Jacqueline Sears Ragos

Advisor: Saba Masho, MD, MPH, DrPH

Preceptor: Saba Masho, MD, MPH, DrPH

Objective:  Male-to-male sexual contact is the most common mode of transmission for HIV among Latino men. Psychosocial factors such as machismo, homophobic discrimination, and internalized homophobia have been hypothesized to greatly impact sexual behaviors among Latinos. However, studies investigating the relationship between these psychosocial factors and risky sexual behaviors are limited. This study examined the impact of machismo on risky sexual behaviors among Latino Male who have Sex with Men (MSM).

Methods: This study utilized data collected from 254 Latino MSM in 1999 from selected cities within Virginia. The analysis focused on respondent demographic characteristics, psychosocial factors, acculturation, and sexual risky behaviors. Composite measures for acculturation, machismo, internalized homophobia, and sexual discrimination were created by combining sets of relevant questions. Bivariate and multivariate analyses were used and odds ratio and 95% confidence intervals were calculated.   

Results
The study found a statistically significant relationship between machismo and HIV/STD sexual risk behaviors. Latino MSM with high machismo values were over four times more likely to engage in HIV/STD sexual risk behaviors compared to those with low machismo values  (OR=4.11, 95%CI =1.47-11.45). In contrast, HIV/STD sexual risk behaviors were not significantly associated with acculturation, discrimination, or homophobia.  

Conclusions
Machismo is a significant risk factor for HIV and STD sexual risk behaviors in Latino MSM. Culturally competent messaging and appropriate skill building opportunities addressing machismo values should be incorporated into HIV and STD prevention programs that target Latino MSM.

Keywords: Latino MSM, HIV/STD risk, Machismo, Internalized Homophobia, Internalized Discrimination, Acculturation