Skip to main content

Advertisement

SpringerLink
Log in

Factors Associated with Sexual Risk of HIV Transmission Among HIV-Positive Latino Men Who have Sex with Men on the U.S.-México Border

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

We present results from a cross-sectional, clinic-based survey of border-region Latino men who have sex with men (MSM) and who also are living with HIV in the El Paso-Ciudad Juárez area. Among the 66 participants who reported serodiscordant anal or vaginal intercourse, we examined levels of psychological distress and substance use and the association of these variables with condomless sex. Bivariate analyses indicated that MSM who reported condomless sex with a serodiscordant partner were more likely to report higher scores on measures of anxiety, depression, and trauma. These men were also more likely to report more days of alcohol use to the point of intoxication. In multivariate logistic regression, no variables were independently associated with sexual risk behavior, but symptoms of anxiety trended toward statistical significance. Our study is one of few reports aimed at understanding the HIV epidemic among Latino MSM living with HIV in the El Paso-Ciudad Juárez border region. Although we found no evidence of a relation between our measures of psychological distress and substance use and sexual risk behavior in multivariate analyses, psychological distress and problematic alcohol use were common in the sample and are important targets for intervention in their own right.

Resumen

Nosotros presentamos los resultados de un estudio transversal, encuesta basada en la clínica de la región fronteriza de El Paso Ciudad Juárez con hombres latinos que tienen sexo con hombres (HSH) y que viven con VIH. Entre los 66 participantes que reportaron sexo anal o vaginal serodiscordante, examinamos los niveles de estrés psicológico y el uso de sustancias y la asociación de estos variables con el variable de sexo sin condón. Los análisis bivariantes indicaron que los HSH que reportaron tener sexo sin condón con una pareja serodiscordante eran más propensos a reportar puntuaciones más altas en las medidas de la ansiedad, la depresión y el trauma. Estos hombres también eran más propensos a reportar más días de consumo de alcohol hasta el punto de intoxicación. En la regresión logística multivariante, los variables no se asociaron de forma independiente con comportamientos sexuales de riesgo, pero los síntomas de ansiedad mostraron una tendencia hacia la significación estadística. Nuestro estudio es uno de los pocos reportes dirigido a la comprensión de la epidemia del VIH entre HSH latinos que viven con el VIH en la región fronteriza de El PasoCiudad Juárez. Aunque nosotros no encontramos ron pruebas de un relación entre nuestras medidas de los trastornos psicológicos, consumo de sustancias, y el comportamiento sexual de riesgo en los análisis multivariantes, angustia psicológica y problemático uso de alcohol eran comunes en la muestra, y son objetivos importantes para la intervención en su propio derecho.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. CDC. HIV among young men who have sex with men. 2014. Available from: http://www.cdc.gov/hiv/risk/gender/msm/. Accessed 15 May 2015.

  2. CDC. Diagnoses of HIV infection in the United States and dependent areas, 2013. Vol. 25, HIV Surveillance Report. 2015. Available from: http://www.cdc.gov/hiv/library/reports/surveillance/. Accessed 30 Mar 2015.

  3. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas—2012. Vol. 19, HIV Surveillance Supplemental Report. Centers for Disease Control and Prevention; 2014. Report No.: 3.

  4. CDC. HIV Infections Attributed to Male-to-Male Sexual Contact—Metropolitan Statistical Areas, United States and Puerto Rico, 2010. MMWR Morb Mortal Wkly Rep. 2012;61(47). http://www.cdc.gov/mmwr/pdf/wk/mm6147.pdf.

  5. Santos G, Puga AM, Medina C. HAART, adherence, and cultural issues in the US Latino community. AIDS Read. 2004;14(10 Suppl):S26–9.

    PubMed  Google Scholar 

  6. Espinoza L, Hall HI, Hu X. Increases in HIV Diagnoses at the U.S.–Mexico Border, 2003–2006. AIDS Educ Prev. 2009;21(supplement b):19–33.

    Article  PubMed  Google Scholar 

  7. Gudelia Rangel M, Martínez-Donate AP, Hovell MF, Santibáñez J, Sipan CL, Izazola-Licea JA. Prevalence of risk factors for HIV infection among Mexican migrants and immigrants: probability survey in the north border of Mexico. Salud Pública Méx. 2006;48:3–12.

    Article  PubMed  Google Scholar 

  8. Sanchez MA, Lemp GF, Magis-Rodríguez C, Bravo-García E, Carter S, Ruiz JD. The epidemiology of HIV among Mexican migrants and recent immigrants in California and Mexico. JAIDS. 2004;1(37 Suppl 4):S204–14.

    Google Scholar 

  9. Rhodes SD, McCoy TP, Hergenrather KC, Vissman AT, Wolfson M, Alonzo J, et al. Prevalence estimates of health risk behaviors of immigrant Latino men who have sex with men. J Rural Health. 2012;28(1):73–83.

    Article  PubMed  Google Scholar 

  10. Crepaz N, Lyles CM, Wolitski RJ, Passin WF, Rama SM, Herbst JH, et al. Do prevention interventions reduce HIV risk behaviours among people living with HIV? A meta-analytic review of controlled trials. AIDS. 2006;20(2):143–57.

    Article  PubMed  Google Scholar 

  11. del Rio C. Latinos and HIV care in the Southeastern United States: new challenges complicating longstanding problems. Clin Infect Dis. 2011;53(5):488–9.

    Article  PubMed  Google Scholar 

  12. Kelley CF, Hernandez-Ramos I, Franco-Paredes C, del Rio C. Clinical, epidemiologic characteristics of foreign-born Latinos with HIV/AIDS at an urban HIV clinic. AIDS Read. 2007;17(2):73–88.

    PubMed  Google Scholar 

  13. Fendrich M, Avci O, Johnson TP, Mackesy-Amiti ME. Depression, substance use and HIV risk in a probability sample of men who have sex with men. Addict Behav. 2013;38(3):1715–8.

    Article  PubMed  Google Scholar 

  14. Carrico AW, Johnson MO, Morin SF, Remien RH, Charlebois ED, Steward WT, et al. Correlates of suicidal ideation among HIV-positive persons. AIDS. 2007;21(9):1199–203.

    Article  PubMed  Google Scholar 

  15. Keesee MS, Shinault KA, Carabin H. Socio-demographic characteristics of HIV/AIDS individuals living and receiving care along the US-Mexico border through five SPNS demonstration projects. J HIV/AIDS Soc Svs; 2006.

  16. White JM, Gordon JR, Mimiaga MJ. The role of substance use and mental health problems in medication adherence among HIV-infected MSM. LGBT Health. 2014;1(4):319–22.

    Article  PubMed  Google Scholar 

  17. Leserman J, Barroso J, Pence BW, Salahuddin N, Harmon JL. Trauma, stressful life events and depression predict HIV-related fatigue. AIDS Care. 2008;20(10):1258–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hart TA, James CA, Purcell DW, Farber E. Social anxiety and HIV transmission risk among HIV-seropositive male patients. AIDS Patient Care STDS. 2008;22(11):879–86.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Bradley MV, Remien RH, Dolezal C. Depression symptoms and sexual HIV risk behavior among serodiscordant couples. Psychosom Med. 2008;70(2):186–91.

    Article  PubMed  Google Scholar 

  20. DeSantis JP, Arcia A, Vermeesch A, Gattamorta KA. Using structural equation modeling to identify predictors of sexual behaviors among Hispanic men who have sex with men. Nurs Clin N Am. 2011;46(2):233–48.

    Article  Google Scholar 

  21. De Santis JPJ, Colin JMJ, Vasquez EEP, McCain GCG. The relationship of depressive symptoms, self-esteem, and sexual behaviors in a predominantly Hispanic sample of men who have sex with men. Am J Mens Health. 2008;2(4):314–21.

    Article  PubMed  Google Scholar 

  22. Ciesla JA, Roberts JE. Meta-analysis of the relationship between HIV infection and risk for depressive disorders. Am J Psychiatry. 2001;158(5):725–30.

    Article  CAS  PubMed  Google Scholar 

  23. Schafer KR, Gupta S, Dillingham R. HIV-infected men who have sex with men and histories of childhood sexual abuse: implications for health and prevention. J Assoc Nurses AIDS Care. 2013;24(4):288–98.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Semple SJ, Stockman JK, Goodman-Meza D, Pitpitan EV, Strathdee SA, Chavarin CV, et al. correlates of sexual violence among men who have sex with men in Tijuana, Mexico. Arch Sex Behav; 2016.

  25. Perry NS, Taylor SW, Elsesser S, Safren SA, O’Cleirigh C. the predominant relationship between sexual environment characteristics and hiv-serodiscordant condomless anal sex among HIV-positive men who have sex with men (MSM). AIDS Behav. 2015;20(6):1228–35.

    Article  Google Scholar 

  26. Bedoya CA, Mimiaga MJ, Beauchamp G, Donnell D, Mayer KH, Safren SA. Predictors of HIV transmission risk behavior and seroconversion among Latino men who have sex with men in Project EXPLORE. AIDS Behav. 2012;16(3):608–17.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Boone MR, Cook SH, Wilson P. Substance use and sexual risk behavior in HIV-positive men who have sex with men: an episode-level analysis. AIDS Behav. 2013;17(5):1883–7.

    Article  PubMed  Google Scholar 

  28. Mansergh G, Flores S, Koblin B, Hudson S, McKirnan D, Colfax GN, et al. Alcohol and drug use in the context of anal sex and other factors associated with sexually transmitted infections: results from a multi-city study of high-risk men who have sex with men in the USA. Sex Transm Infect. 2008;84(6):509–11.

    Article  CAS  PubMed  Google Scholar 

  29. Poppen PJ, Reisen CA, Zea MC, Bianchi FT, Echeverry JJ. Predictors of unprotected anal intercourse among HIV-positive Latino gay and bisexual men. AIDS Behav. 2004;8(4):379–89.

    Article  PubMed  Google Scholar 

  30. Mizuno Y, Borkowf CB, Ayala G, Carballo-Dieguez A, Millett GA. correlates of sexual risk for hiv among us-born and foreign-born Latino men who have sex with men (MSM): an analysis from the Brothers y Hermanos Study. J Immigr Minor Health. 2015;17(1):47–55.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Hess K, Hu X, Lansky A, Mermin J, Hall HI. Estimating the lifetime risk of a diagnosis of HIV infection in the United States. In: Conference on retroviruses and opportunistic infections CROI, 22–25 Feb 2016, Boston, Abstract 52.

  32. Simoni JM, Wiebe JS, Sauceda JA, Huh D, Sanchez G, Longoria V, Bedoya CA, Safren SA. A preliminary RCT of CBT-AD for adherence and depression among HIV-Positive Latinos on the U.S.-Mexico border: the Nuevo Día study. AIDS Behav. 2013;17(8):2816–29.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Brislin RW. Translation and content analysis of oral and written material. In: Triandis HC, Berry JW, editors. Handbook of cross-cultural psychology. Boston; 1980. p. 389–444.

  34. Zea MC, Asner-Self KK, Birman D. The abbreviated multidimentional acculturation scale: empirical validation with two Latino/Latina samples. Cultur Divers Ethnic Minor Psychol. 2003;9(2):107–26.

    Article  PubMed  Google Scholar 

  35. Remis RS, Alary M, Liu J, Kaul R, Palmer RWH. HIV transmission among men who have sex with men due to condom failure. PLoS ONE. 2014;9(9):e107540.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77–100.

    Article  Google Scholar 

  37. Beck AT, Steer RA. Manual for the revised Beck depression inventory. Austin: The Psychological Association; 1987.

    Google Scholar 

  38. Marshall GNG. Posttraumatic stress disorder symptom checklist: factor structure and English-Spanish measurement invariance. J Trauma Stress. 2004;17(3):223–30.

    Article  PubMed  Google Scholar 

  39. McDonald SD, Calhoun PS. The diagnostic accuracy of the PTSD Checklist: a critical review. Clin Psychol Rev. 2010;30(8):976–87.

    Article  PubMed  Google Scholar 

  40. Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. J Psychosom Res. 2002;52(2):69–77.

    Article  PubMed  Google Scholar 

  41. Babor TF, la Fuente de JR, Saunders J, Grant M. The alcohol use disorders identification test: guidelines for use in primary care. Geneva, Switzerland: World Health Organization; 2001

  42. McLellan AT, Cacciola JC, Alterman AI, Rikoon SH, Carise D. The Addiction Severity Index at 25: origins, contributions and transitions. Am J Addict. 2006;15(2):113–24.

    Article  PubMed  Google Scholar 

  43. Crepaz N, Marks G, Liau A, Mullins MM, Aupont LW, Marshall KJ, et al. Prevalence of unprotected anal intercourse among HIV-diagnosed MSM in the United States: a meta-analysis. AIDS. 2009;23(13):1617–29.

    Article  PubMed  Google Scholar 

  44. Darrow WW, Montanea JE, Gladwin H. AIDS-related stigma among Black and Hispanic young adults. AIDS Behav. 2009;13(6):1178–88.

    Article  PubMed  Google Scholar 

  45. Pines HA, Gorbach PM, Weiss RE, Shoptaw S, Landovitz RJ, Javanbakht M, et al. Sexual risk trajectories among MSM in the United States: implications for pre-exposure prophylaxis delivery. JAIDS. 2014;65(5):579–86.

    PubMed  PubMed Central  Google Scholar 

  46. Grov C, Rendina HJ, Moody RL, Ventuneac A, Parsons JT. HIV serosorting, status disclosure, and strategic positioning among highly sexually active gay and bisexual men. AIDS Patient Care STDS. 2015;29(10):559–68.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psych. 2005;62(6):617.

    Article  Google Scholar 

  48. Shim RS, Baltrus P, Ye J, Rust G. Prevalence, treatment, and control of depressive symptoms in the United States: results from the National Health and Nutrition Examination Survey (NHANES), 2005-2008. J Am Board Fam Med. 2011;24(1):33–8.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Bostwick WB, Boyd CJ, Hughes TL, McCabe SE. Dimensions of sexual orientation and the prevalence of mood and anxiety disorders in the United States. Am J Pub Health. 2010;100(3):468–75.

    Article  Google Scholar 

  50. McCabe SE, Hughes TL, Bostwick WB, West BT, Boyd CJ. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction. 2009;104(8):1333–45.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Longoria A, Wiebe JS, Jones A. A nurse-based disease management model of HIV/AIDS care on the U.S./Mexico Border. In: Curiel H, editor. Innovative strategies for HIVAIDS prevention care along the US-Mexico Border. Washington DC; 2007.

  52. Asch SM, Kilbourne AM, Gifford AL, Burnam MA, Turner B, Shapiro MF, et al. Underdiagnosis of depression in HIV: who are we missing? J Gen Intern Med. 2003;18(6):450–60.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Lewis-Fernández R, Das AK, Alfonso C, Weissman MM, Olfson M. Depression in US Hispanics: diagnostic and management considerations in family practice. J Am Board Fam Pract. 2005;18(4):282–96.

    Article  PubMed  Google Scholar 

  54. Akin M, Fernandez MI, Bowen GS, Warren JC. HIV risk behaviors of Latin American and Caribbean men who have sex with men in Miami, Florida, USA. Rev Panam Salud Publica. 2008;23(5):341–8.

    Article  PubMed  Google Scholar 

  55. Fernandez MI, Bowen GS, Warren JC, Ibañez GE, Hernandez N, Harper GW, et al. Crystal methamphetamine: a source of added sexual risk for Hispanic men who have sex with men? Drug Alcohol Depend. 2007;86(2–3):245–52.

    Article  PubMed  Google Scholar 

  56. De Santis JP, Arcia A, Vermeesch A, Gattamorta KA. Using structural equation modeling to identify predictors of sexual behaviors among Hispanic men who have sex with men. Nurs Clin North Am. 2011;46(2):233.

    Article  PubMed  Google Scholar 

  57. Sikkema KJ, Hansen NB, Kochman A, Santos J, Watt MH, Wilson PA, et al. The development and feasibility of a brief risk reduction intervention for newly HIV-diagnosed men who have sex with men. J Commun Psychol. 2011;39(6):717–32.

    Article  Google Scholar 

  58. Herbst JH, Kay LS, Passin WF, Lyles CM, Crepaz N, Marín BV, et al. A systematic review and meta-analysis of behavioral interventions to reduce HIV risk behaviors of Hispanics in the United States and Puerto Rico. AIDS Behav. 2006;11(1):25–47.

    Article  PubMed  Google Scholar 

  59. Chan KS, Orlando M, Joyce G, Gifford AL, Burnam MA, Tucker JS, et al. Combination antiretroviral therapy and improvements in mental health: results from a nationally representative sample of persons undergoing care for HIV in the United States. JAIDS. 2003;33(1):104–11.

    PubMed  Google Scholar 

  60. Alciati A, Gallo L, Monforte AD, Brambilla F, Mellado C. Major depression-related immunological changes and combination antiretroviral therapy in HIV-seropositive patients. Hum Psychopharmacol. 2007;22(1):33–40.

    Article  PubMed  Google Scholar 

  61. Lima VD, Geller J, Bangsberg DR, Patterson TL, Daniel M, Kerr T, et al. The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART. AIDS. 2007;21(9):1175–83.

    Article  PubMed  Google Scholar 

  62. Olatunji BO, Mimiaga MJ, Cleirigh CO. A review of treatment studies of depression in HIV. Top HIV Med. 2006;14(3):112–24.

    PubMed  Google Scholar 

  63. Alegría M, Chatterji P, Wells K, Cao Z. Disparity in depression treatment among racial and ethnic minority populations in the United States. Psychiatr Serv. 2008;1(59):1264–72.

    Article  Google Scholar 

  64. Alvarez J, Jason LA, Olson BD, Ferrari JR, Davis MI. Substance abuse prevalence and treatment among Latinos and Latinas. J Ethn Subst Abuse. 2007;6(2):115–41.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Alvarez J, Olson BD, Jason LA, Davis MI, Ferrari JR. Heterogeneity among Latinas and Latinos entering substance abuse treatment: findings from a national database. JSAT. 2004;26(4):277–84.

    Google Scholar 

  66. University Medical Center of El Paso. Community Health Needs Assessments & Implementation Plans 2014–2016. El Paso. 2014. pp. 1–15. http://www.umcelpaso.org/WebShell/umcep.nsf/DefaultFrameset/Site+Defaults?OpenDocument&DocID=8E164B0DDE46203887256D85006DAA51. Accessed 25 May 2016.

  67. Griner D, Smith TB. Culturally adapted mental health intervention: a meta-analytic review. Psychotherapy. 2006;43(4):531–48.

    Article  PubMed  Google Scholar 

  68. Schraufnagel TJ, Wagner AW, Miranda J, Roy-Byrne PP. Treating minority patients with depression and anxiety: what does the evidence tell us? Gen Hosp Psychiatry. 2006;28(1):27–36.

    Article  PubMed  Google Scholar 

  69. Cohen MS, Smith MK, Muessig KE, Hallett TB, Powers KA, Kashuba AD. Antiretroviral treatment of HIV-1 prevents transmission of HIV-1: where do we go from here? Lancet. 2013;382(9903):1515–24.

    Article  CAS  PubMed  Google Scholar 

  70. US Public Health Service. Preexposure Prophylaxis for the Prevention of HIV Infection in the United States—2014. HIV Surveillance Supplemental Report. Centers for Disease Control and Prevention; 2014. p. 1–43.

  71. Gamarel KE, Golub SA. Intimacy motivations and pre-exposure prophylaxis (PrEP) adoption intentions among HIV-negative men who have sex with men (MSM) in romantic relationships. Ann Behav Med. 2015;49(2):177–86.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Mustanski B, Starks T, Newcomb ME. Methods for the design and analysis of relationship and partner effects on sexual health. Arch Sex Behav. 2013;43(1):21–33.

    Article  Google Scholar 

  73. Skarbinski J, Rosenberg E, Paz-Bailey G, Hall HI, Rose CE, Viall AH, et al. Human immunodeficiency virus transmission at each step of the care continuum in the United States. JAMA Intern Med. 2015;175(4):588–96.

    Article  PubMed  Google Scholar 

  74. Dawes SE, Suarez P, Vaida F, Marcotte TD, Atkinson JH, Grant I, et al. Demographic influences and suggested cut-scores for the Beck Depression Inventory in a non-clinical Spanish speaking population from the US-Mexico border region. Int J Cult Ment Health. 2010;3(1):34–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Dennis AM, Napravnik S, Seña AC, Eron JJ. Late entry to HIV care among Latinos compared with non-Latinos in a southeastern US cohort. Clin Infect Dis. 2011;53(5):480–7.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Johnson WD, Díaz RM, Flanders WD, Goodman M, Hill AN, Holtgrave D, et al. Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. Cochrane Database Syst Rev. 2008;3:CD001230.

    Google Scholar 

Download references

Acknowledgments

We are grateful to the patients and staff of Centro de Salud Familiar la Fe CARE Center, Inc. for their participation and facilitation of this study. We thank members of our community and administrative advisory boards as well as research consultants Jaime Anaya, Kurt C. Organista, Steffanie A. Strathdee, Karina Walters, and Randolph Whitworth. We would also like to thank those who aided with project implementation, including Jessica Armendariz, Teresa Frias, Carolina Lara, Chrisie Lemon, Virginia Longoria, Elsa Martin, Antonio Martinez, Miriam Pando, Tatiana Rodriguez, and Cesar Villareal Ramos from the University of Texas at El Paso, and Joyce Yang, Cynthia Pearson, and Samantha Yard from the University of Washington.

Funding

This research project was supported by the National Institute of Mental Health (Grants #1R34MH08674, #K24MH093243, #T32MH19105, #T32MH078788 and #F31MH088851, and minority research supplement award #R34MH084674-S1) and in part by the Center for AIDS Research, University of Washington (Grant # P30AI027757).

Author information

Authors and Affiliations

  1. Department of Psychology, University of Washington, 3909 W. Stevens Way NE, Campus Box 351525, Seattle, WA, 98195-1525, USA

    Bryan A. Kutner & Jane M. Simoni

  2. Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA

    Kimberly M. Nelson

  3. Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, RI, USA

    Kimberly M. Nelson

  4. Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA

    John A. Sauceda

  5. Department of Psychology, University of Texas at El Paso, El Paso, TX, USA

    John S. Wiebe

Authors
  1. Bryan A. Kutner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kimberly M. Nelson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jane M. Simoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John A. Sauceda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John S. Wiebe
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bryan A. Kutner.

Ethics declarations

Conflict of Interest

Bryan A. Kutner, Kimberly M. Nelson, Jane M. Simoni, John A. Sauceda, and John S. Wiebe declares that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kutner, B.A., Nelson, K.M., Simoni, J.M. et al. Factors Associated with Sexual Risk of HIV Transmission Among HIV-Positive Latino Men Who have Sex with Men on the U.S.-México Border. AIDS Behav 21, 923–934 (2017). https://doi.org/10.1007/s10461-016-1449-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-016-1449-z

Keywords

Search

Navigation