218392 Gender, sexual relationships, and HIV risk among homeless men in Los Angeles County

Wednesday, November 10, 2010

David Kennedy, PhD , RAND Health, RAND Corporation, Santa Moncia, CA
Ryan Brown, PhD , RAND Health, RAND Corporation, Santa Moncia, CA
Daniela Golinelli, PhD , RAND Corporation, Santa Monica, CA
Gery Ryan, PhD , RAND Health, RAND Corporation, Santa Moncia, CA
Samuel Wertheimer, MPH , RAND Health, RAND Corporation, Santa Moncia, CA
Joan Tucker, PhD , RAND Health, RAND Corporation, Santa Moncia, CA
Suzanne Wenzel, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Risk of HIV transmission within heterosexual relationships is significant, especially among homeless people. Many studies have explored the association between traditional masculine attitudes, imbalance of power in heterosexual relationships and risky sex. However, most of these studies have explored this dynamic from women's perspectives. Few have explored gender and heterosexual relationships from the perspective of homeless men. The objective of this study is to describe the beliefs about gender roles among homeless men in Los Angeles. We randomly sampled 30 homeless men and interviewed them using a semi-structured interview protocol designed to elicit their conceptualization of expected gender roles for men and women. We also asked them to discuss how homelessness affects relationships between men and women and to describe particular relationships and sexual events. We analyzed qualitative data systematically to compare idealized gender role beliefs with their pursuit of and experiences with sexual relationships with women. We found that many men had a mixture of traditional gender beliefs and egalitarian views of gender roles within sexual relationships. Men frequently described men's roles as financial support of households and protection while women's roles were limited to child rearing and domestic activities. On the other hand, men also frequently described their belief in egalitarianism within relationships in which men and women share everything, including decision making. We contrast these ideal beliefs with descriptions of these men's actual relationships. Based on these findings, we discuss opportunities and challenges for programs that target HIV reduction among heterosexual homeless men, especially couples based interventions.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
1.Describe sampling methods, innovative semi-structured interview protocol, and systematic qualitative data analysis methods 2. Describe the beliefs about gender roles among homeless men in Los Angeles County 3. Contrast ideal gender role beliefs with descriptions of actual relationships 4. Discuss potential and challenges for HIV intervention development with homeless men who have sex with women

Keywords: HIV Risk Behavior, Homeless

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I have helped design the study, I helped oversee data collection, I conducted analysis of the data, and I am the first author on the paper describing the results.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.