UC Berkeley

The goal of this secondary analysis is to describe the sociodemographic, psychosocial, HIV testing, alcohol and drug use, and sexual risk behavior characteristics in a sample of young Latino men who have sex with men (YLMSM) living in the San Diego-Tijuana border region. In addition, this study will examine the predictors of three distinct outcomes, which include unprotected anal intercourse, HIV infection, and never testing for HIV, among the sampled YLMSM. This study represents a first effort to describe and analyze HIV seroprevalence and HIV risk behavior in YLMSM (of which the majority also reported having sex with women) residing in this border region, an understudied population with unique risks that are not well understood.

The venue-based study collected information, via standardized questionnaire, on eligible participants (N=372) who self-identified as Latino, reported a history of having sex with another man in their lifetimes, resided in the San Diego-Tijuana border region, and were between the ages of 17 and 30 years. A bivariate analysis was done separately for each of the three outcomes to examine the sociodemographic, psychosocial, HIV testing, alcohol and drug use, and sexual risk behavior characteristics among the combined sample. Three separate multivariate analyses (hierarchical logistic regression analysis) examined predictors of unprotected anal intercourse, HIV infection, and never testing for HIV.

Results from the study showed that for the combined sample of both San Diego and Tijuana YLMSM 25% tested positive for HIV, 42% reported having unprotected anal intercourse with a male, and 44% never tested for HIV. Compared to San Diego YLMSM, Tijuana YLMSM reported lower levels of socioeconomic status (e.g., low level of education), condom self-efficacy, HIV seroprevalence, HIV testing rates, and unprotected anal intercourse, but higher levels of alcohol and drug use and sex with both men and women. Findings from the multivariate analysis showed that being young, having an incarceration history, and self-reported likelihood of being infected were the strongest predictors of HIV infection, while San Diego residence and income from exchange sex were the strongest predictors of unprotected anal intercourse. Tijuana residence and no access to care were some of the strongest predictors of never testing for HIV.

The current study provides compelling evidence that the control of the HIV epidemic in the San Diego-Tijuana border region must include primary and secondary HIV prevention efforts directed at YLMSM. There is an urgent need for HIV interventions to address unprotected anal intercourse, high HIV seroprevalence rates, and low HIV testing rates in YLMSM in the US--Mexico border region. These HIV interventions must be empirically-based, culturally and linguistically appropriate, and address the social context of HIV risk.