1. Florida International University
Drug Use and HIV Risk Behaviors among HIV-positive Latino MSM in a Large Urban Setting
Jesus Felizzola, MD
Mario De La Rosa, PhD
Florida International University
2004

2. BACKGROUND
Behavior associated with drug use is the single largest factor in the spread of HIV/AIDS in the U.S.
Young Latino MSM report higher rates of HIV prevalence and sexual risk behavior than white MSM (Valleroy et al., 2000)
HIV+ minorities are less likely to receive timely and optimal care.

3. PURPOSE OF THE SPSN OUTREACH DEMONSTRATION MODELS INITIATIVE:
(17 Sites)
To identify and evaluate demonstration models for HIV positive racial and ethnic minorities who were not in primary HIV care.
-Preliminary findings of a HRSA/SPNS funded project conducted in Miami from

4. CONTRIBUTIONS
Description of a small sample of HIV+ Latino MSM engaging in sexual risk behaviors under the influence of substances.
Mostly Spanish-speaking monolingual not in care.
Understanding about the patterns of sexual risk behaviors in which Latino MSM engage under the influence of substances.

5. RESEARCH QUESTIONS
1- To what extent do outreach programs identify HIV+ individuals and link them to care?
2- What are the characteristics of those individuals outreached and linked to care?
3- What are the factors associated with the engagement of HIV+ individuals into testing and linkage with medical care?
4- What are the barriers that HIV+ individuals find to access HIV services?

6. SAMPLE
107 HIV-positive individuals were enrolled in the evaluation.
98 participants completed baseline.
Criteria: Uninsured, HIV+ adults, who were not in care and were eligible to receive services at Care Resource.

7. PROCEDURES
Recruitment: from 06/01 to 09/03 in the field and in-house.
A written informed consent was obtained from all participants.
No incentives at baseline.

8. DATA COLLECTION
1- System-level: Number of individuals outreached, tested, and assessed at Intake.
2- Client-level: baseline, six, twelve, and eighteen-month follow ups during in-depth bilingual face-to-face interviews.
Demographics, medical history, sexual risk behaviors, Drug use Q, SF-12, CD4 and Viral Loads.

9. FINDINGS
4% positive tests and 73% returning rate.
Outreach/C&T at gay clubs is more effective identifying HIV + individuals (Woods et al. 2000).

10. Care Resource- HIP Outreach Encounters by Ethnicity
Source: Care Resource Information Systems Management Unit

11. Care Resource- WO Outreach Encounters by Ethnicity
Source: Care Resource Information Systems Management Unit

12. Gender by Age, Race and Ethnicity
Demographics
Male
Female
n=86 (86.9%)
n=12 (12.1 %)
Age (Mean)
38.7
40.7
Race:
White
80.2%
50.0 %
African American
18.6%
41.7 %
Asian
8.3%
Am. Indian/ Alaska
1.2 %
Ethnicity
Hispanic n= 50 (51%)
52.2%
36.4%
Non-Hispanic
47.7%
63.7%

13. Gender by Sexual Orientation and Education
Demographics
Male
Female
n=86(86.%)
n=12 (12.1 %)
Sexual Orientation
Heterosexual
12.8%
100%
MSM
84.8%
Prefer not to Identify
2.3%
Education
<High School
11.6 %
50.5%
High School/GED
23.3%
16.7%
Some College/Degree
60.4%
33.3%
Some Grad School/Degree
4.6% 0%

14. Ethnicity by Insurance Type and Medical Care Status
Health Care Info
Latino
Non-Latino
n=50
n=48
Insurance Type
Uninsured
82.0%
75.0%
Medicaid
16.0%
20.8%
Other
2.0%
4.2%
Medical Care Status
In Care
14.0 %
18.7%
Not in Care
86.0%
81.3%

15. SPNS Nationwide Sample (N=288) Insurance Type Among Latinos
Uninsured
33.6%
Medicaid
33.9%
Other
32.5

16. Substance Use Substance Use Latino MSM n=40 Latino n=50
Non-Latino n=48
Yes
27.5%
24%
23% No
72.5%
76%
77%

17. Condom Use Condom Use Latino n=43 Non-Latino n=30 Latino MSM n=34
>1/2 the time
74.4%
86.7%
67.6%
<1/2 the time
25.6%
13.3%
32.4%

18. Substance Use and Condom Use among Latino MSM
Drug/Alcohol Use in the Last
3 Months
Yes n=11
No n=23
>1/2 the time
54.5%
73.9%
<1/2 the time
45.5%
26.1%
90.9% of those LMSM who self-reported use of drugs or alcohol
were not in care or had dropped out of care

19. Condom Use and Length of Time Knowing HIV Status among Latino MSM
Date of First HIV+ Test
< 6 months
n=16
7 months to 2 years n=2
>2 years
>1/2 the time
75.0%
50.0%
62.5%
<1/2 the time
25.0%
37.5%

20. CONCLUSIONS
HIV prevention efforts targeting Latino MSM should consider the nature and context of drug use to construct culturally sensitive programs.

21. IMPLICATIONS FOR INTERNATIONAL RESEARCH Mario (115-16)