Psychosocial Correlates of Unprotected Sex Without Disclosure of HIV-Positivity among African-American, Latino, and White Men Who Have Sex with Men and Women

Abstract

African-American, Latino, and White men who have sex with men and women (MSMW) may be a bridge of HIV transmission from men to women. Very little research has directly compared culturally specific correlates of the likelihood of unprotected sex among MSMW. The present study examined psychosocial correlates of unprotected sex without disclosure of HIV status with male and female partners among 50 African American, 50 Latino, and 50 White HIV-positive MSMW recruited from AIDS service organizations in Los Angeles County. Multivariate logistic regressions were conducted to examine relationships of race/ethnicity and psychosocial variables (e.g., condom attitudes, self-efficacy for HIV disclosure, sexual identification) to unprotected sex without disclosure of HIV status, for male and female partners separately. For female partners, different effects emerged by race/ethnicity. Among African-Americans, less exclusively homosexual identification and low self-efficacy for disclosure of HIV status to female partners were associated with unprotected sex without disclosure; among Latinos, less exclusively homosexual identification and negative attitudes about condoms were significant. Participants who were more exclusively homosexually identified, who held less positive condom attitudes, and who had low self-efficacy for disclosure to female partners were more likely to have unprotected sex without disclosure of HIV status to male partners. Culturally tailored community-level interventions may help to raise awareness about HIV and bisexuality, and decrease HIV and sexual orientation stigma, thereby increasing African-American and Latino MSMW’s comfort in communicating with their female partners about sexuality, HIV and condoms. Addressing norms for condom use and disclosure between male partners is recommended, especially for homosexually identified MSMW.

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Acknowledgments

This research was supported by funds from the California HIV/AIDS Research Program (ID02-APLA-038, PI: Mutchler). This research was partially supported by the Centers for Disease Control and Prevention (U48/DP000056, PI: Schuster). Preparation of this article was partially supported by the National Institute of Mental Health (R01 MH072351; PI: Bogart) and the National Institute of Nursing Research (R21 R21NR010284; PI: Bogart). We would also like to acknowledge Leonardo Colemon for assistance coordinating the study, Miguel Chion for conducting interviews with the monolingual Spanish-speaking participants in the study, and Scott Stephenson and Kate Sommers-Dawes for their work on manuscript preparation for this article.

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Correspondence to Matt G. Mutchler.

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Mutchler, M.G., Bogart, L.M., Elliott, M.N. et al. Psychosocial Correlates of Unprotected Sex Without Disclosure of HIV-Positivity among African-American, Latino, and White Men Who Have Sex with Men and Women. Arch Sex Behav 37, 736–747 (2008). https://doi.org/10.1007/s10508-008-9363-8

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Keywords

  • HIV/AIDS
  • African-American
  • Latino
  • Homosexuality
  • Bisexuality
  • Sexual risk