Latinx sexual minority youth (LSMY) are disproportionately affected by adverse health outcomes, due to stigma and/or lack of family support. There are currently no family-based interventions for LSMY. This qualitative study describes the development of Familias con Orgullo (Families with Pride), a family-based intervention to prevent/reduce substance use, risky sexual behavior, and depressive symptoms in LSMY. Familias con Orgullo was developed using an iterative, user-centered methodology across two study phases. A general inductive approach was used to analyze intervention development individual interviews (N = 24: n = 12 parents, n = 12 LSMY) and post-intervention focus groups (N = 4) to query participants about program components and enhancements to the developed program after delivery. Data were coded into 11 themes representative of program features for LSMY and their families. An intervention would need LSMY information delivered in a safe space and focused on communication, peer pressure, and mental health. Furthermore, participation would be dependent on parental level of acceptance. Informed by participants, we developed an intervention which addresses the multiple ecological levels of LSMY contexts within a cultural lens. Families gave positive feedback and indicated that additional content should focus on sexual health and intrapersonal topics. The intervention was modified and delivered to a new cohort of families; families felt the new intervention promoted inclusiveness; enriched relationships and communication between families; and enhanced lesbian, gay, bisexual, transgender, or queer (LGBTQ) knowledge. Familias con Orgullo begins to address the significant gap in intervention research with LSMY and their families. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Pre-exposure prophylaxis (PrEP) and HIV testing inadequately reach Latino sexual minority men (LSMM), fueling HIV disparities. This study identified determinants of LSMM's PrEP use and HIV testing and examined differences across subgroups (i.e., age and immigration history). First, we identified the most to least endorsed barriers and facilitators of PrEP use and HIV testing among LSMM (1) over vs. under 40 years old, and (2) across immigration histories (U.S. born, recent immigrant, established immigrant). Next, we examined differences in barrier/facilitator ratings across these age and immigration status groups. Key overall determinants were cost, knowledge, and perceived benefit/need. However, there was variation in determinants across age groups (i.e., cost, affordability, navigation support, and normalization) and immigration statuses (i.e., language, immigration concerns, and HIV knowledge). There were also differences across service types; mistrust and concerns was a barrier related to PrEP but not HIV testing. We found unique and common multilevel factors across prevention services and subgroups. Language, cost, and clinic/system issues are key barriers in accessing HIV prevention that should be considered when developing implementation strategies to enhance the reach of these services to LSMM.

Purpose: Latino sexual minority men (LSMM) may experience oppression based on their ethnicity, sexual orientation, and migratory status, yet scientific literature is only beginning to explore the intersection of these experiences. This study examined mental health (MH) in relation to LSMM's experiences of intersectional oppression and affirmation. Methods: We conducted a secondary analysis of baseline data from a cohort study examining LSMM's ( n = 290) health care engagement in Miami, FL, from February to September 2020. Latent class analysis (LCA) identified classes based on self-reported multiple identity discrimination (e.g., race, ethnicity, and skin color), sexual orientation stigma/affirmation, and migration-related stress. Logistic and linear regressions examined associations between class membership and anxious, depressive, post-traumatic stress, somatic symptoms, and overall MH burden. Results: The LCA revealed a three-class solution: (1) affirmed LSMM (73.8%), (2) LSMM with intersectional oppression (21.7%), and (3) LSMM with immigration stress (4.5%). The three classes varied in terms of multiple identity discrimination, sexual orientation stigma/affirmation, and migration-related stress. Compared with Class 1, Class 2 had greater conditional probabilities of reporting clinically significant depressive ( p = 0.033) and post-traumatic stress symptoms ( p = 0.031), and at least one MH concern ( p = 0.018). Greater depressive symptoms ( p = 0.007), post-traumatic stress symptoms ( p = 0.049), somatic symptoms ( p = 0.024), and clinically significant MH concerns ( p = 0.018) were found among Class 2 than among Class 1. Conclusion: Findings identified three groups of LSMM based on their experiences of intersectional oppression and affirmation. Discrimination at the intersection of multiple identities, sexual orientation stigma/affirmation, and migration-related stress were associated with LSMM's MH outcomes, particularly among immigrants.

Purpose: The purpose of this study is to refine and establish measures of multilevel barriers and facilitators to HIV testing and PrEP for Latino sexual minority men (LSMM). Design: Cross-sectional measure validation. Setting: Participants from Miami, FL. Subjects: 290 LSMM from the DÍMELO study. Measures: Based on prior qualitative work, we developed two measures that evaluated multiple determinants (i.e., barriers and facilitators) to (1) HIV testing and (2) PrEP use. Analysis: All measures included in this analysis assessed a set of theoretically distinct barriers and facilitators. We performed 11 exploratory factor analyses (EFA) to assess the dimensionality of theoretical groupings of items informed by prior qualitative work, including: knowledge, perceived need and benefit, mistrust and concerns, stigma and normalization, cultural competence, navigation support, provider demeanor, clinic and medical system issues, privacy concerns, cost, and language and immigration barriers. Based on EFA results, we conducted two confirmatory factor analyses (CFA), one for each measure. Results: Within each measure, the 11 EFAs extracted 10 barrier factors and 7 facilitator factors. The CFAs for HIV testing and PrEP measures were consistent, such that all models retained the structures identified in the EFAs. Conclusion: Findings support the use of these measures with LSMM. These measures can inform multilevel implementation strategies for health promotion professionals to scale up and disseminate HIV prevention services to LSMM.