Interpersonal and Community-Level Influences Across the PrEP Cascade Among Young Adult Latinx Men who Have Sex with Men Living in a US-Mexico Border Region: A Qualitative Study.

Latinx men who have sex with men (MSM) are an at-risk population for new HIV diagnoses. Pre-exposure prophylaxis (PrEP) is a suite of biomedical approaches to prevent HIV infection. Latinx MSM are less likely to take PrEP compared to non-Latinx White MSM. This qualitative study identified interpersonal- and community-level barriers and facilitators of PrEP among young adult Latinx MSM. Using stratified purposeful sampling, 27 Latinx men, ages 19-29 years and living in a US-Mexico border region, completed self-report demographic surveys and participated in semi-structured in-depth interviews assessing barriers and facilitators to PrEP. Directed content analysis was used to identify both a priori and emerging themes. Most participants reported that other people, including peers, friends, partners, and health care providers were both supportive and discouraging of PrEP use. Participants' intersectional identities as members of both Latinx and LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer) communities both hindered and facilitated PrEP use.

Examining COVID-19 pandemic-related economic and household stress and its association with mental health, alcohol, and substance use in a national sample of Latinx sexual minority and heterosexual adults.

OBJECTIVE: Sexual minority adults of Latinx descent faced compounded intersectional stressors during the COVID-19 pandemic across socioeconomic and health domains. Latinx people have experienced some of the highest COVID-19 infection, hospitalization, and mortality rates in the United States in addition to significant economic challenges. Yet, current data have not observed the unique pandemic-related experiences of sexual minority Latinx (SML) adults. We examined sexual identity differences in economic and household stress, social support, mental health symptomatology (depression, anxiety), alcohol, and substance use among sexual minority and nonsexual minority Latinx adults in the United States. METHOD: Primary data were collected via the AmeriSpeak panel, a national probability sample of U.S.-based 2,286 Latinx adults [sexual minority = .34% (n = 465)]. Data were collected from November 2020 to January 2021, during the third wave of the COVID-19 pandemic. RESULTS: SML adults endorsed higher levels of economic and household stress, mental health symptomatology, and alcohol and substance use than nonsexual minority Latinx adults. Economic stress was associated with increased mental health symptomatology, alcohol, and substance use among SML adults. Social support moderated the association between economic stress and mental health symptomatology and substance use, but not alcohol use. CONCLUSION: Findings highlighted unique intersectional considerations among SML adults during the COVID-19 pandemic, including the importance of social support and the negative toll of economic stress on mental health and substance use. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Examining Mental Health, Academic, and Economic Stressors During the COVID-19 Pandemic Among Community College and 4-Year University Students.

Objective: The COVID-19 global pandemic has created severe, long-lasting challenges to college students in the United States (US). In the present study, we assessed mental health symptomatology (depression, anxiety, life stress), academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Method: A total sample of 361 college students (Mage = 22.26, SD = 5.56) was gathered from a community college (N = 134) and mid-size public university (N = 227) in Southwest US, both designated as Hispanic Serving Institutions. Results: Pearson and point biserial correlations indicated associations between mental health symptomatology, academic challenges, and economic stress, including expected delays in graduation. Multivariate analysis revealed that community college students had statistically significantly higher scores on anxiety F(1, 312) = 5.27, p = .02, ηp2 = .01 than 4-year university students, as well as key differences with respect to academic challenges. Chi Square analyses revealed that Latinx families experienced greater economic hardships, including job loss or reduced work hours (χ2 (1, N = 361) = 28.56, p = .00) than other ethnic/racial groups. Conclusions/Contributions: Findings revealed that community college students faced disparately negative mental health symptomatology, academic challenges, and economic stress during the first wave of the Coronavirus pandemic. Further, Latinx students' families experienced significant economic hardship that may have impacted students' academic progress and future planning.

Geographic mobility and its impact on sexual health and ongoing HIV transmission among migrant latinx men who have sex with men.

An understudied social process that may determine variable HIV risk, testing, and linkage to care is geographic mobility, including immigration as well as short-term mobility, especially among sexual minority populations. We aimed to assess how geographic mobility over the lifecourse between Latin America and the U.S., and within the U.S., was linked to sexual risk and health behaviors among Latinx migrant men who have sex with men (MSM) in San Bernardino County, California. Qualitative analysis of 16 semi-structured interviews revealed four major domains of influence on participants' sexual risk behaviors. At the micro level, these included social environment/interpersonal factors (e.g., family and peer support) and geographic factors and pathways (e.g., migration journey to the U.S.). At the macro level data centered on cultural factors (e.g., gender norms in home country) and structural factors (e.g., HIV healthcare). Our results can illuminate and promote effective health policies and HIV reduction efforts for Latinx migrant MSM in metro areas.

Traditional Machismo, Caballerismo, and the Pre-Exposure Prophylaxis (PrEP) Cascade Among a Sample of Latino Sexual Minority Men.

Between 2010 and 2017, HIV diagnoses increased 17% among Latino sexual minority men (SMM) while decreasing 19% among White SMM and stabilizing among African American SMM. Traditional machismo is characterized by aggressiveness/power; caballerismo consists of family values/chivalry. Latino SMM high in traditional machismo may avoid seeking Pre-Exposure Prophylaxis (PrEP) to prevent being stigmatized as effeminate. Latino SMM high in caballerismo may be more likely to use PrEP to remain healthy for their family and/or partners. The current study explored the association between traditional machismo and caballerismo with four steps of the PrEP cascade. Participants were 151 HIV-negative/unknown Latino SMM living in San Diego, California (M = 24.18 years old) who completed an online study. Traditional machismo was associated with low odds of PrEP awareness, willingness, and adherence and high odds of PrEP use. Caballerismo was associated with greater odds of PrEP awareness, willingness, use, and adherence. High levels of traditional machismo among Latino SMM may be a barrier to PrEP. Caballerismo may be a facilitator of PrEP awareness, willingness, use, and adherence. Programs which serve to move Latino SMM through the PrEP cascade may benefit from discussing culturally-relevant masculinity given the potential for their differential associations with PrEP variables.