AIDS and Behavior

, Volume 8, Issue 4, pp 379–389 | Cite as

Predictors of Unprotected Anal Intercourse Among HIV-Positive Latino Gay and Bisexual Men

  • Paul J. Poppen
  • Carol A. Reisen
  • María Cecilia Zea
  • Fernanda T. Bianchi
  • John J. Echeverry
Article

Abstract

This study examined sexual behaviors in a sample of 155 HIV-positive Latino gay and bisexual men. Nearly half the sample had engaged in unprotected anal intercourse in the past 12 months; unprotected anal intercourse was more likely when the partner was also HIV-positive. Separate regression models predicted the number of receptive and insertive partners for unprotected anal intercourse. Participants reported both more unprotected insertive and receptive partners if they had sex under the influence of alcohol or drugs. Older participants and those with lower levels of Latino acculturation reported having more partners with whom they took the receptive role during unprotected anal intercourse, whereas those with higher levels of depression reported having more partners with whom they took the insertive role. Hierarchical set logistic regression revealed that the dyadic variable of seroconcordance added to the prediction of unprotected anal sex with the most recent male partner, beyond the individual characteristics. Results show the importance of examining both individual and dyadic characteristics in the study of sexual behavior.

Latino MSM HIV-positive sex risk 

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References

  1. Bajos, N., and Marquet, J. (2000). Research on HIV sexual risk: Social relations-based approach in a cross-cultural perspective. Social Science and Medicine, 50, 1533–1546.PubMedGoogle Scholar
  2. Beck, A. T., and Beck, R. W. (1972). Screening depressed patients in family practice: A rapid technique. Postgraduate Medicine, 52, 81–85.PubMedGoogle Scholar
  3. Becker, M. H., and Joseph, J. G. (1988). AIDS and behavioral change to reduce risk: A review. American Journal of Public Health, 78, 394–410.CrossRefPubMedGoogle Scholar
  4. Bingham, T. A., Harawa, N. T., Johnson, D. F., Secura, G. M., MacKellar, D. A., and Valleroy, L. A. (2003). The effect of partner characteristics on HIV infection among African American men who have sex with men in the Young Men’s Survey, Los Angeles, 1999–2000. AIDS Education and Prevention, 15(Suppl. A), 39–52.PubMedGoogle Scholar
  5. Brislin, R. W. (1986). The wording and translation of research instruments. In W. J. Lonner and J. W. Berry (Eds.), Field methods in cross-cultural psychology (pp. 137–164). Beverly Hills, CA: Sage.Google Scholar
  6. Buchanan, D. R., Poppen, P. J., and Reisen, C. A. (1996). The nature of partner relationship and AIDS sexual risk-taking in gay men. Psychology and Health, 11, 541–555.Google Scholar
  7. Carballo-Diéguez, A., Remien, R. H., Dolezal, C., and Wagner, G. (1997). Unsafe sex in the primary relationships of Puerto Rican men who have sex with men. AIDS and Behavior, 1, 9–17.Google Scholar
  8. Carballo-Diéguez, A., Dolezal, C., Nieves, L., Díaz, F., Decena, C., and Balan, I. (2004). Looking for a tall, dark, macho man...sexual-role behaviour variations in Latino gay and bisexual men. Culture, Health, and Sexuality, 6, 159–171.Google Scholar
  9. Carlson, R. G., Wang, J., Siegal, H. A., Falck, R. S., and Guo, J. (1994). An ethnographic approach to targeted sampling: Problems and solutions in AIDS prevention research among drug and crack-cocaine users. Human Organization, 53, 279–286.Google Scholar
  10. Catania, J. A., Kegeles, S. M., and Coates, T. J. (1990). Towards an understanding of risk behavior: An AIDS risk reduction model (ARRM). Health Education Quarterly, 17, 53–72.PubMedGoogle Scholar
  11. CDC. (2000). US HIV and AIDS cases reported through December, 1999. Year end edition. HIV/AIDS surveillance report, 11. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  12. CDC. (2002). US HIV and AIDS cases reported through December, 2001. Year end edition. HIV/AIDS surveillance report, 13. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
  13. Corbin, W. R., and Fromme, K. (2002). Alcohol use and serial monogamy as risks for sexually transmitted diseases in young adults. Health Psychology, 21, 229–236.PubMedGoogle Scholar
  14. Crepaz, N., and Marks, G. (2001). Are negative affective states associated with HIV sexual risk behaviors? A meta-analytic review. Health Psychology, 20, 291–299.PubMedGoogle Scholar
  15. Davidovich, U., deWit, J., and Stroebe, W. (2000). Assessing sexual risk behaviour of young gay men in primary relationships: The incorporation of negotiated safety and negotiated safety compliance. AIDS, 14, 701–706.PubMedGoogle Scholar
  16. DeRosa, C. R., and Marks, G. (1998). Preventive counseling of HIV-positive men and self-disclosure of serostatus to sex partners: New opportunities for prevention. Health Psychology, 17, 224–231.Google Scholar
  17. Díaz, R. M. (1998). Latino gay men and HIV: Culture, sexuality, and risk behavior. New York: Routledge.Google Scholar
  18. Díaz, R. M. (1999). Trip to Fantasy Island. Sexualities, 2, 89–112.Google Scholar
  19. Dolezal, C., Meyer-Bahlburg, H. F. L., Remien, R. H., and Petkova, E. (1997). Substance use during sex and sensation as predictors of sexual risk behavior among HIV+ and HIV− gay men. AIDS and Behavior, 1, 19–28.Google Scholar
  20. Dolezal, C., Carballo-Diéguez, A., Nieves-Rosa, L., and Díaz, F. (2000). Substance use and sexual risk behavior: Understanding their association among four ethnic groups of Latino men who have sex with men. Journal of Substance Abuse, 11, 323–336.PubMedGoogle Scholar
  21. Ekstrand, M. L., Stall, R. D., Paul, J. P., Osmond, D. H., and Coates, T. J. (1999). Gay men report high rates of unprotected sex with partners of unknown or discordant HIV status . AIDS, 13, 1525–1533.PubMedGoogle Scholar
  22. Elford, J., Bolding, G., Maguire, M., and Sherr, L. (2001). Gay men, risk and relationships. AIDS, 15, 1053–1055.PubMedGoogle Scholar
  23. Fisher, J. D., and Fisher, W. A. (2000). Theoretical approaches to individual-level change in HIV risk behavior. In J. L. Peterson and R. J. DiClemente (Eds.), Handbook of HIV prevention (pp. 3–48). New York: Kluwer Academic/Plenum Publishers.Google Scholar
  24. Flowers, P., Sheeran, P., Beail, N., and Smith, J. A. (1997). The role of psychosocial factors in HIV risk-reduction among gay and bisexual men: A quantitative review. Psychology and Health, 12, 197–230.Google Scholar
  25. Frijida, N. H. (1988). The laws of emotion. American Psychologist, 43, 349–358.Google Scholar
  26. Hays, R. B., Kegeles, S. M., and Coates, T. J. (1997a). Unprotected sex and HIV risk-taking among young gay men within boyfriend relationships. AIDS Education and Prevention, 9, 314–329.Google Scholar
  27. Hays, R. B., Paul, J., Ekstrand, M., Kegeles, S. M., Stall, R., and Coates, T. J. (1997b). Actual versus perceived HIV status, sexual behaviors and predictors of unprotected sex among young gay and bisexual men who identify as HIV-negative, HIV-positive and untested. AIDS, 11, 1495–1502.Google Scholar
  28. Janssen, M., DeWit, J., Stroebe, W., and VanGriensven, F. (2000). Educational status and risk of HIV in young gay men. Journal of Health Psychology, 5, 487–499.CrossRefGoogle Scholar
  29. Kalichman, S. (2000). HIV transmission risk behaviors of men and women living with HIV-AIDS: Prevalence, predictors, and emerging clinical interventions. Clinical Psychology: Science and Practice, 7, 32–47.Google Scholar
  30. Kalichman, S. C., Nachimson, D., Cherry, C., and Williams, E. (1998). AIDS treatment advances and behavioral prevention setbacks: Preliminary assessment of reduced perceived threat of HIV-AIDS. Health Psychology, 17, 546–550.PubMedGoogle Scholar
  31. Kelly, J. A., and Kalichman, S. C. (1998). Reinforcement value of unsafe sex as a predictor of condom use and continued HIV/AIDS risk behavior among gay and bisexual men. Health Psychology, 17, 328–335.PubMedGoogle Scholar
  32. Kippax, S., Crawford, J., Davis, M., Rodden, P., and Dowsett, G. (1993). Sustaining safe sex: A longitudinal sample of homosexual men. AIDS, 7, 257–263.PubMedGoogle Scholar
  33. Koblin, B. A., Chesney, M. A., Husnik, M. J., Bozeman, S., Celum, C. L., Buchbinder, S., Mayer, K., McKirnan, D., Judson, F. N., Hunag, Y., Coates, T. J., and the EXPLORE Study Team. (2003). High-risk behaviors among men who have sex with men in 6 US cities: Baseline data from the EXPLORE study. American Journal of Public Health, 93, 926–932.PubMedCrossRefGoogle Scholar
  34. Leigh, B., and Stall, R. (1993). Substance use and risky sexual behavior for exposure to HIV: Issues in methodology, interpretation, and prevention. American Psychologist, 48, 1035–1045.PubMedGoogle Scholar
  35. Lye Chng, C., and Geliga-Vargas, J. (2000). Ethnic identity, gay identity, sexual sensation seeking and HIV risk among multiethnic men who have sex with men. AIDS Education and Prevention, 12, 326–339.Google Scholar
  36. Marín, G., and Marín, B. V. (1991). Research with Hispanic populations. Applied social research methods series (Vol. 23). Newbury Park, CA: Sage.Google Scholar
  37. Marín, B. V., González, F. J., and Gómez, C. A. (1998). Unmarried Latino men who report sex with men: Psychocultural and demographic characteristics. AIDS and Behavior, 2, 203–211.Google Scholar
  38. Marks, G., Richardson, J. L., and Maldonado, N. (1991). Self-disclosure of HIV infection to sexual partners. American Journal of Public Health, 81, 1321–1323.PubMedGoogle Scholar
  39. Marks, G., Bingham, C. R., and Duval, T. S. (1998a). Negative affect and unsafe sex in HIV-positive men. AIDS and Behavior, 2, 89–99.Google Scholar
  40. Marks, G., Cantero, P. J., and Simoni, J. M. (1998b). Is acculturation associated with sexual risk behaviours? An investigation of HIV-positive Latino men and women. AIDS Care, 10, 283–295.CrossRefGoogle Scholar
  41. Marks, G., Burris, S., and Peterson, T. A. (1999). Reducing sexual transmission of HIV from those who know they are infected: The need for personal and collective responsibility. AIDS, 13, 297–306.PubMedGoogle Scholar
  42. Mason, H. R. C., Marks, G., Simoni, J. M., and Ruiz, M. S. (1995). Culturally sanctioned secrets? Latino men’s nondisclosure of HIV infection to family, friends, and lovers. Health Psychology, 14, 6–12.PubMedGoogle Scholar
  43. McAuliffe, T. L., Kelly, J. A., Sikkema, K. J., Murphy, D. A., Winett, R. A., Solomon, L. J., and Roffman, R. A. (1999). Sexual HIV risk behavior levels among young and older gay men outside of AIDS epicenters: Findings of a 16-city sample. AIDS and Behavior, 3, 111–119.Google Scholar
  44. Myers, T., Allman, D., Calzavara, L., Morrison, K., Marchand, R., and Major, C. (1999). Gay and bisexual men’s sexual partnerships and variations in risk behaviour. The Canadian Journal of Human Sexuality, 8, 115–126.Google Scholar
  45. Ostrow, D. G., McKirnan, D., Klein, C., and DiFranceisco, W. (1999). Patterns and correlates of risky behavior among HIV+ gay men: Are they really different from HIV− men? AIDS and Behavior, 3, 99–110.Google Scholar
  46. Parker, R. G. (1996). Behaviour in Latin American men: Implications for HIV/AIDS interventions. International Journal of STD and AIDS, 7, 62–65.PubMedGoogle Scholar
  47. Parsons, J. T., Halkitis, P. N., Wolitski, R. J., Gómez, C. A., and the Seropositive Urban Men’s Study Team. (2003). Correlates of sexual risk behaviors among HIV-positive men who have sex with men. AIDS Education and Prevention, 15, 383–400.PubMedGoogle Scholar
  48. Pinkerton, S. D., and Abramson, P. R. (1997). Effectiveness of condoms in preventing HIV transmission. Social Science and Medicine, 44, 1303–1312.PubMedGoogle Scholar
  49. Remien, R. H., Carballo-Diéguez, A., and Wagner, G. (1995). Intimacy and sexual behavior in serodiscordant male couples. AIDS Care, 7, 429–438.PubMedGoogle Scholar
  50. Ross, M. W., Rosser, B. R. S., Bauer, G. R., Bockting, W. O., Robinson, B. E., Rugg, D, L., and Coleman, E. (2001). Drug use, unsafe sexual behavior, and internalized homonegativity in men who have sex with men. AIDS and Behavior, 5, 97–103.Google Scholar
  51. San Doval, A., Duran, R., O’Donnell, L., and O’Donnell, C. R. (1995). Barriers to condom use in primary and nonprimary relationships among Hispanic STD clinic patients. Hispanic Journal of Behavioral Sciences, 17, 385–397.Google Scholar
  52. Stall, R., and Purcell, D. W. (2000). Intertwining epidemics: A review of research on substance use among men who have sex with men and its connection to the AIDS epidemic. AIDS and Behavior, 4, 181–192.Google Scholar
  53. Stall, R. D., McKusick, L., Wiley, J., Coates, T. J., et al. (1986). Alcohol and drug use during sexual activity and compliance with safe sex guidelines for AIDS: The AIDS Behavioral Research Project. Health Education Quarterly, 13, 359–371.PubMedGoogle Scholar
  54. Stall, R. D., Hays, R. B., Waldo, C. R., Ekstrand, M., and McFarland, W. (2000). The gay ‘90s: A review of research in the 1990s on sexual behavior and HIV risk among men who have sex with men. AIDS, 14(Suppl. 3), S1–S14.Google Scholar
  55. Strathdee, S. A., Hogg, R. S., Martindale, S. L., Cornelisses, P. G. A., Craib, K. J. P., Montaner, J. S. G., O’Shaughnessy, M. V., and Schechter, M. T. (1998). Determinants of sexual risk-taking among young HIV-negative gay and bisexual men. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 19, 61–66.PubMedGoogle Scholar
  56. Watters, J. K., and Biernacki, P. (1989). Targeted sampling: Options for the study of hidden populations. Social Problems, 36, 416–430.Google Scholar
  57. Wenger, N., Kusseling, F., Beck, K., and Shapiro, M. (1994). Sexual behavior of individuals infected with human immunodeficiency virus. Archives of Internal Medicine, 154, 1849–1854.PubMedGoogle Scholar
  58. Zea, M. C., Belgrave, F. Z., Townsend, T. G., Jarama, S. L., and Banks, S. R. (1996). The influence of social support and active coping on depression among African Americans and Latinos with disabilities. Rehabilitation Psychology, 41, 223–240.Google Scholar
  59. Zea, M. C., Reisen, C. A., and Poppen, P. J. (1999). Psychological well-being among Latino lesbians and gay men. Cultural Diversity and Ethnic Minority Psychology, 5, 371–379.Google Scholar
  60. Zea, M. C., Asner-Self, K., Birman, D., and Buki, L. (2003). The Abbreviated Multidimensional Acculturation Scale: Empirical validation with two Latino/Latina samples. Cultural Diversity and Ethnic Minority Psychology, 9, 107–126.PubMedGoogle Scholar
  61. Zea, M. C., Reisen, C. A., Poppen, P. J., Echeverry, J. E., and Bianchi, F. T. (2004). Disclosure of HIV-positive status to Latino gay men’s social networks. American Journal of Community Psychology, 33, 107–116.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2004

Authors and Affiliations

  • Paul J. Poppen
    • 1
  • Carol A. Reisen
    • 1
  • María Cecilia Zea
    • 1
  • Fernanda T. Bianchi
    • 1
  • John J. Echeverry
    • 1
  1. 1.George Washington UniversityWashington

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