The Influence of Acculturation, Values and Relationship Power on Latina HIV Prevention Strategies Sofia Mendoza Psychology & Social Behavior/Criminology, Law & Society Faculty Mentors: Kris Beals, PhD. & Susan Charles, PhD. Funding provided by the Undergraduate Research Opportunities Program at UC Irvine

Sariah Gonzales-Kakishita Health Educator at ASF OC “The average Latina client that is HIV positive and comes to ASF has a history of: “The average Latina client that is HIV positive and comes to ASF has a history of: Having migrated to the U.S. by herself Having migrated to the U.S. by herself NO drugs NO drugs NO sex for drugs or $ NO sex for drugs or $ NO multiple partners NO multiple partners Has been with the same MALE partner for a couple of years Has been with the same MALE partner for a couple of years Has no idea how her partner was infected Has no idea how her partner was infected Usually receives diagnosis when she became pregnant.” Usually receives diagnosis when she became pregnant.” Picture was obtained through Positive since 1986

Latinas and HIV/AIDS  In 2005, Latinos made up 14% of the U.S. population, but accounted for 21.4% of HIV cases and 20% of AIDS cases ( CDC 2003 ).  Latinas are one of the fastest growing groups living with HIV/AIDS.  Latinas are seven times more likely than white women to get infected.  The most common mode of transmission for Latinas is through heterosexual contact.

Research Question How do… How do… Acculturation Acculturation Gender Values Gender Values Relationship Power Relationship Power …influence condom use among Latinas? …influence condom use among Latinas?

Acculturation Acculturation is defined as the process of culture change that an individual goes through as a result of contact with the new culture (Munet-Vilaro, Folkman & Gregorich, 1999). Acculturation is defined as the process of culture change that an individual goes through as a result of contact with the new culture (Munet-Vilaro, Folkman & Gregorich, 1999). Higher levels of acculturation has been shown to be positively correlated with patterns of condom use ( Salabarria-Pena et al., 2003; Marin & Garcia 1997 ). Higher levels of acculturation has been shown to be positively correlated with patterns of condom use ( Salabarria-Pena et al., 2003; Marin & Garcia 1997 ). Depending on levels of acculturation, Latinas are encouraged to believe that they are not a “risk group”, and that being married, or in what they believe to be a monogamous relationship, protects them from infection (Latino Commission on AIDS 2004). Depending on levels of acculturation, Latinas are encouraged to believe that they are not a “risk group”, and that being married, or in what they believe to be a monogamous relationship, protects them from infection (Latino Commission on AIDS 2004).

Gender Values  Gender Values are studied as traditional gender role beliefs specific to the Latino culture.  Machismo (neg) is known to include, physical aggression and male dominance among men.  Marianismo prescribes appropriate behavior for women, such as purity, chastity, devotion to the home, humbleness, and submissiveness  Traditional gender role values influence sexual submissiveness among Latinas which can impede positive sexual negotiation skills ( Faulkner, 2003 ).

Relationship Power  Sexual relationship power is the ability to make and carry out sexual negotiations.  Women with the most relationship power are more likely to maintain the control and negotiation of condom use ( Osmond et al. 1993; Pulerwitz et al., 2003 ).

Specific Hypotheses  H 1 : Acculturation = condom use patterns  H 2 : Gender Values = condom use patterns  H 3 : Relationship Power = condom use patterns

Methodology Design Design  A quantitative survey study sampling 158 Latinas Setting  The community sample was recruited from:  one CBO in L.A., a Laundromat, video store & market in Tustin  The college sample was recruited from:  UC Irvine

Measures/Scales ScaleAuthorReliability Marin Short Acculturation Scale* Marin et al., 1997 Alpha=.92 Sexual Relationship Power Scale* Pulerwitz et al., 2000 Alpha=.84 Mirande Sex Role Inventory Mirande, 1997 Alpha= *Author had translated Spanish version of the scale.

Participants N= 158 Latinas

Demographics Mexican American Central American Other birac/eth South American

Demographics Age: 21.5 Age: 21.5 Some SomeCollege Age : 25.5 High School

Demographics - Religion Catholic None Christian Other

Sexual Activity Community Sample  Last three mos: n=65 College Sample  Last three mos: n= % Not Always 31.8% Always Condom Use

Mean Scores CommunityCollegeT-score Acculturation ** Gender Values ** RelationshipPower * * Significant at.01 level; **Significant at.001 level.

Results  Acculturation, values and relationship power do not predict condom use at a significant level.  Relationship power did, however, predict barriers to condom use.

Barriers to Condom Use Reasons:CommunityCollege Cost9%4.5% Religious Beliefs 00 Not sure how to use them 1.5%0 *On birth control 20%40% Partner Refuses 9%7% I Refuse 3%0 *Does not feel the same 26%32% Condom irritates skin 9%11% Don’t want to stop 1.5%14% Never have any 1.5%7% * Top 2 reasons for not using condoms

Barriers to Condom Use and Relationship Power Reasons: Relationship Power Cost-.181* Not sure how to use them -.266** Partner Refuses -.206* I refuse.152 (.052 level) Does not feel the same (.055 level) *Pearson Correlation is significant at the.05 level; **Correlation is significant at the.01 level

Miscellaneous Findings Diagnosed with any STD? Diagnosed with any STD? College: 2 (3%) College: 2 (3%) Community: 10 (13.5%) Community: 10 (13.5%) Female condom: Female condom: Only 1 person Only 1 person Condom Initiation Both 71.6% 14.6% Self Partner 13.5%

Miscellaneous Findings Condom Purpose: Condom Purpose: Birth Control STD Prevention Both College45%5%50% Community29%6%65% Both 57% Birth Control 36% 6% STD

Discussion  The college sample had acculturation, gender role values, relationship power and a percentage of “always” using condoms than the community sample.  Of those that were having sex, only 31% always used condoms and 69% did not.  Of those that did use condoms, a high percentage did so for birth control purposes, highlighting low perception of risk.  In this study, we did not find expected associations between condom use and acculturation, values, and relationship power.  We found that relationship power did predict reasons for lack of condom use.

Implications Public Health concern not limited to STD’s and pregnancy rise, but also increasing rates of HIV and AIDS in the United States Public Health concern not limited to STD’s and pregnancy rise, but also increasing rates of HIV and AIDS in the United States Latinas and African American women are at the highest risk because they are more likely to be infected by a male whose risky behavior is unknown. Latinas and African American women are at the highest risk because they are more likely to be infected by a male whose risky behavior is unknown. Future generations where HIV/AIDS will be the leading cause of death in the U.S. Future generations where HIV/AIDS will be the leading cause of death in the U.S.

Future Directions  Prevention and intervention research with a focus on relationship dynamics and sexual negotiation.  Perception of risk assessment  Provide Latinas with facts about HIV/STD’s is critical  There is a great need for encouraging alternative female controlled methods such as the female condom.

Acknowledgements Kristin Beals, PhD. Susan Charles, PhD. Val Jenness, PhD. Undergraduate Research Opportunities Program Social Ecology Honors Program Shields For Families Rosa Reyes Juanita Andrews Family and Friends