Adapting and testing a vulnerability model for Latino/a sexual and gender minorities in a new settlement state

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Fang-Yu Ma (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Robert Strack

Abstract: Sexual health vulnerability among Latino/a sexual and gender minorities is poorly understood, despite high rates of HIV and STDs among Latino/as, particularly in new settlement states in the southern US. The lack of a model specific to Latino/a sexual and gender minorities complicates the study of vulnerability. To move vulnerability research forward with this population, key constructs must be defined and processes for model development described. Clarity in the operationalization of vulnerability, as well as in the approach for adapting a vulnerability model to Latino/a sexual and gender minorities, can improve replicability to other similar populations and standardize a method toward model development. This study tests a new theoretical model of vulnerability for Latino/a sexual and gender minorities by adapting the General Model of Vulnerability. A community-based participatory research partnership recruited Latino/a sexual and gender minorities (i.e., men who have sex with men and transgender women; N=186) in North Carolina to participate in the HOLA intervention. Using baseline data collected in 2012, I performed latent class analysis to operationalize vulnerability across three domains (i.e., socioeconomic stability, health care, and social) using eight indicators (i.e., educational attainment, employment status, routine check-up, social support, acculturation, racial/ethnic and sexual discrimination, and internalized homonegativity) to identify underlying classes of vulnerability, then tested the association between class membership and three sexual health behaviors (i.e., HIV testing, STD testing, and condom use). In this sample, I identified three latent classes of vulnerability: High Education and Employment (18.8% of the sample; characterized by high educational attainment and employment status), Low Education and High Social Support (63.4%), and High Education and Discrimination (17.7%; high educational attainment and racial/ethnic and sexual discrimination). Membership in the Low Education and High Social Support class and the High Education and Discrimination class was significantly associated with more condomless anal or vaginal intercourse, whereas membership in the High Education and Employment class was associated with less condomless anal or vaginal intercourse (p < 0.05). I found no significant associations between vulnerability and HIV testing nor STD testing. Overall, the results from this study found that the identification of latent classes of vulnerability differentially predicted a sexual health behavior among Latino/a sexual and gender minorities in NC. These findings highlight the utility of identifying typologies of vulnerability to predict patterns of sexual health behavior. This information can be used to tailor future efforts to specific groups of Latino/a sexual and gender minorities, as well as other vulnerable populations living in other parts of the US. Developing intervention components that harness facilitators (e.g., social support) and address barriers (e.g., discrimination) to health, focusing specifically on those uniquely vulnerable, is critical to increasing the reach and effectiveness of tailored health promotion and HIV/STD prevention programming.

Additional Information

Language: English
Date: 2017
Latent class analysis, Latino/a sexual and gender minority, New settlement state, Sexual health, Vulnerability
Hispanic American sexual minorities $x Health and hygiene $z North Carolina

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