Martinez Omar, Muñoz-Laboy Miguel, Levine Ethan C, Starks Tyrel, Dolezal Curtis, Dodge Brian, Icard Larry, Moya Eva, Chavez-Baray Silvia, Rhodes Scott D, Fernandez M Isabel
School of Social Work, College of Public Health, Temple University, Ritter Annex, Philadelphia, PA, 19122, USA.
Center for HIV Education Studies and Training, The City University of New York, New York, NY, USA.
Arch Sex Behav. 2017 May;46(4):987-999. doi: 10.1007/s10508-016-0835-y. Epub 2016 Sep 15.
The HIV epidemic continues to be a major public health concern, affecting communities with varying prevention and treatment needs. In the U.S., Latino men who have sex with men (MSM) bear a disproportionate burden of HIV incidence. While recent studies have highlighted the relevance of relationship factors for HIV transmission among MSM generally, the unique needs and experiences of Latino MSM have received relatively little attention. Consequently, associations between relationship factors and HIV risk among Latino MSM remain unknown. This mixed-method study examined relationship status and dynamics and potential HIV-related risk behaviors among Latino MSM. Quantitative analyses with 240 Latino MSM investigated associations between relationship status and engagement in condomless anal intercourse (CAI). Focus groups with 20 Latino male couples and 10 health service providers explored the impact of relationship dynamics on sexual behaviors, as well as opportunities to intervene on HIV risk. The majority of participants were predominantly Spanish speaking, most screened positive for high-risk alcohol consumption in the past month, more than half engaged in CAI in the past 3 months, and a majority reported multiple sexual partners in this period. Among participants in same-sex relationships (n = 175), approximately half reported multiple partners in the previous 3 months and more than two-thirds reported CAI in this time period. Being in a same-sex relationship was positively associated with high-risk alcohol consumption and being age 30 or older and negatively associated with having multiple partners. Moreover, being in a same-sex relationship significantly increased the likelihood that participants would report engaging in CAI. Qualitative analyses identified themes related to relationship dynamics and sexual behavior, as well as opportunities to intervene on HIV risk. Despite the challenges encountered by Latino male couples, most participants expressed commitment to and support for their partners. As such, prevention efforts involving Latino male couples must address relationship dynamics and the role they play in sexual health, including safer sex practices.
艾滋病毒流行仍然是一个重大的公共卫生问题，影响着有着不同预防和治疗需求的社区。在美国，与男性发生性关系的拉丁裔男性承受着不成比例的艾滋病毒感染负担。虽然最近的研究普遍强调了关系因素在男男性行为者中艾滋病毒传播方面的相关性，但拉丁裔男男性行为者的独特需求和经历却相对很少受到关注。因此，拉丁裔男男性行为者中关系因素与艾滋病毒风险之间的关联仍然未知。这项混合方法研究考察了拉丁裔男男性行为者的关系状况和动态以及潜在的与艾滋病毒相关的风险行为。对240名拉丁裔男男性行为者进行的定量分析调查了关系状况与无保护肛交（CAI）行为之间的关联。对20对拉丁裔男性伴侣和10名医疗服务提供者进行的焦点小组讨论探讨了关系动态对性行为的影响，以及干预艾滋病毒风险的机会。大多数参与者主要说西班牙语，大多数人在过去一个月里筛查出高风险饮酒呈阳性，超过一半的人在过去3个月里有过无保护肛交行为，而且大多数人在此期间报告有多个性伴侣。在处于同性关系中的参与者（n = 175）中，约一半人报告在之前3个月里有多个伴侣，超过三分之二的人在此期间报告有过无保护肛交行为。处于同性关系与高风险饮酒以及年龄在30岁及以上呈正相关，与有多个伴侣呈负相关。此外，处于同性关系显著增加了参与者报告有过无保护肛交行为的可能性。定性分析确定了与关系动态和性行为相关的主题，以及干预艾滋病毒风险的机会。尽管拉丁裔男性伴侣面临挑战，但大多数参与者表示对伴侣的承诺和支持。因此，涉及拉丁裔男性伴侣的预防工作必须解决关系动态及其在性健康中所起的作用，包括安全性行为。
