthermore, community involvement appears to also heighten the perception of stigma.

Stigmatization, substance use, and sexual risk behavior among Latino gay and bisexual men and transgender persons

Following the minority stress model as a framework, we examine the associations between racial and homosexual stigma, substance use, and sexual risk behavior among a respondent-driven sample of Latino gay and bisexual men and male-to-female transgender persons (GBT) in Chicago and San Francisco (N = 643). We use structural equations to test such a model and disentangle the possible effects of the different stigmas and their corresponding dimensions (i.e., perception, experience, internalization). Findings revealed distinct pathways to sexual risk. Two are typified by experienced homosexual stigma and internalized racial stigma via multiple drug use, and two are characterized by experienced racial stigma and internalized homosexual stigma via alcohol use.

The fit between theory and data in respondent-driven sampling: Response to Heimer

., thisissue). As Heimer states, Respondent-Driven Sam-pling (RDS) is “an innovative and powerful method-ology,” thus, we welcome this opportunity to furtherclarify the theoretical basis and applications of RDS.Like any other probability sampling method,RDS is based on a statistical theory of the samplingprocess. Such theory provides the means to calcu-late population estimators of minimal or zero bias,and estimates of the variability of those estimatorsin the form of confidence intervals or standard er-rors. This theory also constrains the contexts in whichsampling can validly take place, because necessaryinformation required by the statistical theory must beattainable, and data structures must have the formpresumed by the statistical theory. Consequently,evaluating an application of a sampling method mustassess the fit between the requirements of the sam-pling method’s statistical theory and the data fromwhich research conclusions are derived. To the ex-tent that the assumptions of the statistical theory areviolated, confidence on the validity and reliability ofestimators is correspondingly reduced. This is the fo-cus of Heimer’s comments. He repeatedly expressesconcerns that we failed to address what he sees asdiscrepancies between the data reported in our arti-cle and the requirements of the RDS method. These

HIV/AIDS stigma: Measurement and relationships to psycho-behavioral factors in Latino gay/bisexual men and transgender women

Despite the increased interest in HIV/AIDS stigma and its negative effects on the health and social support of people living with HIV/AIDS (PLWHA), little attention has been given to its assessment among Latino gay/ bisexual men and transgender women (GBT) living with HIV/AIDS. The purpose of this paper is twofold: to develop a multidimensional assessment of HIV/AIDS stigma for Latino GBT living with HIV/AIDS, and to test whether such stigma is related to self-esteem, safe sex self-efficacy, social support, and alcohol, and drug use. The sample included 170 HIV+ Latino GBT persons. The results revealed three dimensions of stigma: internalized, perceived, and enacted HIV/AIDS stigma. Enacted HIV/AIDS stigma comprised two domains: generalized and romantic and sexual. Generalized enacted HIV/AIDS stigma was related to most outcomes. Internalized HIV/AIDS stigma mediated the associations between generalized enacted HIV/AIDS stigma and self-esteem and safe sex self-efficacy. In addition, romantic and sexual enacted HIV/AIDS stigma significantly predicted drug use. Perceived HIV/AIDS stigma was not associated with any outcome. These findings expand the understanding of the multidimensionality of stigma and the manner in which various features impact marginalized PLWHA.