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Differences in HIV Risk and Prevention Among Cisgender Latino Sexual Minority Men by Language of Online Survey Completion: Analysis of National and Washington State Data

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Abstract

Internet-based surveys can be programmed and advertised in multiple languages to reach non-English-speaking individuals, but it is unclear the extent to which this enhances the diversity of participants and supports inclusion of individuals at higher risk for HIV. We sought to examine how language of survey completion (English or Spanish) was associated with sociodemographic characteristics and indicators of HIV risk and prevention among cisgender Latino sexual minority men (SMM). We analyzed national and Washington State data using the Understanding New Infections through Targeted Epidemiology (UNITE) Cohort Study (2017 and 2018) and the Washington HIV/STI Prevention Project (WHSPP) survey (2017 and 2018/2019), respectively. Latino SMM who completed online surveys in Spanish differed from those who completed surveys in English across several sociodemographic characteristics including age, education, and income. After adjusting for sociodemographic characteristics and HIV-related risk factors, Spanish language respondents in UNITE were less likely to have tested for HIV in the past year, and those in WHSPP were more likely to report a recent STI diagnosis. Findings suggest that Latino SMM who complete surveys in Spanish comprise a unique subgroup that may have a specific HIV health and risk behavior profile. Our results suggest a need for increased and tailored efforts to recruit and include Spanish-speaking Latino SMM for local and national research and public health programming.

Resumen

Encuestas por internet pueden ser programadas y anunciadas para alcanzar a personas que no hablan inglés, pero no queda claro si esto pueda mejorar la diversidad de los participantes de investigación y apoyar la inclusión de los individuos de alto riesgo a infección con el VIH. En este estudio examinamos la relación del idioma de completar la encuesta en línea (inglés o español) entre hombres Latinos de minorías sexuales (HLMS) cisgénero con características sociodemográficas y determinantes para el riesgo y prevención del VIH. Analizamos los datos nacionales y estatales con el estudio de cohorte de Understanding New Infections through Targeted Epidemiology (UNITE) (2017 y 2018) y El Proyecto de Washington para la Prevención del VIH/Infecciones de Transmisión Sexual (WHSPP) (2017 y 2018/2019), respectivamente. Los HLSM quienes completaron las encuestas por internet en español fueron diferentes a los que completaron las encuestas en inglés por varias características sociodemográficas incluso la edad, la educación, y el ingreso. Después de ajustar por las características sociodemográficas y los factores de riesgo asociados con el VIH, los participantes de UNITE que respondieron en español tuvieron menos probabilidad de haberse hecho la prueba de VIH en el año pasado y los que participaron en el WHSPP eran más probable que reportaran un diagnóstico de ITS. Los resultados indican que los HLSM quienes completan las encuestas en español representan un subgrupo distinto que tiene un perfil específico de comportamiento de riesgo y salud respecto al VIH. Los resultados demuestran la necesidad de mayores esfuerzos especializados para reclutar e incluir los HLSM quienes hablan español para que participen en las investigaciones en línea a nivel local y nacional y la programación de la salud pública.

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Data Availability

The WHSPP data and UNITE data are not publicly available.

Code Availability

Statistical analyses for WHSPP were performed using R version 3.5.3 and STATA version 13.1; analyses for UNITE were performed using SPSS v. 23.

References

  1. Centers for Disease Control and Prevention. HIV and gay and bisexual men. Available at: https://www.cdc.gov/hiv/group/msm/index.html. Accessed Dec 15 2020.

  2. Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2018 (Updated). Atlanta, GA: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; 2020.

  3. Crowley JS, Bland SE. Bolstering Latinx gay and bisexual men to promote health and reduce HIV transmission. Washington: O’Neill Institute for National & Global Health Law; 2019.

    Google Scholar 

  4. Timmins CL. The impact of language barriers on the health care of Latinos in the United States: a review of the literature and guidelines for practice. J Midwifery Women Health. 2002;47(2):80–96.

    Article  Google Scholar 

  5. Tanner AE, Reboussin BA, Mann L, Ma A, Song E, Alonzo J, et al. Factors influencing health care access perceptions and care-seeking behaviors of immigrant Latino sexual minority men and transgender individuals: baseline findings from the HOLA intervention study. J Health Care Poor Underserved. 2014;25(4):1679–97.

    Article  Google Scholar 

  6. Spadafino JT, Martinez O, Levine EC, Dodge B, Muñoz-Laboy M, Fernandez MI. Correlates of HIV and STI testing among Latino men who have sex with men in New York City. AIDS Care. 2016;28(6):695–8.

    Article  Google Scholar 

  7. Mogobe KD, Shaibu S, Matshediso E, Sabone M, Ntsayagae E, Nicholas PK, et al. Language and culture in health literacy for people living with HIV: perspectives of health care providers and professional care team members. AIDS Res Treat. 2016;2016:5015707.

    PubMed  PubMed Central  Google Scholar 

  8. Avoundjian T, Bennett A, Kerani R, Golden M, Buskin S, Dombrowski J, et al. editors. Disparities in late HIV diagnosis by race/ethnicity, nativity and language preference among MSM and transgender persons living in King County, WA. Society for Epidemiologic Research Annual Meeting 2018; Baltimore, MD.

  9. Schwei RJ, Del Pozo S, Agger-Gupta N, Alvarado-Little W, Bagchi A, Chen AH, et al. Changes in research on language barriers in health care since 2003: a cross-sectional review study. Int J Nurs Stud. 2016;54:36–44.

    Article  Google Scholar 

  10. Kinsler JJ, Lee S-J, Sayles JN, Newman PA, Diamant A, Cunningham W. The impact of acculturation on utilization of HIV prevention services and access to care among an at-risk Hispanic population. J Health Care Poor Underserved. 2009;20(4):996–1011.

    Article  Google Scholar 

  11. Du H, Li X. Acculturation and HIV-related sexual behaviours among international migrants: a systematic review and meta-analysis. Health Psychol Rev. 2015;9(1):103–22.

    Article  Google Scholar 

  12. Raj A, Amaro H, Reed E. Culturally tailoring HIV/AIDS prevention programs: why, when, and how. In: Kazarian SS, Evans DR, editors. Handbook of cultural health psychology. San Diego: Academic Press; 2001. p. 195–239.

    Chapter  Google Scholar 

  13. Rios-Ellis B, Frates J, D’Anna LH, Dwyer M, Lopez-Zetina J, Ugarte C. Addressing the need for access to culturally and linguistically appropriate HIV/AIDS prevention for Latinos. J Immigr Minor Health. 2008;10(5):445–60.

    Article  Google Scholar 

  14. Hanrahan D, Sexton P, Hui K, Teitcher J, Sugarman J, London AJ, et al. Linguistic and cultural challenges in communication and translation in US-sponsored HIV prevention research in emerging economies. PLoS ONE. 2015;10(7):e0133394.

    Article  Google Scholar 

  15. Castillo-Mancilla JR, Cohn SE, Krishnan S, Cespedes M, Floris-Moore M, Schulte G, et al. Minorities remain underrepresented in HIV/AIDS research despite access to clinical trials. HIV Clin Trials. 2014;15(1):14–26.

    Article  Google Scholar 

  16. Murray S, Buller AM. Exclusion on grounds of language ability—a reporting gap in health services research? J Health Serv Res Pol. 2007;12:205–8.

    Article  Google Scholar 

  17. Paz-Bailey G, Hoots BE, Xia M, Finlayson T, Prejean J, Purcell DW. Trends in internet use among men who have sex with men in the United States. J Acquir Immune Defic Syndr. 2017;75(Suppl 3):S288–95.

    Article  Google Scholar 

  18. Sanchez TH, Smith A, Denson D, Dinenno E, Lansky A. Internet-based methods may reach higher-risk men who have sex with men not reached through venue-based sampling. Open AIDS J. 2012;6(1):83–9.

    Article  Google Scholar 

  19. Sanchez TH, Zlotorzynska M, Sineath RC, Kahle E, Tregear S, Sullivan PS. National trends in sexual behavior, substance use and HIV testing among United States men who have sex with men recruited online, 2013 through 2017. AIDS Behav. 2018;22(8):2413–25.

    Article  Google Scholar 

  20. Krogstad JM, Lopez MH. Use of Spanish declines among Latinos in major U.S. metros. Pew Research Center: Pew Research Center; 2017.

  21. Rao DW, Carr J, Naismith K, Golden M. Washington HIV prevention project: key findings, 2017. Seattle, WA: Washington State Department of Health Public Health—Seattle & King County University of Washington; 2017.

  22. Wittenauer R, Rao DW, Downs J, Naismith K, Golden M. Washington HIV prevention project: key findings, 2018–2019. Seattle, WA: Washington State Department of Health Public Health--Seattle & King County University of Washington; 2019.

  23. Rao DW, Carr J, Naismith K, Hood JE, Hughes JP, Morris M, et al. Monitoring HIV preexposure prophylaxis use among men who have sex with men in Washington State: findings from an internet-based survey. Sex Transm Dis. 2019;46(4):221–8.

    Article  Google Scholar 

  24. Rendina HJ, Talan AJ, Tavella NF, Matos JL, Jimenez RH, Jones SS, et al. Leveraging technology to blend large-scale epidemiologic surveillance with social and behavioral science methods: successes, challenges, and lessons learned implementing the UNITE Longitudinal Cohort Study of HIV risk factors among sexual minority men in the U.S. Am J Epidemiol. 2020;190(4):681–95.

    Article  Google Scholar 

  25. Centers for Disease Control and Prevention (CDC). Pre-exposure prophylaxis (PrEP). 2019.

  26. R Core Team. A language and environment for statistical computing. Vienna, Austria: Foundation for Statistical Computing; 2020.

  27. StataCorp. Stata statistical software: release 13. College Station, TX: StataCorp LP; 2013.

  28. IBM SPSS Statistics for Windows, Version 23.0 [Internet]. IBM Corp. 2015.

  29. Patten E. The nation’s Latino population is defined by its youth. Washington: Pew Research Center; 2016.

    Google Scholar 

  30. Jaksić I. Debating race, ethnicity, and Latino identity: Jorge J. E. Gracia and his critics. New York, NY: Columbia University Press; 2015.

  31. Washington State Department of Health. End AIDS Washington 2020. Washington State Department of Health; 2016.

  32. Washington State Department of Health. STD fast facts: Washington State 2018. Olympia, WA: Office of Infectious Disease, Disease Control and Health Statistics, Washington State Department of Health; 2020.

  33. Kanny D, Jeffries WLI, Chapin-Bardales J, Denning P, Cha S, Finlayson T, et al. Racial/ethnic disparities in HIV preexposure prophylaxis among men who have sex with men—23 urban areas, 2017. MMWR Morb Mortal Wkly Rep. 2019;68(37):801–6.

    Article  Google Scholar 

  34. Centers for Disease Control and Prevention. HIV and Hispanics/Latinos 2020 Available at: https://www.cdc.gov/hiv/group/racialethnic/hispaniclatinos/index.html. Accessed July 26, 2020.

  35. Centers for Disease Control and Prevention. First year geographic focus, ending the HIV epidemic: a plan for America 2020, updated May 21, 2020. Available at: https://www.cdc.gov/endhiv/priorities.html#WA-King. Accessed July 15, 2020.

  36. Sun CJ, Sutfin E, Bachmann LH, Stowers J, Rhodes SD. Comparing men who have sex with men and transgender women who use Grindr, other similar social and sexual networking apps, or no social and sexual networking apps: implications for recruitment and health promotion. J AIDS Clinical Res. 2018;9(2):757.

    Article  Google Scholar 

  37. Noe-Bustamante L. Key facts about U.S. Hispanics and their diverse heritage. Washington, D.C.: Pew Research Center; 2019.

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Acknowledgements

This research received additional support from the University of Washington/Fred Hutch Center for AIDS Research (CFAR) (NIH P30 AI027757). From the University of Washington, Rachel Wittenauer helped with implementation and data management for the 2018/2019 WHSPP survey. Matthew Golden, with the University of Washington and Public Health—Seattle & King County, alongside Jason Carr and Jonathon Downs with the Washington State Department of Health, provided input and guidance on the WHSPP survey design and implementation. We thank all the staff, students, and volunteers who made the UNITE study possible, particularly those who worked closely on the study’s recruitment and enrollment: Trinae Adebayo, Paula Bertone, Dr. Cynthia Cabral, Juan Castiblanco, Jorge Cienfuegos Szalay, Nicola Forbes, Ruben Jimenez, Scott Jones, Jonathan López-Matos, Raymond Moody, Dr. Ali Talan, Nicola Tavella, Brian Salfas, and Ore Shalhav. The UNITE team also gratefully acknowledges the support of the National Institutes of Health, particularly our Project Scientists, Drs. Gerald Sharp, Sonia Lee, and Michael Stirratt, and the contributions of Dr. Mark Pandori and the Alameda County Public Health Laboratory. We gratefully acknowledge the contributions of all participants within the WHSPP and UNITE studies for their time and feedback.

Funding

The WHSSP was funded by the University of Washington STD/AIDS Research Training Program (NIH T32 AI07140) and the Washington State Department of Health. The UNITE study was supported by a grant jointly awarded by the National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Mental Health (NIMH), and Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (UG3/UH3-AI133674, PI: Rendina). Jane J. Lee and Darcy W. Rao were supported by the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number KL2TR002317. Roxanne P. Kerani was supported by NIAID R01 AI127232. Gabriel Robles was supported by an early career faculty diversity supplement (UH3-AI133674-04S1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. School of Social Work, University of Washington, 4101 15th Ave NE, Seattle, WA, 98105, USA

    Jane J. Lee

  2. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Darcy White Rao

  3. School of Social Work, Rutgers University, New Brunswick, NJ, USA

    Gabriel Robles

  4. Department of Medicine, University of Washington, Seattle, WA, USA

    Roxanne P. Kerani

  5. Washington State Department of Health, Tumwater, WA, USA

    Kelly Naismith

  6. The George Washington University-Milken Institute School of Public Health, Washington, DC, USA

    Carlos E. Rodriguez-Díaz & H. Jonathon Rendina

  7. Department of Global Health, University of Washington, Seattle, WA, USA

    David A. Katz

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  1. Jane J. Lee
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  7. H. Jonathon Rendina
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  8. David A. Katz
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Contributions

All authors contributed to the study conception and design. Data analyses were performed by Darcy W. Rao and Gabriel Robles. The first draft of the manuscript was written by Jane J. Lee. All authors supported the review and editing of the manuscript. All authors read and approved the manuscript.

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Correspondence to Jane J. Lee.

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The authors declare that they have no conflicts of interest.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committees and with the 1964 Helsinki Declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Lee, J.J., Rao, D.W., Robles, G. et al. Differences in HIV Risk and Prevention Among Cisgender Latino Sexual Minority Men by Language of Online Survey Completion: Analysis of National and Washington State Data. AIDS Behav 26, 662–673 (2022). https://doi.org/10.1007/s10461-021-03426-2

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