Familial, Social and Cultural Influences On HIV Risk and Prevention Among Latino Men Who Have Sex with Men

HIV/AIDS among Latino men who have sex with men (MSM) remains a serious social welfare concern. To date, relatively little research has explored the role of Latino families in preventing HIV among MSM. The present study sought to better understand how families influence HIV-related risk behaviors, namely substance use and sexual risk taking, among Latino MSM. Because research suggests that contextual factors such as stigma, discrimination and homophobia are important for preventing HIV among Latino MSM, we specifically examined how family relationships operated in conjunction with these contextual factors. In doing so, the present study addresses an important gap in the literature, as little is known about the potential ways in which family members may shape HIV-related risk behaviors among Latino MSM.

The present study analyzed individual in-depth interviews with a venue-based sample of 62 urban, Latino MSM residing in Northern California (M = 35 years; Range: 18-64). Interviews examined the familial, social, and cultural factors associated with men’s sexual behavior and substance use, as well as their experiences with disclosing their sexual orientation to their family. Men also completed a close-ended survey assessing basic demographic characteristics. Interviews were conducted in English and Spanish and were audiotape recorded. A written transcript was produced for each interview and Spanish interviews were translated into English using the backward-forward method (Marín & Van Oss Marín, 1991). Three independent coders conducted a content analysis of each transcript to identify, categorize, and code themes from the data.

In general, MSM reported low incomes; almost 80% had an annual income < $30,000. Many men were recent immigrants, with approximately 50% residing in the U.S. for less than six years. Overall, most Latino MSM reported having large social support networks consisting of family members and close friends. Although a key theme was the importance of family and family support for promoting HIV-risk reduction, rejection from family and friends related to disclosure of sexual orientation and/or HIV status also emerged as a critical factor that shaped men’s HIV-related risk taking. MSM identified rejection and stigma as factors that contributed to poor mental health and an increased likelihood of engaging in risky sex. Conversely, MSM described emotionally close relationships with specific members of their families of origin (i.e., mothers, fathers, siblings) that helped them to manage negative experiences with homophobia, stigma and discrimination.

Family members have rarely been involved in HIV-prevention interventions for Latino MSM. Although many Latino MSM have close relationships with their family, family relationships also reflected patterns of stigma, discrimination and homophobia. Our findings suggest two points of intervention. First, in families where Latino MSM experience support, there may be organic relationships that can be leveraged in HIV-prevention programs. Second, in families where Latino MSM experience rejection, social workers could play an important role in helping MSM manage these experiences or can work directly with families who are struggling to support their sons. Future research with Latino MSM and their families is needed and should continue to explore how families can help to prevent HIV.