Latino Sexual Minority Men Living with HIV in South Florida have Varied Experiences of Intersectional Discrimination: A Mixed Methods Pilot Study.

Abstract

Culturally tailored behavioral interventions are needed to improve HIV treatment outcomes among Latino gay, bisexual, and other sexual minority cisgender men (LSMM) living with HIV. From 2022 to 2023, this study collected cross-sectional survey data (n = 58) and qualitative interview data (n = 10) to describe intersectional discrimination and obtain insights for tailoring interventions to address discrimination among LSMM living with HIV in Miami, Florida, USA. The sample was diverse in age (range 21-75), sexual orientation (83% gay, 17% bisexual), and country of origin (71% born outside the USA), with many participants born in Cuba (28%), and more than half of participants (64%) completing the study in Spanish. Experiences of discrimination varied, with 41% personally experiencing discrimination in the past year. Over one-third reported experiences of violence due to discrimination (36% physically attacked, 35% sexually assaulted). Lifetime discrimination was most often attributed to sexual orientation (60%). All forms of discrimination were more severe among men from minoritized racial groups, and some forms of discrimination varied by time spent living in the USA. In interviews, discrimination was described as less severe in the USA compared to countries of origin, driven in part by religiosity and machismo. The impacts of discrimination ranged from mild and temporary to traumatic and persistent. Intervention suggestions included focusing on broad stressors, offering group- and individual options, prioritizing in-person interventions, offering trauma-informed care, and providing legal and immigration services. Findings demonstrate the need for multiple interventions to meet the varied needs, experiences, and preferences of LSMM living with HIV.