Immigrant sexual and gender minority Latinos constitute a vulnerable subgroup about which little is known. We examined HIV testing among 190 such Latinos recruited via respondent-driven sampling in North Carolina, a state with little historical Latino presence but recent, rapid growth of this population. Sixty-eight percent reported an HIV test in the past year, and nearly half reported multiple HIV tests. Concern for their health was the most frequent reason for seeking an HIV test. Reasons not to get tested included fear of a positive test, previous HIV tests, worry that test results might be reported to the government, and concerns that others might treat the person differently if found to be HIV positive. In a multiple variable model, correlates of HIV testing included age, educational attainment, HIV stigma, comfort with sexual orientation, and previous STD diagnoses. Among participants reporting anal sex, consistent condom use was associated with HIV testing, suggesting that protective behaviors may co-occur. These findings may inform the development of more efficacious interventions to increase HIV testing among this subgroup.
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References
1.
EnnisSR, Rios-VargasM, AlbertNG. The Hispanic Population: 2010. Washington DC: Census Bureau, 2011.
2.
FreyWH. Diversity Spreads Out: Metropolitan Shifts in Hispanic, Asian, and Black Populations since 2000. Washington DC: The Brookings Institution, 2006.
3.
KochlarR, SuroR, TafoyaS. The New Latino South: The Context and Consequences of Rapid Population Growth. Washington DC: Pew Hispanic Center, 2005.
4.
DocktermanD, VelascoG. Statistical Portrait of Hispanics in the United States, 2008. Washington DC: Pew Hispanic Center, 2010.
5.
KasardaJD, JohnsonJH. The Economic Impact of the Hispanic Population on the State of North Carolina. Chapel Hill NC: Frank Hawkins Kenan Institute of Private Enterprise, 2006.
6.
GriffithDC. Rural Industry and Mexican Immigration and Settlement in North Carolina. ZuñigaVA, Hernández-LeónR. New Destinations: Mexican Immigration in the United States. New York NY: Russel Sage Foundation, 2005; 50–75.
7.
ReifS, GeonnottiKL, WhettenK. HIV infection and AIDS in the Deep South. Am J Public Health, 2006; 96:970–973.
8.
AralSO, O'LearyA, BakerC. Sexually transmitted infections and HIV in the southern United States: An overview. Sex Transm Dis, 2006; 33:S1–S5.
9.
Department of Health and Human Services. 2010 HIV/STD Surveillance Report. Raleigh NC: Communicable Disease Surveillance Unit, 2011.
10.
LiebS, PrejeanJ, ThompsonDRet al.HIV prevalence rates among men who have sex with men in the southern United States: Population-based estimates by race/ethnicity. AIDS Behav, 2011; 15:596–606.
11.
MarksG, CrepazN, JanssenRS. Estimating sexual transmission of HIV from persons aware and unaware that they are infected with the virus in the USA. AIDS, 2006; 20:1447–1450.
12.
MillettGA, DingH, MarksGet al.Mistaken assumptions and missed opportunities: Correlates of undiagnosed HIV infection among Black and Latino men who have sex with men. J Acquir Immune Defic Syndr, 2011; 58:64–71.
13.
Lopez-QuinteroC, ShtarkshallR, NeumarkYD. Barriers to HIV-testing among Hispanics in the United States: Analysis of the National Health Interview Survey, 2000. AIDS Patient Care STDS, 2005; 19:672–683.
14.
CohallA, DiniS, NyeA, DyeB, NeuN, HydenC. HIV testing preferences among young men of color who have sex with men. Am J Public Health, 2010; 100:1961–1966.
15.
SolorioMR, GalvanFH. Self-reported HIV antibody testing among Latino urban day laborers. J Natl Med Assoc, 2009; 101:1214–1220.
16.
ChenN, ErbeldingE, YehHC, PageK. Predictors of HIV testing among Latinos in Baltimore City. J Immigr Minor Health, 2010; 12:867–874.
17.
FernandezMI, CollazoJB, BowenGS, VargaLM, HernandezN, PerrinoT. Predictors of HIV testing and intention to test among Hispanic farmworkers in South Florida. J Rural Health, 2005; 21:56–64.
18.
GalvanFH, BluthenthalRN, AniC, BingEG. Increasing HIV testing among Latinos by bundling HIV testing with other tests. J Urban Health, 2006; 83:849–859.
19.
SeñaA, HammerJ, WilsonK, ZeveloffA, GambleJ. Feasibility and acceptability of door-to-door rapid HIV testing among Latino immigrants and their HIV risk factors in North Carolina. AIDS Patient Care STDS, 2010; 24:165–173.
20.
RhodesSD, McCoyTP, VissmanATet al.A randomized controlled trial of a culturally congruent intervention to increase condom use and HIV testing among heterosexually active immigrant Latino men. AIDS Behav, 2011; 15:1764–1775.
21.
FernandezMI, PerrinoT, RoyalS, GhanyD, BowenGS. To test or not to test: Are Hispanic men at highest risk for HIV getting tested?AIDS Care, 2002; 14:375–384.
22.
FernandezMI, PerrinoT, BowenGS, RoyalS, VargaL. Repeat HIV testing among Hispanic men who have sex with men—A sign of risk, prevention, or reassurance?AIDS Educ Prev, 2003; 15:S105–S116.
23.
DuranD, UsmanH, BeltramiJ, AlvarezM, ValleroyL, LylesC. HIV counseling and testing among Hispanics at CDC-funded sites in the United States, 2007. Am J Public Health, 2010; 100:S152–158.
24.
Ramirez-VallesJ. The quest for effective HIV-prevention interventions for Latino gay men. Am J Prev Med, 2007; 32:S34–S35.
25.
HeckathornDD. Respondent-driven sampling: A new approach to the study of hidden populations. Soc Probl, 1997; 44:174–199.
26.
Ramirez-VallesJ, HeckathornDD, VazquezR, DiazRM, CampbellRT. From networks to populations: The development and application of respondent-driven sampling among IDUs and Latino gay men. AIDS Behav, 2005; 9:387–402.
27.
MagnaniR, SabinK, SaidelT, HeckathornD. Review of sampling hard-to-reach and hidden populations for HIV surveillance. AIDS, 2005; 19:S67–S72.
28.
BehlingO, LawKS. Translating Questionnaires and Other Research Instruments: Problems and Solutions. London UK: Sage, 2000.
29.
Census Advisory Committees. Language Translation of Data Collection Instruments and Supporting Materials. Washington DC: US Census Bureau, 2004.
30.
KnipperE, RhodesSD, LindstromK, BloomFR, LeichliterJS, MontanoJ. Condom use among heterosexual immigrant Latino men in the southeastern United States. AIDS Educ Prev, 2007; 19:436–447.
31.
BergerBE, FerransCE, LashleyFR. Measuring stigma in people with HIV: Psychometric assessment of the HIV stigma scale. Res Nurs Health, 2001; 24:518–529.
32.
MarinBV, TschannJM, GomezCA, GregorichS. Self-efficacy to use condoms in unmarried Latino adults. Am J Community Psychol, 1998; 26:53–71.
33.
KalichmanSC, RompaD. Sexual sensation seeking and Sexual Compulsivity Scales: Reliability, validity, and predicting HIV risk behavior. J Pers Assess, 1995; 65:586–601.
34.
RhodesSD, HergenratherKC, BloomFR, LeichliterJS, MontanoJ. Outcomes from a community-based, participatory lay health adviser HIV/STD prevention intervention for recently arrived immigrant Latino men in rural North Carolina. AIDS Educ Prev, 2009; 21:S103–S108.
35.
OngAS, WardC. The construction and validation of a social support measure for sojourners: The Index of Sojourner Social Support (ISSS) Scale. J Cross Cult Psychol, 2005; 36:637–661.
36.
RosenbergM. Society and the Adolescent Self-Image. Princeton NJ: Princeton University Press, 1965.
37.
HallMA, ZhengB, DuganEet al.Measuring patients' trust in their primary care providers. Med Care Res Rev, 2002; 59:293–318.
38.
MarinG, SabogalF, MarinBV, Otero-SabogalR, Perez-StableEJ. Development of a short acculturation scale for Hispanics. Hispanic J Behav Sci, 1987; 9:183–205.
39.
RossMW, RosserBR. Measurement and correlates of internalized homophobia: A factor analytic study. J Clin Psychol, 1996; 52:15–21.
40.
MarsigliaFF, KulisS. Diversity, Oppression, and Change. Chicago, IL: Lyceum, 2009.
41.
HosmerD, LemeshowS. Applied Logistic Regression, 2nd. New York NY: John Wiley & Sons, Inc., 2000.
42.
JohnstonLG, MalekinejadM, KendallC, IuppaIM, RutherfordGW. Implementation challenges to using respondent-driven sampling methodology for HIV biological and behavioral surveillance: Field experiences in international settings. AIDS Behav, 2008; 12:S131–S141.
43.
JennessSM, BegierEM, NeaigusA, MurrillCS, WendelT, HaganH. Unprotected anal intercourse and sexually transmitted diseases in high-risk heterosexual women. Am J Public Health, 2011; 101:745–750.
44.
WayalS, CowanF, WarnerP, CopasA, MabeyD, ShahmaneshM. Contraceptive practices, sexual and reproductive health needs of HIV-positive and negative female sex workers in Goa, India. Sex Transm Infect, 2011; 87:58–64.
45.
TownsendL, RosenthalSR, ParryCD, ZembeY, MathewsC, FlisherAJ. Associations between alcohol misuse and risks for HIV infection among men who have multiple female sexual partners in Cape Town, South Africa. AIDS Care, 2010; 22:1544–1554.
46.
GarfeinRS, LozadaR, LiuLet al.High prevalence of latent tuberculosis infection among injection drug users in Tijuana, Mexico. Intl J Tuberculosis Lung Dis, 2009; 13:626–632.
47.
Carballo-DieguezA, BalanI, DolezalC, MelloMB. Recalled sexual experiences in childhood with older partners: A study of Brazilian men who have sex with men and male-to-female transgender persons. Arch Sexual Behav, 2012; 41:363–376.
48.
SchneiderJ, MichaelsS, BourisA. Family network proportion and HIV risk among Black men who have sex with men. J Acquir Immune Defic Syndr, 2012; 61:627–635.
49.
SongEY, LeichliterJS, BloomFR, VissmanAT, O'BrienMC, RhodesSD. The use of prescription medications obtained from non-medical sources among immigrant Latinos in the rural southeastern U.S. J Health Care Poor U, 2012; 23:678–693.
50.
HelmsDJ, WeinstockHS, MahleKCet al.HIV testing frequency among men who have sex with men attending sexually transmitted disease clinics: Implications for HIV prevention and surveillance. J Acquir Immune Defic Syndr, 2009; 50:320–326.
51.
GlasmanLR, WeinhardtLS, HacklKL. Disparities in access to HIV prevention among men of Mexican descent living in the Midwestern United States. J Immigr Minor Health, 2011; 13:1125–1133.
52.
RobinsonKT, SandersSA, BoydJL. High-risk HIV minorities in the United States: Who gets tested and where?Am J Health Behav, 2012; 36:348–359.
53.
Deep South Project. Shaping the New Response: HIV/AIDS & Latinos in the Deep South. New York NY: Latino Commission on AIDS, 2008.
54.
TejedaG. From LA to NC, Officials Interested in Latinos w/ AIDS. The South Chicagoan, October15, 2008.
55.
ShedlinM, ShulmanL. Qualitative needs assessment of HIV services among Dominican, Mexican and Central American immigrant populations living in New York City. AIDS Care, 2004; 16:434–445.
56.
van ServellenG, BrownJ, LombardiE, HerreraG. Health literacy in low-income Latino men and women receiving antiretroviral therapy in community-based treatment centers. AIDS Patient Care STDS, 2003; 17:283–298.
57.
BeougherSC, GomezW, HoffCC. The couple as context: Latino gay male couples and HIV. Cult Health Sex, 2011; 13:299–312.
58.
US Preventive Services Task Force. The Guide to Clinical Preventive Services. Washington DC: Agency for Healthcare Research and Quality, 2011.
59.
MeyerM, ChampionJ. Protective factors for HIV infection among Mexican American men who have sex with men. J Assoc Nurs AIDS Care, 2010; 21:53–62.
60.
StockmanJK, SchwarezSK, ButlerLMet al.HIV prevention fatigue among high-risk populations in San Francisco. J Acquir Immune Defic Syndr, 2004; 35:432–434.
61.
RowniakS. Safe sex fatigue, treatment optimism, and serosorting: New challenges to HIV prevention among men who have sex with men. J Assoc Nurs AIDS Care, 2009; 20:31–38.
62.
MacKellarD, HouS, WhalenCet al.HIV/AIDS complacency and HIV infection among young men who have sex with men, and the race-specific influences of underlying HAART beliefs. Sex Transm Dis, 2011; 38:755–763.
63.
BrooksR, LeeS, StoverG, BarkleyT. HIV testing, perceived vulnerability and correlates of HIV sexual risk behaviours of Latino and African American young male gang members. Int J STD AIDS, 2011; 22:19–24.
64.
FernandezM, BowenG, PerrinoTet al.Promoting HIV testing among never-tested Hispanic men: A doctor's recommendation may suffice. AIDS Behav, 2003; 7:253–262.
65.
GonzalezJ, HendriksenE, CollinsE, DuranR, SafrenS. Latinos and HIV/AIDS: examining factors related to disparity and identifying opportunities for psychosocial intervention research. AIDS Behav, 2009; 13:582–602.
66.
Rios-EllisB, EspinozaL, BirdMet al.Increasing HIV-related knowledge, communication, and testing intentions among Latinos: Protege tu familia, hazte la prueba. J Health Care Poor U, 2010; 21:148–168.
67.
OlshefskyA, ZiveM, ScolariR, ZunigaM. Promoting HIV risk awareness and testing in Latinos living on the US-Mexico border: The Tu No Me Conoces social marketing campaign. AIDS Educ Prev, 2007; 19:422–435.
68.
ErausquinJT, DuanN, GruskyO, SwansonAN, KerroneD, RudyET. Increasing the reach of HIV testing to young Latino MSM: Results of a pilot study integrating outreach and services. J Health Care Poor U, 2009; 20:756–765.
69.
FarleyTA. Sexually transmitted diseases in the Southeastern United States: Location, race, and social context. Sex Transm Dis, 2006; 33:S58–S64.
