Individual and structural factors predicting HIV testing among Latinx MSM: substance use as a moderator.

The rate of HIV infection for Latinx men who have sex with men (LMSM) increased by 20% from 2008 to 2014 even as rates stabilized among MSM of other racial and ethnic backgrounds. We hypothesize that this disparity is partially attributable to individual and structural factors associated with HIV testing, including substance use practices, among LMSM. In this retrospective study, we examined data from 502 LMSM to determine whether (a) hypothesized relationships exist between individual factors (perceived HIV susceptibility, experiences with HIV prevention, condom use, sex under the influence, sexual identity development status, heterosexual self-presentation, and traditional Latinx gender norms) and structural factors (access to healthcare resources and social support) and HIV testing for LMSM. We also tested whether (b) substance use practices moderate relations between individual and structural factors and HIV testing. Findings indicate that (a) relationships exist between several individual and structural factors and HIV testing and that (b) substance use moderated these relationships to HIV testing in a number of hypothesized ways. Practice and prevention implications are discussed.

A dyadic study of multicultural counseling competence.

Using the Kenny, Kashy, and Cook (2006) one-with-many method, we investigated client and counselor reports of counselors' level of multicultural counseling competence (MCC) across 4 therapy sessions at a university counseling center. Specifically, we analyzed the association between counselor MCC and client psychological well-being among 133 clients of color receiving psychotherapy from 24 counselors. We found that both client and counselor perspectives suggested that some counselors possessed generally higher MCC than others. Counselors' self-assessments of MCC, however, did not relate with their clients' assessments of counselor MCC-replicating findings from past studies of MCC. On average, counselors whose clients generally perceived them as more multiculturally competent did not report improved psychological well-being at the fourth session. Likewise, counselors who generally reported more MCC did not have clients who improved more in psychological well-being than would be expected over 4 sessions. Notably, at the dyad-level, clients who rated their counselor more highly on MCC than their counselors' other clients tended to report greater improvement in well-being. Suggestions for future MCC research involving dyadic analytic designs are described. (PsycINFO Database Record