Theoretical understandings of alcohol use and abuse within the gay Latino community in San Francisco: A qualitative investigation

Introduction: In San Francisco, Latinos represent 13% of the general population yet constitute 19% of new HIV transmissions. An estimated 82% of those HIV infections are among gay Latinos. The San Francisco Department of Public Health identified alcohol consumption as a significant driver for HIV transmission among gay Latinos. Limited research exist that incorporate theories of alcohol consumption within sexual minority populations. The aims of this study were to assess the sociocultural influences and impact of alcohol use within the local gay Latino community from a theoretical perspective.

Methods: Purposeful sampling was used to recruit participants who could speak about personal experiences with alcohol, perceptions of alcohol in the community, and the impact of alcohol on their social, sexual and familial relationships. In-depth interviews were conducted with 41 self-identified gay Latinos (ages 18–45; mean = 28.5 years) between September 2010 and February 2011. Thematic content analysis of the transcribed interviews was conducted utilizing a constructed grounded theory approach.

Results: Three main themes were delineated relating to the aims of the study: (1) cultural norms within both gay and Latino communities encouraged alcohol use among the participants; (2) men used alcohol to cope with internalized homophobia, racism and social oppression; and (3) participants attributed alcohol use to specific undesirable health outcomes, including unprotected intercourse, depression and domestic violence.

Conclusions: The findings from this study expand on prevailing individual-level theories of the relationship between alcohol use and associated risk behaviors (e.g., the alcohol myopia theory and the alcohol expectancy theory) by contextualizing risk within the cultural and social norms of a specific community. Development of socioculturally appropriate community-level alcohol risk-reduction interventions, based on sound theoretical models of alcohol use, is needed for this marginalized population.