Influence of recent migration on sexual and contraceptive decision making among migrants from Puebla, Mexico residing in New York City

Background: Recent literature suggests that geographic mobility and migration from conservative communities to more permissive environments is a risk factor for HIV transmission among newly arrived migrants. However, less well understood are the differential influences of the sending country versus the receiving community cultural-, social- and gender- norms on sexual decision making among these recent migrants. Methods: Using semi-structured, in-depth surveys, we conducted 40 interviews with an equal number of recent (≤ 5 years in the US) male and female migrants from Puebla, Mexico currently residing in New York City. Participants were recruited from community based organizations and community venues and asked to provide information and beliefs around pre- and post- migration social, cultural and gender normative beliefs and sexual and contraceptive decision-making. Thematic analysis was applied to understand the complex nature of these transitions and their influence on sexual health. Results: Analysis of interview transcripts revealed that post-migration, cultural and gender norms begin to shift toward a more balanced sexual and contraceptive decision-making dynamic within relationships compared with the pre-migration experience. These transitions were primarily motivated by perceptions of greater HIV risk in the receiving communities, greater access to and affordability of condoms and other contraception, and complex economic costs associated with childbearing. Conclusions: The process of migration can subtly reshape previously held social and gender-based norms among recent Mexican migrants to yield more balanced sexual decision making. An understanding of these transitions among recent migrants may inform the development of effective HIV prevention programming.