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Mental health disparities among Latino sexual minority men (LSMM) are exacerbated by un(der)treated mental health needs. This study sought to establish the factor structure of the Cultural Attitudes Toward Healthcare and Mental Illness Questionnaire (CAHMIQ) and examine measurement invariance across nativity (born in vs. outside the continental U.S.). Participants included 290 LSMM in South Florida. Confirmatory factor analysis examined the factor structure of CAHMIQ and measurement invariance examined equivalence across LSMM born outside (51.4%) and inside (48.3%) the continental U.S. The second-order factor model showed an acceptable fit (CFI/RMSEA =.91/.03) and consisted of first-ordered factors representing manifest indicators of causes and supports for mental health. Measurement invariance results suggest that the CAHMIQ performs equivalently across nativity groups (∆χ2(18) = 16.941, p =.5272). The CAHMIQ may be used among both nativity groups to understand attitudes toward healthcare and mental illness and inform LSMMs' engagement in mental health treatment. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Despite their efficacy, biomedical HIV prevention tools such as post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) have been insufficiently scaled up and disseminated, especially among marginalized subgroups that face substantial HIV disparities. Given the minimal literature available on PEP among Latino sexual minority men (LSMM), this cross-sectional secondary analysis explored factors associated with PEP awareness among a group of LSMM living in South Florida, a US HIV epicenter. The parent study examined patterns of engagement in PrEP and behavioral health treatment services among LSMM (N = 290). The current secondary analysis (N = 243) identified factors associated with PEP awareness using three methods: stochastic search variable selection, participatory data science, and literature review—before being modeled using linear regression. Most participants (67.5%) reported having little to no awareness about PEP before initiating our study. Simple linear regression models suggested that higher PrEP knowledge (B = 0.17, SE = 0.02, p < 0.001), HIV knowledge (B = 0.15, SE = 0.04, p < 0.001), PrEP self-efficacy (B = 0.37, SE = 0.13, p < 0.05), and high perceived community norms for HIV testing (B = 0.29, SE = 0.14, p < 0.05) were each associated with LSMM's greater PEP awareness, while identity affirmation was associated with less PEP awareness (B = −0.13, SE = 0.05, p < 0.01). Results suggest the utility of our three-pronged variable selection approach and address gaps in PEP awareness and use among LSMM living in a US HIV epicenter to support Ending the HIV Epidemic goals. [ABSTRACT FROM AUTHOR]