Paul J. Poppen

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.

Psychosocial, Behavioral, and Cultural Predictors of Sexual Risk for HIV Infection Among Latino Men Who Have Sex with Men

This study sought to replicate and extend an investigation by Diaz et al. (1999) on determinants of HIV risk among Latino gay and bisexual men living in San Francisco who were predominantly English-speaking. Compared to the Diaz et al. study, the current study sample consisted of predominantly Spanish-speaking MSM, who resided outside of HIV/AIDS epicenters and whose countries of origin were primarily Central & South American. The relationships of unprotected anal sex and multiple sexual partners with demographic, developmental, behavioral, cultural and psychosocial variables were examined. Data were collected in a convenience sample of 250 participants (primarily immigrants from El Salvador) residing in Virginia. Most men in the sample had more than one sexual partner in the last 3 months (62%) and more than a third had unprotected anal sex with a casual partner in the same time period. Communication about HIV, sexual attraction, machismo, and experiences of discrimination based on homosexual behavior were predictive of HIV risk behaviors. The findings support an integrative approach to investigating HIV risk among Latino MSM. Implications for prevention programs are discussed.

The influence of sex and sex role orientation on sexual coercion

One hundred female and 77 male college students completed a questionnaire in which they indicated whether they had ever used physical or verbal coercive strategies to initiate sexual behavior with a partner, or had ever engaged in sexual behavior in response to a partners coercive initiatives. Results showed that males are far more likely than females to initiate coerced sexual behavior and females are more likely to be victimized. In addition, masculine persons reported using coercive strategies more than other sex role orientation types. However, this was due principally to the fact that males were masculine types much more frequently than females. Therefore, sex (that is, being male or female) seems a more critical factor in determining, initiating, or responding to sexual coercion than sex role orientation.

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.

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.

Complementary and alternative medicine and adherence to care among HIV-positive Latino gay and bisexual men

Abstract The purpose of this study was to examine the degree to which HIV-positive Latino gay and bisexual men utilized complementary and alternative medicine (CAM), and to explore the relationship between CAM use and adherence to treatment. The sample consisted of 152 HIV-positive Latino gay and bisexual men. Eighty percent of participants reported use of some form of CAM. Asian CAM was most commonly used, followed by herbal remedies and Latino CAM. Adherence to Western medical care was also explored, with more than two-thirds of the sample adhering completely to recommendations concerning seeing the doctor, taking medications and following instructions. The relationships between CAM use and Western medical care were examined with logistic regressions. Those who used Latino CAM were less likely to keep doctors’ appointments, follow physicians’ recommendations and adhere to the prescribed medication regimen in the past three days. Plant-based CAM was also significantly related to non-adherence to Western medicine.

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 nature of partner relationship and AIDS sexual risk-taking in gay men

Abstract This study examined the importance of the nature of the relationship between sexual partners in predicting types of sexual practices for 293 gay and bisexual men. Demographics, personal beliefs, substance use, and variables from the health belief model, theory of self-efficacy, and theory of reasoned action were used to predict sexual behaviors. Sexual practices varied by type of partner relationship and duration, with a higher probability of risky behaviors occurring with primary partners than with non-primary partners; relationship status also moderated the effects of safer sex partner norms and denial on sexual risk-taking. In addition, men who were younger, had less education, and used alcohol or drugs prior to sex engaged in higher risk behaviors. This study indicates that a more comprehensive assessment of dimensions of partner relationship will lead to greater understanding of sexual risk-taking.