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Immigrant Sexual minority Latino men—who may or may not self-identify as gay—constitute a minority within a minority. Informed by a Social Ecological Framework, we sought to describe key social variables for such men in rural North Carolina and to test associations with three sexual outcomes: Participants reported limited English-language use, predominantly Latino close friends, middle levels of social support despite numerous social ties, and frequent experiences of discrimination.

There were unique sets of correlates for each sexual outcome. Findings may inform health promotion interventions and guide future research. Even less is known about sexual minority Latino men, a sub-group that includes gay-identified men, men who have sex with men MSM but who do not self-identify as gay, and gender variant or transgender men. Although most Latino immigrants have been integrated into the economy i.

In North Carolina, receptivity to Latino immigrants has been mixed over time and across different communities Perreira, While there have been some initiatives to integrate Latinos, such as church-based supportive programs and secular community-based organizations Bailey,these efforts have often been accompanied by increased social tensions, including Latino men all over the world discrimination, residential segregation, and racial profiling Bauer et al.

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Immigrant sexual minority Latino men may be particularly vulnerable as they could be marginalized due to sexual orientation in addition to ethnicity, immigration status, and language use. Such social ecological approaches recognize that individuals are embedded within inter-personal relationships, neighborhood contexts, geographic characteristics, social policies, and economic factors, among others. Given the vastly different community characteristics and social contexts in non-traditional migration destination states, however, the generalizability of research findings obtained in established Latino communities particularly those that also have visible gay male communities to newly emerging Latino communities cannot be assumed Farley, Informed by the Social Ecological Model Bronfenbrenner,in which individuals are nested with interpersonal relationships, communities, cultures, and political systems, we have sought to understand Latino men all over the world sexual minority Latino men's health.

In qualitative studies, we identified a number of social and contextual factors that affect these men in North Carolina Rhodes, Hergenrather, Aronson, Bloom, Felizzola, Wolfson, Vissman, Alonzo, Allen, et al. Loneliness, the limited venues available for socializing, reluctance to disclose sexual orientation out of fear of rejection, and the lack of a sense of community have been identified as frequent challenges.

In addition, many men cited discrimination and political factors particularly immigration policy as stressors. We sought to extend previous research by taking advantage of quantitative data obtained via an in-depth behavioral and psychosocial assessment. Our goal in the present study was to describe the social context of immigrant sexual minority Latino men in North Carolina and to test the association of demographic, psychosocial, and behavioral variables with three sexual outcomes: As a descriptive Latino men all over the world study, no a priori hypotheses were proposed.

Data for this analysis come from a study of HIV risk and protective factors among immigrant sexual minority Latino men in rural North Carolina. The study was guided by a community-based participatory research CBPR partnership that included representatives from public health departments, AIDS service organizations, universities, the local Latino community including immigrant sexual minority menand community-based organizations serving the Latino community. Because researchers often consider this a hard-to-reach population, we used respondent-driven sampling RDS to recruit participants.

Nine additional seeds were enrolled to expedite recruitment in accordance with standard RDS procedures, for a total of 17 seeds. Participants self-identified as Latino, were age 18 or older, reported having had sex with another man since age 18, and resided in one of seven rural counties in central North Carolina.

Each seed provided informed consent, completed an in-depth psychosocial and behavioral assessment described belowreceived instruction on the study's recruitment protocol and eligibility criteria, and recruited up to three additional participants from their social networks. Each subsequent participant completed an assessment, received instruction on the study's recruitment protocol and eligibility criteria, and recruited up to three new participants from his social network.

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The CBPR partnership developed a comprehensive quantitative assessment, using established Spanish-language measures whenever possible and adapting established English-language measures or developing new measures when necessary. The group included professional translators including native Spanish speakers from Mexico and Central Americaa translation reviewer, content specialists, and a questionnaire design expert.

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Multiple group members made independent translations of the assessment, and the full committee met to discuss and reconcile the various versions.

The full assessment included over items, but we restricted this analysis to a sub-set of 26 demographic, social, and behavioral variables described below. Among social variables, we assessed language use with the 5-item sub-scale of the Short Acculturation Scale for Hispanics e.

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Although the response options appeared to confound ethnicity and nationality, it presented the most salient contrast for our study population i. These measures served as proxies for assimilation, with greater English-language use and more non-Latino close friends indicating greater participation in US society. A single item asked participants how many other immigrant sexual minority Latinos they knew.

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