Isa Fernandez, Ph.D. Nova Southeastern University

Size: px

Start display at page:

Download "Isa Fernandez, Ph.D. Nova Southeastern University"

Griffin Harper
7 years ago
Views:

1 Isa Fernandez, Ph.D. Nova Southeastern University Presented at The Sexual Health of Gay Men and Other MSM: HIV/STD Prevention Plus Conference Fenway Institute April 26, 2010

2 To present key findings from our NIDA supported study (R-O1 DA 16024) that illustrate social and cultural influences on sexual and drug use behaviors of Latino men in South Florida To present a conceptual framework that could guide today s discussion and future research

3 Heterogeneous and diverse A high proportion are not born in the U.S. 75% to 88% in adult studies 40% to 60% in youth focused studies Immigration experience impacts different facets A shared cultural heritage provides a common bond As a group these men are highly resourceful and resilient

4 To compare the effectiveness and cost of Internet vs. face-to-face strategies for recruiting Latino MSM to participate in research studies To gather quantitative and qualitative data to develop a culturally-tailored intervention to reduce unprotected anal sex and drug use and promote health and resilience

5 Mixed methods quantitative date collected via ACASI in-depth qualitative interviews Quasi-experimental design Recruitment approaches implemented sequentially in cycles alternating between internet and community recruitment Used time and space sampling to recruit participants

6 Demographic Variables Age, education, income, employment, sexual identification, place of birth, HIV status Sexual Behavior Alcohol and Drug Use Behavioral Acculturation Scale Hispanicism, Americanism (Szapocznik et al., 1980)

7 Social Oppression Homophobia, Racism (Díaz et al., 2001) Social Support Loneliness, Social Connections (Díaz et al., 2001) Identification and Involvement with the Gay Community (Vanable et al., 1998) Mental Health Psychological Distress (Díaz et al., 2001) History of suicide attempts

8 Age 31.2 (sd=6.9 Born outside U.S. 88% Spanish interview 71% Internet recruit 52% (n=294) Employed 79% HIV+ 16% Gay 92% Bisexual 8% Monthly Income (<$1,500) 59% Education Less than high school 6% High school 23% Some college 28% College + 38%

9 Compared sample characteristics by method Groups were comparable on sexual behavior and drug use Internet sample more likely to be bisexual (10.3% vs 4.8%), HIV+ (19.4% vs 12%) Collapsed sample Conducted hierarchical logistic regression to compare club drug users (43%) and non-club drug users (57%) Conducted logistic regression to examine factors associated with UAS among 466 participants who were foreign born (44% engaged in UAS in last 3 months)

10 * p 0.05; ** p 0.01; *** p Step One: Control Variables Step Two: Cultural Orientation Step Three: Social Oppression Step Four: Social Support Step Five: Mental Health Step Six: Sexual Risk Behaviors OR OR OR OR OR OR Community Venues Seropositive 2.404*** 2.394*** 2.375*** 2.439*** 2.456*** 2.094** Hispanicism 0.970*** 0.973*** 0.978*** 0.979** 0.980* Americanism 1.014* Homophobia * 0.544* 0.510** Racism 2.131* Income * 1.536* Gay Community Attachment 1.388* 1.376* 1.381* Social Connection 0.556* 0.569* Loneliness Psychological Distress History of Suicide Attempts Number of Sex Partners 1.041*** Unprotected Intercourse 1.861**

11 Odds ratio 95% C.I. Age , 1.02 Employment status , 2.10 HIV positive at time of immigration a , 12.5 Club drug use a , 3.06 Number of partners a , 1.02 Loneliness , 1.40 Psychosocial distress a , 1.82 History of suicide attempts , 1.82 Level of Americanism a , 2.26

12 20 participants 16 HIV negative or unknown status 15 had used drugs and had risky sex Areas of exploration Meaning, relationship and role of drugs and sex Context and motivation of drug use/non drug use and risky/protected sex Role of Hispanic and gay culture Role of family, friends, partners in risk and protection Intervention development issues $50 compensation

13 Negative cultural and societal messages about homosexuality lead to isolation, secrecy, shame, and low sense of self Strong cultural influences and conflicting messages from Hispanic, mainstream American and gay culture contribute to risk and protection The need of acceptance from family, partners, friends and society Poverty and Immigration experience exacerbates these conditions

14 Going back to what society expects from us and you know, that expectation is not being fulfilled and I think that is one huge reason you grow up thinking "I am not good enough" because I can't be what society expects from me, so I think that plays a huge role in you, in us, being insecure. 43 year old HIV + I know.. The heart of why I do everything is insecurity gay men are very lonely and they have a need to be accepted so they would do whatever they can to make them feel that way. 36 year old HIV

15 High congruency among our work and that of others Social, cultural and structural influences impact risk and protection Social influences (i.e. oppression, racism, discrimination) Hispanic cultural influences (i.e. negative messages regarding homosexuality, masculine gender norms) Gay cultural influences (i.e. sexual objectification. Substance use norms) Structural influences (i.e., poverty, immigration)

16 SOCIAL Influences CULTURAL Influences STRUCTURAL Influences Individual Processes Sexual Health Sexual Risk

17 Negative social and cultural influences begin early and do not go away unless there is a true transformative process of liberation grounded in experience and self acceptance This is the foundation of sexual health

18 This work was supported by NIDA RO1-DA We thank our participants who willingly gave their time and shared their stories The staff of the Behavioral Health Promotion Program

Mental health and social wellbeing of gay men, lesbians and bisexuals in England and Wales A summary of findings

Mental health and social wellbeing of gay men, lesbians and bisexuals in England and Wales A summary of findings Report funded by in collaboration with and Mental health and social wellbeing of gay men,