Patterns of Sexual Experience among Urban Latino & African American 9th Grade Students

This analysis assessed patterns of sexual experience, the order in which behaviors were initiated, and associated factors, among Latino and African American ninth grade students (average age 15.2) who self-administered audio-computer-assisted surveys on netbooks in classes at 10 Los Angeles–area public high schools. 

Lifetime experiences with vaginal and oral sex were most common (19% and 16%, respectively); fewer reported anal sex (6%). Of the 23% reporting any sex, 91% fell into four categories: 36% reporting both oral and vaginal sex; 23% vaginal only; 18% all three; and 13% oral only. Most sexually experienced students (88%) initiated with vaginal or oral sex (46% vaginal, 33% oral, 9% both same day). 

No dominant pathway of sexual onset emerged for those reporting all three types of sex. We found no evidence that oral or anal sex substituted for or delayed vaginal sex. Males, those with a current partner, and those reporting multiple partners were more likely than others to report all three sexual behaviors versus vaginal only (odds ratios [ORs] 2.0, 1.5, 3.0; p = .02, .06, < .01, respectively). 

Although vaginal intercourse dominated their early sexual behavior, one-fifth of sexually experienced students reported anal intercourse, highlighting the need for specific prevention messages surrounding this higher-risk behavior.

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By:  Robin A. Donatello^a*, Christine J. De Rosa^b, Bret D. Moulton^c,Emily Q. Chung^d, Rachel Viola^c, Louise Ann Rohrbach^c &Abdelmonem A. Afifi^e

^a Department of Mathematics and Statistics, California State University, Chico

^b Los Angeles County Department of Public Health, Division of HIV and STD Programs; Institute for Health Promotion and Disease Prevention, University of Southern California

^c Institute for Health Promotion and Disease Prevention, University of Southern California

^d Los Angeles County Department of Public Health, Division of HIV and STD Programs

^e Department of Biostatistics, Fielding School of Public Health, University of California at Los Angeles 

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Promotion of Latina Health: Intersectionality of IPV and Risk for HIV/AIDS

Latina women in the United States are vulnerable to two intersecting public health concerns: intimate partner violence (IPV) and subsequent risk for HIV/AIDS infection. Examination of the cultural and contextual life factors of this understudied population is crucial to developing culturally relevant HIV interventions. 

Focus groups with Latinas (15 monolingual; 10 bilingual) who have experienced IPV were conducted. Monolingual and bilingual Latinas endorsed that they were concerned about HIV infection, naming partner infidelity and experiences of forced and coerced sex as primary reasons for their concern. However, monolingual participants had lower levels of HIV knowledge, spending much time discussing myths of HIV infection, whereas bilingual participants spent more time discussing specific prevention techniques, including challenges related to the violence in their relationships. 

These findings suggest that HIV/AIDS prevention programs for Latinas need to pay close attention to the different historical, contextual, and cultural experiences of this at-risk group of women.

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By:  Rountree MA1, Granillo T2, Bagwell-Gray M3.

• 1University of Texas at Austin School of Social Work, USA mrountree@mail.utexas.edu.
• 2Con Mi Madre, Austin, TX, USA.
• 3Arizona State University School of Social Work, Phoenix, USA. 
• Violence Against Women. 2016 Apr;22(5):545-64. doi: 10.1177/1077801215607358. Epub 2015 Oct 14.

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Community Connectedness, Challenges, and Resilience among Gay Latino Immigrants

To date, relatively little psychological research has focused on the experiences of lesbian, gay, bisexual, and transgender (LGBT) Latino/a immigrants to the United States. 

This qualitative study used face-to-face semi-structured interviews to explore the unique sources of stress, challenges, as well as opportunities and factors related to resilience among 13 gay Latino first- and second-generation immigrants. Iterative coding of interview transcripts revealed four key themes, each of which is illustrated with verbatim quotes: 1) feelings of connectedness to the LGBT community, 2) feelings of connectedness to the Latino/a community, 3) intersectional challenges and strategies, and 4) well-being, strength, and resilience. 

As suggested by these themes, gay Latino immigrants have distinct sources of stress and conflict, many of them associated with community memberships, but also draw on unique sources of support and adaptive thoughts and behaviors in facing stressors. 

Implications for studying risk and resilience factors among stigmatized populations, including LGBT individuals and immigrants, are discussed.

...As Hector, a 42-year-old second-generation gay man who adopted a more masculine gender presentation noted:

I guess because I'm not flamboyant a lot of people don't realize [I’m gay] in just general public settings. So I guess if I was more effeminate it would be more obvious and then it might've been an issue for me… because of that I also stay away from gay culture more.

Hector recalled that the only gay role models he had growing up were extremely feminine and that he never identified or saw commonality with them. Presently, he stated that he chooses to affiliate with more masculine men, and wishes to be seen by others and by mainstream society as “just a regular guy.”

Another source of disconnection involved the perceived tension between ethnic groups within the LGBT community or between an ethnic community and the “mainstream” gay community. Some participants felt that being an ethnic minority member of the LGBT community was difficult at times; they perceived the LGBT community as largely White and privileged. Perhaps reflecting this, many also felt that ethnic minorities were poorly represented within the community, including in community spaces, in discussions of activism, and in the media. Ernesto, a 49-year-old Peruvian who moved to the U.S. as an adult, described his perception of the LGBT community as narrowly focused, and as having an agenda that was mainly driven by White, gay men. Having lived in several multicultural communities throughout his lifetime, he was particularly attuned to what he felt was a one-dimensional approach to defining the priorities of the LGBT community:

I think their interests are very, like I said, self-serving. It’s about what interests them. It’s like this whole Prop 8 thing…everyone's fighting for that. That's fine, but you know minorities are fighting for other things. But, but still the White elite, they think that gay minorities should be fighting for the same thing they are fighting. But it’s like what about when they are fighting about immigration, or, you know, the Dream Act, or other stuff? We don't see them. You know, they’re, they’re just not there, you know? They're totally out of touch...

Sample demographics (n = 13).

Pseudonym	Age	Sexual Orientation	Generation (Birth Country)	Primary Language	Employment Status	Education	Income
Humberto	51	Gay	1st (Venezuela)	Spanish	Full time	Graduate	$75k-$100k
Jorge	21	Queer	1st (Mexico)	English	Student	Some College	<$20k
Ernesto	49	Gay	1st (Peru)	English	Unemployed	Bachelor's	<$20k
Jose Luis	37	Gay	1st (Mexico)	English & Spanish	Full time	Graduate	$75k-$100k
Manuel	32	Gay	1st (Mexico)	English	Full time	Bachelor's	$100k+
David	19	Gay	2nd (Mexico/Mexico)	English	Part time	High School	<$20k
Carlos	26	Gay	2nd (Mexico/Mexico)	English	Full time	Some College	$20k - $30k
Oscar	53	Gay	2nd (U.S./Mexico)	English	Unemployed	Some College	<$20k
Hector	42	Gay	2nd (U.S./Mexico)	English	Self-employed	Some College	<$20k
Gabriel	29	Gay	2nd (Mexico/Mexico)	English	Full time	Some College	$20k - $30k
Edgar	23	Gay	2nd (El Salvador/Guatemala)	English	Part time	Some College	<$20k
Raul	33	Gay	2nd (Mexico/Mexico)	English	Unemployed	Associate's	<$20k
Hugo	48	Gay	2nd (Venezuela/Italy)	English	Part time	Graduate	N/A

Note: Birth country for 2nd-generation is represented as (Mother’s Birth Country/Father’s Birth Country.)

Full article at:   http://goo.gl/KL9XCL

By:  Nicole N. Gray, David M. Mendelsohn, and Allen M. Omoto

Nicole N. Gray, Department of Psychology, Claremont Graduate University;

Contributor Information.

Correspondence concerning this article should be addressed to Nicole N. Gray, Department of Psychology, Claremont Graduate University (http://www.cgu.edu/pages/1.asp), 123 E. 8^th Street, Claremont, CA 91711. Email: ude.ugc@yarg.elocin

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Documentation Status as a Contextual Determinant of HIV Risk among Young Transgender Latinas

PURPOSE:

The purpose of this study was to explore the contextual factors that determine or mitigate vulnerability to HIV among Latina transgender women. Documentation status (legal authorization to live in the United States) has been cited by other studies as a barrier to recruitment or engagement in HIV-related care among immigrant Latinos, but not explored as a determinant of HIV risk for transgender immigrant Latinas.

METHODS:

We collaborated with a community-based organization to explore these contextual, including social and structural, factors. In-depth interviews in Spanish captured life histories of eight 18- to 29-year-old transgender Latinas, who collectively self-identify as chicas trans. Codes were assigned deductively from the interview guide, and emerging themes were identified throughout data collection.

RESULTS:

Most participants migrated to the United States from Central America after experiencing discrimination and violence in their countries of origin. Participants emphasized documentation status as a critical factor in three areas related to social and structural determinants of HIV risk: gender identity expression, access to services, and relationship power dynamics. Chicas trans who gained legal asylum reported greater control over sexual relationships, improved access to services, and less risky employment.

CONCLUSIONS:

Documentation status emerged as a key HIV risk factor for this population. For undocumented transgender Latinas, legal asylum appears to be a promising HIV-related protective factor. Further research could assess whether legal assistance combined with wraparound support services affects HIV prevention for this population.

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By:   Palazzolo SL1, Yamanis TJ1, De Jesus M1, Maguire-Marshall M1, Barker SL2.

• 1 School of International Service, American University , Washington, District of Columbia.
• 2 Community Health Action Department , La Clínica del Pueblo, Washington, District of Columbia.

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Posttraumatic Stress among Victimized Latino Women: Evaluating the Role of Cultural Factors

Research examining victimization and posttraumatic symptomatology among Latinos is lacking in the extant literature. This analysis used the victimized subsample (N = 752) of the Sexual Assault Among Latinas Study. The aim was to evaluate victimization prevalence and test the following hypotheses:

1. that victimization would be associated with higher levels of posttraumatic symptoms,
2. that cultural factors that move away from traditional Latino culture would be associated with higher levels of posttraumatic symptomatology, and
3. that cultural factors associated with traditional Latino culture would be related to lower posttraumatic symptomatology. 

Average age of the sample was 44.57 years, with three fourths having a high school education or higher, and two thirds having a household income below $30,000. 

Of exposure types, adulthood threats were most likely to result in Criterion A traumatic events (23.4%). Using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) based PTSD Checklist, between 8.8% and 45.5% of individuals met presumed PTSD diagnosis based on various PCL cut scores or algorithm criteria. 

Regression analyses indicated that the combined different types of adult and childhood victimizations, masculine gender role, and negative religious coping were associated with increased symptoms (βs ranging from .16 to .27). 

The results suggested a role of culture in posttraumatic symptoms for Latinas.

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By:  Cuevas CA1, Sabina C2, Picard EH3.

• 1School of Criminology and Criminal Justice, Northeastern University, Boston, Massachusetts, USA.
• 2School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, Pennsylvania, USA.
• 3Department of Psychology, Fordham University, Bronx, New York, USA. 

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Latino Mother/Daughter Dyadic Attachment as a Mediator for Substance Use Disorder & Emotional Abuse

To date, no studies have investigated emotional abuse of adult Latina women by their mothers despite evidence that emotional maternal abuse may significantly contribute to the emotional abuse experienced by Latina women in their lifetime. 

Cross-sectional data including 316 women was analyzed using mediation and logistic regression. Overall, 7.1 % of mothers and 24.1 % of daughters abused drugs; and, 19.5 % of daughters were emotionally abused by their mothers. 

Mother's attachment to her daughter mediated the association between mother's drug abuse and emotionally abusing her adult daughter (indirect effect: 0.863). Latina women can serve as perpetrators of emotional abuse of their adult children. Since drug-abusing daughters are more likely to be victims of emotional abuse by their mothers and drug-abusing mothers are more likely to abuse their daughters, drug-rehabilitation practitioners should incorporate a family abuse component into rehabilitation programs.

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By:  Kanamori M1, Weissman J2, De La Rosa M2, Trepka MJ2, Rojas P2, Cano MA3, Melton J2, Unterberger A4.

• 1Center for Research on U.S. Latinos HIV/AIDS and Drug Abuse, Florida International University, 11200 SW 8th Street. AHC5 422, Miami, FL, 33199, USA. mkanamor@fiu.edu.
• 2Center for Research on U.S. Latinos HIV/AIDS and Drug Abuse, Florida International University, 11200 SW 8th Street. AHC5 422, Miami, FL, 33199, USA.
• 3Department of Epidemiology, College of Public Health and Social Work, Florida International University, Miami, FL, USA.
• 4Center for Labor Research and Studies, Florida International University, Miami, FL, USA. 

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"Is That A Method of Birth Control?" A Qualitative Exploration of Young Women's Use of Withdrawal

Despite its ubiquity, withdrawal is understudied as a family planning method. We investigated the context of and decision making around withdrawal use, drawing on in-depth, qualitative interviews with 38 Black and Latina women (ages 18 to 24). 

We examined contraceptive use histories to understand when and why participants used withdrawal. The majority of participants (n = 29; 76%) had used withdrawal in their lifetimes, though two-thirds of users mentioned withdrawal in their contraceptive histories only after interviewer prompts. 

Withdrawal was primarily used during transitions between contraceptive methods and when other methods were not desired. Relationship context was also an important factor, as many used withdrawal to increase intimacy with their partners; because they felt condoms were no longer necessary due to monogamy; or to fulfill their partners' preferences to increase sexual pleasure. Our findings indicate that decision making around withdrawal is embedded in situational and relational contexts. 

Future research should explore how health care providers and sex educators can engage young women in discussions of withdrawal's benefits and constraints. 

A harm reduction framework, which recognizes that optimal use of withdrawal is preferable to not using a pregnancy prevention method at all, may inform the ways that withdrawal can be addressed in clinical and educational settings.

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By: Arteaga S¹, Gomez AM².

¹a Department of Maternal and Child Health , School of Public Health, University of California , Berkeley.

²b School of Social Welfare , University of California , Berkeley.

  

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Screening for Cervical Cancer and Sexually Transmitted Diseases among HIV-Infected Women

Women living with HIV infection are at higher risk for cervical cancer, an AIDS-defining diagnosis. We examined the prevalence of cervical cancer and sexually transmitted disease (STD) screening among human immunodeficiency virus (HIV)-infected women and factors associated with the receipt of Papanicolaou (Pap) tests.

We did a cross-sectional analysis of weighted data from a sample of HIV-infected adults receiving outpatient medical care. We used matched interview (report of Pap test) and medical record data (STD screenings) from HIV-infected women. We performed logistic regression to compute adjusted prevalence ratios and 95% confidence intervals for the association between demographic, behavioral, and clinical factors and receipt of Pap tests among HIV-infected women.

Data were available for 2,270 women, who represent 112,894 HIV-infected women; 62% were African American, 17% were Hispanic/Latina, and 18% were white. Most (78%) reported having a Pap test in the past year. Among sexually active women (n = 1234), 20% reported sex without condoms, 27% were screened for gonorrhea, and 29% were screened for chlamydia. Being screened for STDs was less likely among women who did not have a Pap test in the past year (adjusted prevalence ratios 0.82, 95% confidence interval 0.77-0.87). Women who were ≥50 years of age and reported income above federal poverty level, no sexual activity, depression, no HIV care from an obstetrician/gynecologist, and no documented STD tests, were less likely to report a Pap test (p < 0.05).

Screening for cervical cancer and STDs among HIV-infected women is suboptimal. Clinical visits for Pap tests are an important opportunity for HIV-infected sexually active women to also receive STD screenings and counseling regarding condoms.

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By: Frazier EL1, Sutton MY1, Tie Y1,2, McNaghten AD1,3, Blair JM1, Skarbinski J1.

• 1Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention , Atlanta, Georgia .
• 2ICF International , Atlanta, GA.
• 3Rollins School of Public Health, Emory University , Atlanta, Georgia . 

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Diagnoses and Prevalence of HIV Infection among Hispanics or Latinos — United States, 2008–2013

Hispanics or Latinos* represent about 17% of the total U.S. population and are disproportionately affected by human immunodeficiency virus (HIV) infection in the United States (1,2). In 2013, the rate of HIV diagnosis among Hispanics or Latinos (18.7) was nearly three times that of non-Hispanic whites (6.6) (1). To better characterize HIV infection among Hispanics or Latinos aged ≥13 years in the United States, CDC analyzed data from the National HIV Surveillance System (NHSS). During 2008–2013, the rate of diagnoses of HIV infection among adult and adolescent Hispanics or Latinos decreased from 28.3 per 100,000 population in 2008 to 24.3 in 2013 (estimated annual percentage change [EAPC] = -3.6); however, the number of diagnoses among males with infection attributed to male-to-male sexual contact increased 16%, from 6,141 in 2008 to 7,098 in 2013 (EAPC = 3.0). In 2013, the rate of diagnosis of HIV infection among males (41.3) was six times the rate among females (6.8). 

During 2008–2013, behavioral risk factors for HIV infection among Hispanics or Latino differed among males and females and by place of birth. Among Hispanic or Latino males born in Puerto Rico, the proportion of HIV infections attributed to injection drug use (24.9%) was greater than among those born elsewhere. Among HIV-infected Hispanic or Latino females, those born in the United States (21.2%) and Puerto Rico (20.5%) had a greater proportion of HIV infections attributed to injection drug use than those born elsewhere. Additional interventions and public health strategies to further decrease the rates of HIV among the Hispanic or Latino population are needed....

Below:  Estimated number of diagnoses attributed to male-to-male sexual contact* compared with other transmission categories among Hispanic or Latino males aged ≥13 years, by year — United States, 2008–2013

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Cultural Influences on HIV Testing among Latino Youth

Young Latinos aged 13-24 years in the USA are disproportionately impacted upon by HIV. Despite the elevated risk, lower rates of HIV testing have been documented among Latino youth relative to other racial/ethnic groups. 

The objective of the current study was to examine the influence of acculturation and cultural values on HIV testing among Latino youth. The study consisted of 51 sexually experienced young Latinos aged 13-16 years from a major city in the Southeastern USA. Participants completed a survey on HIV testing history, cultural orientation and Latino cultural values. 

Results indicate that 21.6% of the young people had been tested for HIV. The number of times tested ranged from one to four (M = 1.9 ± 1.0). HIV testing was associated with US American cultural orientation and familism (and emphasis on strong family commitment, family support and emotional closeness). Participants with greater orientation to US American culture were more likely, whereas those who endorsed higher familism value were less likely, to have had an HIV test. 

For participants scoring high on familism, the desire to maintain family honour may serve as a deterrent to testing. Incorporating culturally relevant strategies, such as promoting sexual communication and conversations on HIV prevention within the family, may enhance testing and narrow the gap in HIV infection between Latino youth and other ethnic groups.

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By: Ma M1, Malcolm LR1

• 1a College of Psychology, Nova Southeastern University , Fort Lauderdale , USA. 

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A Path Analysis of Latino Parental, Teenager and Cultural Variables in Teenagers' Sexual Attitudes, Norms, Self-Efficacy, and Sexual Intentions

Below: Conceptual Model Used in the Present Study

OBJECTIVE:

To test a theoretical model based on the Parent-Based Expansion of the Theory of Planned Behavior examining relation between selected parental, teenager and cultural variables and Latino teenagers' intentions to engage in sexual behavior.

METHOD:

A cross-sectional correlational design based on a secondary data analysis of 130 Latino parent and teenager dyads.

RESULTS:

Regression and path analysis procedures were used to test seven hypotheses and the results demonstrated partial support for the model. Parent familism and knowledge about sex were significantly associated with parents' attitudes toward sexual communication with their teenagers. Parent Latino acculturation was negatively associated with parents' self-efficacy toward sexual communication with their teenagers and positevely associated with parents' subjective norms toward sexual communication with their teenagers. Teenager knowledge about sex was significantly associated with higher levels of teenagers' attitudes and subjective norms about sexual communication with parents. Only the predictor of teenagers' attitudes toward having sex in the next 3 months was significantly associated with teenagers' intentions to have sex in the next 3 months.

CONCLUSION:

The results of this study provide important information to guide future research that can inform development of interventions to prevent risky teenager sexual behavior among Latinos.

Via:  http://ht.ly/RUl04

By: Vanessa Pirani Gaioso, 2 Antonia Maria Villarruel, 3 Lynda Anne Wilson, 4 Andres Azuero, 5 Gwendolyn Denice Childs, 6and Susan Lane Davies 7

³PhD, Full Professor, University of Pennsylvania, School of Nursing, Philadelphia, PA, United States

⁴PhD, Full Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

⁵PhD, Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

⁶PhD, Assistant Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

⁷

2PhD, Instructor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

2PhD, Instructor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

3PhD, Full Professor, University of Pennsylvania, School of Nursing, Philadelphia, PA, United States

4PhD, Full Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

5PhD, Associate Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

6PhD, Assistant Professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL, United States

7PhD, Associate Professor, University of Alabama at Birmingham, School of Public Health, Birmingham, AL, United States