Drug Use and Hispanic Men Who Have Sex With Men in South Florida: Implications for Intervention Development

Signature Grand, Davie, Florida, USA

Objective. This paper examines the socio-cultural and psychological predictors of drug use among Hispanic MSM and their impact on intervention development. Background. Hispanic men who have sex with men (HMSM), continue to be at high risk of HIV. Fueling this epidemic are the often co-occurring behaviors of drug use and unprotected anal sex with multiple sexual partners. Interventions that target these co-occurring behaviors and are tailored to Hispanic MSM are urgently needed. Methods. We used time and space sampling to recruit 566 Hispanic MSM in community and internet venues. Participants completed a computer-assisted self-interview that tapped behavioral, psychosocial, and cultural factors (e.g., gay community attachment, racism, discrimination, loneliness, familismo, bicultural orientation) which might be associated with risk and protection. Results. Participants reported high rates of drug use, unprotected sex, and multiple sex partners. In the final step of a hierarchical linear regression, use of drugs was significantly associated with lower orientation to the Hispanic community, stronger attachment to the gay community, less homophobia, more sex partners and more unprotected anal sex. In qualitative interviews, the need for acceptance and desire to please partners emerged as core factors associated with unprotected sex and drug use. We integrated the qualitative and quantitative data and developed Proyecto SOL, a four session group level intervention that is undergoing efficacy testing. Conclusion. In addition to being grounded in behavioral theory, interventions to reduce HIV risk among HMSM should be holistic and multi-dimensional, tailored to address men and their circumstances, incorporate the protective elements of both Hispanic and gay culture, and emphasize positive social connections. Proyecto SOL exemplifies this type of intervention.