Friday, 13 January 2006 - 2:00 PM

Intimate Partner Violence and HIV Sexual Risk in Latino Gay Men: The Role of Sexual Self-Efficacy and Participation in Difficult Sexual Situations

Matthew B. Feldman, PhD, Columbia University and Rafael Diaz, PhD, San Francisco State University.

Purpose: Intimate partner violence (IPV) and HIV sexual risk are two social and public health problems that impact the gay community. Few studies have examined the relationship between these two public health problems among gay men (see Relf, 2001 for a review), and Latino gay men (Toro-Alfonso, 1999; Nieves-Rosa, Carballo-Dieguez, & Dolezal, 2000; Toro-Alfonso & Rodriguez-Madera, 2004a, Toro-Alfonso & Rodriguez-Madera, 2004b). The main objective of this study was to describe the prevalence and relationship between intimate partner violence (IPV) and HIV sexual risk in a sample of Latino gay men, adjusting for the effects of sexual self-efficacy and participation in difficult sexual situations that present challenges to practicing safer sex (e.g., being with a partner who does not want to wear condoms, needing to interrupt sex to find a condom). The study was guided by social-cognitive theory and the psycho-cultural model (Díaz, 1999),

Methods: A secondary data analysis was conducted, using a probability sample of 912 Latino gay men in 3 U.S. cities. Recruitment sessions were done at Latino-identified bars and clubs. To participate in the study, men had to identify as Latino, non-heterosexual, and from the city in which they were screened for eligibility. Men were asked questions about sexuality, social and family networks, general well-being, and perceived reasons for unprotected sex. Research questions and hypotheses were examined using univariate, bivariate, and multivariate analyses.

Results: The mean age of the participants in the study was 31.35 years, ranging from 18 to 69 years old. Under one-fifth (17.3%) of the men reported engaging HIV sexual risk behavior (unprotected anal intercourse with a non-monogamous partner), while almost half (48%) of the participants reported experiencing some type of IPV (psychological, physical, sexual) in their lifetime. Men with a history of IPV were two times more likely to engage in HIV sexual risk (OR= 1.975, CI= 1.364, 2.860, p< .001). Also, a history of IPV was also associated with decreased sexual self-efficacy (r= -.072, p< .05) and increased participation in difficult sexual situations (r= .201, p< .001). Further, when entered in the same regression model, results suggest that participation in sexual situations with context-specific challenges (OR= 1.148, CI= 1.106, 1.192, p< .001) fully mediated the impact of IPV on HIV sexual risk. The results support the relationship between IPV and HIV sexual risk that has been established in prior studies. In addition, the findings underscore the impact of situations that present challenges to practicing safer sex.

Implications: These results suggest the importance of considering the specific contexts in which Latino gay men are engaging in HIV sexual risk behavior. HIV prevention interventions can be designed that help Latino gay men identify and negotiate difficult sexual situations, in addition to understanding how their experience of IPV impacts current behavior.

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