Understanding sociocultural influences in sexual health promotion and HIV protection among Latinx sexually minoritized men: A qualitative study

In the United States, Latinx individuals account for 18% of the overall population, yet sexual minoritized men (SMM) within this demographic disproportionately represent 30% of new HIV diagnoses among all SMM. Despite the availability of highly effective HIV prevention strategies such as Pre- exposure Prophylaxis (PrEP), there are marked inequities in access and utilization of these strategies among Latinx SMM. Sociocultural factors and the experiences of Latinx SMM shape beliefs about sexual health promotion and influence HIV self-protective behavior (e.g., the correct and consistent use of condoms, regular engagement in HIV testing, and PrEP use) in this group. A descriptive, qualitative study, using thematic analysis, was designed to describe the sociocultural barriers and facilitators that influence sexual health promotion and HIV self-protection among Latinx SMM. A convenience sample of 15 Latinx SMM was recruited from an ongoing longitudinal study and online for individual interview, which were conducted virtually between October 2020 and October 2021. Five themes emerged from the data: 1) prevention is better than to cure; 2) cultural and religious norms create a culture of silence around sexual health; 3) lack of information and misinformation leading to self-reliance for sexual health protection; 4) growing wiser: maturity's impact on sexual health and relationships; and 5) unjust and dehumanizing sexual health care. The findings from this study highlighted that stigma and structural factors shape the opportunities of Latinx SMM to engage in sexual health promotion and HIV self-protection. These findings emphasize the need for focus on addressing structural barriers such as sexual health education, access to care, and healthcare provider bias to improve sexual health outcomes among Latinx SMM.