Exploring HIV risk among immigrant Latino gay men and MSM in the rural South using CBPR

Background: The Southeastern United States has the fastest growing Latino population in the country and carries a disproportionate HIV/AIDS disease burden. Little is known about sexual risk among recently arrived Spanish-speaking immigrant Latino men who have sex with men (MSM) in the rural Southeast.

Methods: Our community-based participatory research (CBPR) partnership collected, analyzed, and interpreted qualitative exploratory data to better understand and characterize: social and sexual networking patterns; behavioral, socio-cultural, and psychological correlates of HIV risk; and potential interventions to reduce HIV exposure and transmission among Latino MSM living in rural NC communities.

We completed 3 individual in-depth interviews with each Latino MSM living in rural NC to gain emic (“insider”) perspectives. We used a CBPR approach to research initiation, design, implementation, and analysis.

Results: 21 MSM participated. Mean age of interviewees was 31 years (range 19-48 years), English-language proficiency was limited; 18 men were from Mexico; 2 from Guatemala, and 1 from El Salvador. Two interviewees self-identified as male-to-female transgender.

Qualitative themes included: a need for education about HIV and sexually transmitted diseases; limited access to condoms; geographically broad sexual networking; roles of documentation status, immigration status, and public opinion as barriers to testing and counseling; complex meanings of sex and sexuality among men; and interventions that rely on informal lay natural helpers.

Conclusions: Community-based male-centered interpersonal networks that provide individual (and perhaps group) education and skills building and bilingual experts may be important elements of potentially effective interventions to reach Latino MSM in the rural Southeast.