2021 Theses Doctoral

An Examination of Sexual Health Communication and Decision-making as Behavioral Determinants for the Race/ethnicity-based Disproportionality in New Infections of Human Immunodeficiency Virus Among Men Who Have Sex with Men in the City of New York

Wilkins, James

Worldwide uneven health outcomes based on race/ethnicity is a well-documented phenomenon and conversations relating to health disparities are well underway. In the United States, rates of new infections of HIV among African American and Hispanic men who have sex with men (MSM) have realized an upward trend over the past decade whilst rates among other demographic groups have realized noteworthy declines. The present study presents a quantitative analysis of sexual health communication and behavioral indicators with a view toward identifying whether African American and Hispanic MSM engage in fundamentally different sexual health communication and behaviors such that the divergent trends in new infections of HIV make sense.

Through a series of descriptive, chi-square, binary and ordinal logistic statistical methods, the degree to which sexual health communication and behaviors differed between groups of respondents in the New York City area were analyzed. The results showed a significant divergence in sexual health communication and behavior, based on race/ethnicity, education, age and other indicators. In the overall sample (n = 212), African American and Hispanic MSM were found to be significantly less likely to adhere to HIV medication regimens, use protection, ask about partners’ HIV status and disclose their own HIV status compared to members of other racial/ethnic groups. Other similarly significant findings suggested a need to address the underlying causes of divergent sexual health communication and health maintenance-related behaviors that contribute to disproportionality in new infections of HIV among African American and Hispanic MSM.