Health Communication Among Spanish-Speaking Latino/x Sexual Minority Men in the U.S.: Language Implications for HIV Prevention and Care

Background and Purpose: Language is an important social determinant of health for Spanish-speaking Latino/x sexual minority men (SMM). Language barriers can impact the process of health communication, shaping the ability to receive accurate information and access appropriate resources. Yet there remains a lack of clear guidance on optimizing health communication strategies for improving HIV prevention outcomes within non-dominant language communities. This study sought to bridge this gap by identifying the primary sources of health communication associated with the ability of Spanish-speaking SMM to engage in HIV prevention and care.

Methods: We conducted qualitative interviews with 40 Spanish-speaking Latino/x SMM to identify sources of health information in relation to HIV prevention and care. Participants were purposively recruited through online listservs and peer referrals. Interviews asked participants about communication networks to determine individual- and community-level information sources linked to HIV-related outcomes. Analyses involved a data-reduction process in which emergent themes were identified and coded to yield a set of core themes. Interviews were analyzed in Spanish using Dedoose by two bilingual and bicultural coders.

Results: Average age of participants was 38.7 years (SD: 10.43), with the majority (92.5%, n=38) having completed high school or greater. Half were born in Colombia (50%, n=20), 17.5% (n=7) in Mexico, and 10% (n=4) in Venezuela. On average, participants had spent 8 years (SD: 10.4) in the U.S., and a quarter (25%, n=10) reported unauthorized immigrant status. Interviews revealed three main themes regarding communication-related facilitators and barriers to HIV prevention and care:

• Stigma: Participants described the U.S. as a more open environment for discussing sexual health compared to their home countries. However, within their social networks, family members were often excluded from discussions on sexual health due to prevailing stigma and misconceptions about the gay community. Instead, participants relied on support from friends, partners, and healthcare providers who were more open to addressing these issues.
• Internet and Social Media: The internet, particularly social media, emerged as the preferred platform for seeking sexual health information. Participants highlighted the ease of accessing information in Spanish as an advantage of online platforms. Information credibility hinged on the sender (organization type), perceived scientific backing, regularity of updates, and engagement with users.
• Community Connectedness: Participants discussed their social interactions with local community members and Latino-focused community organizations. There was a distinction between the perceived effectiveness of these two groups: Limited interactions with non-Spanish-speaking community members were attributed to demanding work schedules and differences in language and cultural norms. These challenges affected the utilization of HIV services, especially in areas lacking Latino-specific providers. Participants emphasized the role of Latino-focused community organizations in facilitating access to health information. These organizations were often equipped with Spanish-language resources and culturally-relevant services.

Conclusion and Implications: Our findings underscore the impact of stigma, the prominence of internet use, and the significance of community-connectedness on HIV information access and service utilization among Spanish-speaking SMM in the U.S. To improve HIV prevention outcomes, interventions should consider relevant strategies to optimize health communication for this population.