Gender Neutral? Contextualizing the Sexual Risk and Disclosure Behaviors of HIV-Positive Latino Men Who Have Sex with Men and Women (MSMW) in Los Angeles

Abstract

Disclosure of HIV status among men who have sex with men and women (MSMW) is a primary topic within the context of HIV prevention. Yet, communication about factorsassociated with HIV risk behavior takes place within complex sociocultural contexts that remain largely unexplored. Still less is known about Latino MSMW in particular, despite the fact that Latinos are disproportionately affected by HIV/AIDS nationally and in Los Angeles County. Latino MSM are also more likely than White MSM to have female partners and less likely to identify as gay versus bisexual or heterosexual. Some work has shown that nondisclosure of HIV status is intertwined with sexual risk among Latino MSM,
particularly for those who also have sex with women. The present study uses data from 23 qualitative interviews with HIV‐positive, English‐speaking (n=8), Bilingual (n=7), and Spanish‐speaking (n=8) Latino MSMW to investigate the cultural, social, and sexual interactions that influence disclosure and sexual risk with male and female partners. The analysis pays close attention to the implications of the contexts and meanings of sex and sexual relationships for disclosure behaviors. Interviews were analyzed in a modified grounded theory‐analytical induction. Overall, most men did not discuss HIV with any of their partners. Instead they attempted to find ways around potential transmission to
others through abstinence, isolation, risk reduction, serosorting, or calling off sexual encounters/relationships that they perceived as too risky. Strategies for avoiding risk were generally more beneficial to male partners who participants perceived to be more cognizant of HIV risk and more likely to be HIV‐positive. Findings also highlight the importance of substance use during sex with male and female partners, as well as cultural and familial expectations that certain personal information, particularly information health and sexuality, would not be discussed. Ultimately, the paper argues that the contexts and meanings of sex and sexual relationships differ for male and female partners and that these differences inform disclosure behaviors for Latino MSMW.