Austin C. Eklund’s research while affiliated with State University of New York and other places

El posible efecto de las normas de género masculino tradicionales latinas (p. ej., machismo tradicional y caballerismo) en el desarrollo de la identidad sexual de los Hombres Latinos de Minorías Sexuales (LSMM) es un área de investigación en expansión en la psicología latina. El propósito de este estudio interseccional es determinar si la aprobación del machismo tradicional y el caballerismo entre los LSMM varía según su: (a) estado de desarrollo de la identidad sexual y (b) su identidad sexual auto-etiquetada. Encuestamos a 499 LSMM (con edades de 18 a 57 años) en todo Estados Unidos a través de un estudio en línea. Con base en análisis correlacionados y un análisis multivariante de la varianza, los resultados describen cómo el machismo tradicional y el caballerismo están relacionados con: (a) diferentes niveles de estados teorizados de desarrollo de la identidad sexual (incertidumbre, exploración, compromiso, síntesis/integración) y también con: (b) el uso de etiquetas de identidad sexual por parte de los participantes (exclusivamente heterosexual/convencional, mayoritariamente heterosexual/convencional, bisexual, mayoritariamente homosexual/gay, exclusivamente homosexual/gay). Se encontraron resultados mixtos con respecto a las diferencias hipotéticas en la aprobación del machismo tradicional y el caballerismo por parte de los participantes en los cuatro estados de desarrollo de la identidad sexual. Los resultados respaldan las hipótesis de que los LSMM que indican un machismo tradicional y caballerismo más tradicionales tienden a autoidentificarse con etiquetas de heterosexual/convencional en comparación con los encuestados que se identifican con las etiquetas bisexual o homosexual/gay. Se debaten las implicaciones para la investigación psicológica y la práctica clínica en relación con el fomento del desarrollo de la identidad sexual saludable y culturalmente congruente de los LSMM.

Latinx gay, bisexual, and other men who have sex with men (LMSM) report lower pre-exposure prophylaxis (PrEP) use than their white, non-Latinx counterparts. We hypothesize that this disparity is partially attributable to social ecological factors that can be addressed via prevention interventions. In this retrospective study, we first examined data from 253 LMSM to determine whether theorized associations existed between acquisition of a PrEP prescription (uptake) in relation to several social ecological factors based on a conceptual framework of determinants of access to and uptake of PrEP for LMSM. We also explored relations between frequency of PrEP use (adherence) and social ecological factors with a subsample of 33 LMSM who had initiated PrEP 12 months prior to assessment. In this study, individual-level factors from this framework included age and socioeconomic status. Perceived access to medical care represented both individual- and community-level determinants of PrEP uptake and adherence. Interpersonal-level factors were social support and relationship status. Structural/cultural-level factors were sexual identity development status, the masculinity norm of heterosexual self-presentation, traditional Latinx masculine gender role beliefs of machismo and caballerismo, racial identity, and immigration status. Results indicated that older men and those who endorsed the synthesis/integration status of sexual identity development were more likely to acquire a PrEP prescription during their lifetime in comparison to peers. PrEP adherence was linked with being older, reporting higher socioeconomic status, reporting more appraisal social support, self-identifying as white-Latinx, being U.S.-born, and endorsing less sexual identity uncertainty and more heterosexual self-presentation. Results specify modifiable factors that may inform tailored, community-based prevention efforts to increase PrEP use and decrease existing HIV/AIDS disparities among LMSM.

Objective: Gay, bisexual, and other sexual minority men (SMM) face more barriers to accessing health care compared to other men. In comparison to other SMM populations, Latinx SMM (LSMM) report having less access to health care. The purpose of the present study is to elucidate how theorized environmental–societal-level (i.e., immigration status, education level, and income level), community–interpersonal-level (i.e., social support and neighborhood collective efficacy [NCE]), and social–cognitive–behavioral-level factors (i.e., age, heterosexual self-presentation [HSP], sexual identity commitment, sexual identity exploration [SIE], and ethnic identity commitment [EIC]) may relate with perceived access to health care (PATHC) in a sample of 478 LSMM. Method: We conducted a hierarchical regression analysis examining the hypothesized predictors of PATHC, as well as EIC as a moderator of the direct association between predictors and PATHC. We hypothesized that Latinx EIC would moderate relations between the aforementioned multilevel factors and PATHC. Results: LSMM perceived greater access to care when indicating the following: higher education level, more NCE, more HSP, more SIE, and more EIC. Latinx EIC acted as a moderator of four predictors of PATHC, including education, NCE, HSP, and SIE. Conclusions: Findings inform outreach interventions of researchers and health care providers about psychosocial and cultural barriers and facilitators of health care access.

Although health service psychology programs recognize the need for trainees to gain multicultural competencies by working directly with diverse populations, doing so within the constraints of an academic curriculum is challenging. We describe a team-based assignment for enhancing multicultural competencies in which students engage in consultation with an identified community organization/agency/institution to improve service delivery for a marginalized population. Students completed projects that (a) created an online educational course on trauma and resilience for displaced Syrian medical students, (b) delivered a socioemotional parenting workshop to parents in a grassroots organization, (c) trained medical residents on microaggressions within health care, and (d) presented a workshop on acculturative stress for Muslim leaders in local mosques. Projects require teams to apply theory and research to a focused, collaboratively identified problem; engage in consultation/collaboration with an agency, its professionals, and a team of peers; and practice self-reflection. Each team reflects on opportunities and challenges they experienced.

Little is known about what predicts student service members' and veterans' (SSM/V) adjustment to college. In qualitative research, SSM/V report feeling they do not belong and are misunderstood by college communities, a phenomenon that counseling psychologists call cultural incongruity. The goal of the current study was to quantitatively examine the relationship between cultural incongruity and adjustment to college. We surveyed 814 SSM/V about their adjustment to college using the Student Adaptation to College Questionnaire. Cultural incongruity was operationalized in two ways: feelings of not belonging were measured via direct report and the association with adjustment to college assessed with regression. Feelings of being misunderstood about academic barriers were assessed by comparing SSM/V's perceptions of academic barriers and SSM/V's perceptions of how others view the SSM/V's academic barriers and the association with adjustment was assessed using polynomial regression and response surface analysis. Cultural incongruity predicted adjustment to college. After controlling for other known predictors, feelings of not belonging accounted for 18% of the variance in adjustment to college. Polynomial regression showed that feeling understood about academic barriers protected against the negative impact of the barrier on adjustment to college. Cultural incongruity predicts adjustment to college for SSM/V. Helping SSM/V feel their unique barriers to college adjustment are understood may blunt the impact of these barriers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The rate of HIV infection for Latinx men who have sex with men (LMSM) increased by 20% from 2008 to 2014 even as rates stabilized among MSM of other racial and ethnic backgrounds. We hypothesize that this disparity is partially attributable to individual and structural factors associated with HIV testing, including substance use practices, among LMSM. In this retrospective study, we examined data from 502 LMSM to determine whether (a) hypothesized relationships exist between individual factors (perceived HIV susceptibility, experiences with HIV prevention, condom use, sex under the influence, sexual identity development status, heterosexual self-presentation, and traditional Latinx gender norms) and structural factors (access to healthcare resources and social support) and HIV testing for LMSM. We also tested whether (b) substance use practices moderate relations between individual and structural factors and HIV testing. Findings indicate that (a) relationships exist between several individual and structural factors and HIV testing and that (b) substance use moderated these relationships to HIV testing in a number of hypothesized ways. Practice and prevention implications are discussed.

From 2010 to 2014, HIV diagnoses among Latino men who have sex with other men (LMSM) have increased by 14%, whereas diagnoses declined by 11% among White, non-Latino men who have sex with men (MSM). This health disparity is in part due to exposure to other LMSM with undiagnosed HIV infections. To effectively engage LMSM who are unaware of their serostatus, profiles of men differing in theorized determinants of HIV testing must be considered. In this retrospective study, we examined data from 546 LMSM to investigate whether hypothesized individual- (traditional masculine gender role conformity, sexual identity development status, alcohol and illicit drug use, sexual risk behaviors, perceived HIV susceptibility, and HIV stigma) and community-based (HIV prevention programming, access to health care, social support, and neighborhood collective efficacy) factors were associated with differences in HIV testing. Latent profile analysis was used to identify profiles of men, and subsequent analyses examined whether profiles exhibited differential proportions of HIV testing. Four latent profiles were observed. One profile (50.3% tested) differed markedly from all other profiles (5.1% to 11% tested) in HIV testing. Characteristics of participants in this unique profile included reporting lower levels of heterosexual self-presentation, sexual identity uncertainty (and high levels of sexual identity commitment), condom use, HIV stigma, education, and perceived HIV susceptibility than all other profiles. Findings could improve HIV testing rates among LMSM by specifying ways in which public health advertisements/campaigns and community-based testing outreach efforts could be tailored to men most at risk for transmitting HIV due to unknown serostatus.

There is limited research on working affirmatively with bisexual clients in psychotherapy. The present study contrasted mental health clinicians' perceived affirmative counseling competence with bisexual clients to lesbian and gay (LG) clients. A sample of 312 heterosexual-identified mental health clinicians was recruited via an Internet-based survey. Participants were randomly assigned to either receive measures that referred to LG clients only or bisexual clients only. Path modeling was used to test whether LG group participants would report greater affirmative counseling knowledge, skills, and attitudes competencies compared to those in the bisexual group. Participants assigned to the bisexual client condition group reported less perceived affirmative counseling skills and knowledge but not attitudes compared to participants assigned to the LG client group. Implications, including the need for greater representation of bisexuality in psychotherapy education, training, and research, are discussed.