Dr. Rafael M. Díaz Director César E. Chávez Institute College of Ethnic Studies

1. Welcome to the Acción Mutua web-seminar on Understanding Latino Gay Men and their HIV-related Concerns

2. Acción Mutua is a capacity building assistance (CBA) program of AIDS Project Los Angeles in collaboration with the César E. Chávez Institute of San Francisco State University Funded by the Centers for Disease Control and Prevention

3. Understanding Latino Gay Men and their HIV-related concerns when planning and implementing HIV prevention programs Dr. Rafael M. Díaz Director César E. Chávez Institute College of Ethnic Studies San Francisco State University

4. Presentation Overview • Who are Latino gay men? • What puts us at risk? • What can we do about it?

5. Who are Latino gay men?

6. Who are Latino gay men? • Have sex with men (MSM) • Self-identify as gay, homosexual, bisexual, or queer • Some may use terms such as loca, joto, pato, or maricón to self identify • “de ambiente”

7. Some Latino MSM do not identify as gay or bisexual • May identify as heterosexual or straight • Straight identified men may have sex with men for different reasons • Financial need • Incarceration • Curiosity • Physical pleasure • Experimentation

8. Service providers and researchers must be sensitive to the complex relationships between sexual behavior, orientation, identity and gender for all groups.

9. What puts us at risk?

10. HIV Among Young Men Who Have Sex with Men in the U.S. (Valleroy et al, CDC) Ages 23-29 1998-2000, 6 US cities N=2942 Ages 15-22 1994-1998, 7 US cities N=3449 Prevalence Prevalence Incidence Incidence Whites 3.3% 2.4% 7% 2.5% Latinos 6.9% 1.8% 14% 3.5% African Americans 14.1% 4.0% 32% 14.7% Mixed race 13.4% 5.4% 10%

11. Risk Behavior Skills Motivation / Intentions Information / Perceived Risk Risk as an Individual Factor

12. Risk Behavior High Risk Situations Psychological Impact of Oppression Oppressive Social Factors Risk as a Contextual Factor

13. Explaining HIV Risk as an Outcome of Social Discrimination ? Social Discrimination HIVRisk Behavior • Homophobia • Racism • Poverty

14. Explaining HIV Risk as an Outcome of Social Discrimination Social Discrimination Difficult Sexual Situations HIVRisk Behavior Psychological Distress • Homophobia • Racism • Poverty Denotes mediator Díaz, R.M., Ayala, G., Bein, E., (2004). Sexual Risk as an Outcome of Social Oppression: Data from a probability sample of Latino gay men in three US cities. Cultural Diversity and Ethnic Minority Psychology.10(3): 255-267.

15. Resiliency Factors: What helps Latino gay men be strong, safe and healthy Family Acceptance • Experienced acceptance from mother and/or father • Able to speak openly with at least one family member Social and Sexual Satisfaction • Satisfaction with friendships and lover relationships • Satisfaction with sex life Social/Political Network & Activism • Feeling part of a social network of similar people • Involvement in promotion of gay/Latino rights Gay Role Model in Childhood • Older gay friends or relatives to look up to as a child

16. Social Isolation & Low Self-Esteem Resiliency Psychological Distress Explaining HIV Risk as an Outcome of Social Discrimination Social Discrimination Difficult Sexual Situations HIVRisk Behavior • Homophobia • Racism • Poverty Denotes mediator Díaz, R.M., Ayala, G., Bein, E, Henne, J. and Marin, B.V. (2001) The Impact of Homophobia, Poverty and Racism on the Mental Health of Gay and Bisexual Latino Men: Findings from 3 U.S. Cities. American Journal of Public Health, 91(6):927-932.

17. What can we do about it?

18. Resiliency • Social isolation • Low self esteem High-risk sexual behavior High-risk sexual situations Poverty Homophobia Racism 1. Provide experiences of social support, social belonging, and enhanced self-esteem in the context of a Latino gay identity and community;

19. Resiliency • Social isolation • Low self esteem High-risk sexual behavior High-risk sexual situations Poverty Homophobia Racism 2. Promote critical awareness of social and cultural forces that impact and shape participants’ social and sexual lives;

20. Resiliency • Social isolation • Low self esteem High-risk sexual behavior High-risk sexual situations Poverty Homophobia Racism 3. Increase participants’ sexual self-knowledge, with particular emphasis on sexual contexts and situations of personal vulnerability that limit participants’ ability to practice safer sex, and;

21. Resiliency • Social isolation • Low self esteem High-risk sexual behavior High-risk sexual situations Poverty Homophobia Racism 4. Facilitate community involvement and activism to support a sense of increased personal agency and self-efficacy (instead of fatalism and victimization) in response to oppressive social forces in participants’ lives.

22. Understanding Risk in Prevention Work • Consider “risk” as a property of contexts and situations,rather than an individual characteristic • Prevention must address situational factors that make safer sex difficult, not only individual factors that can promote risk (loneliness, substance use and low self esteem)

23. iGracias ~ Thank You! Questions & Answers

24. Thanks for your participation For more information or to learn how to receive CBA services, contact us at: 213.201.1345 www.accionmutua.org