Background: Sexual risk for HIV is stratified by sexual role and activities, particularly presenting a higher risk for receptive partners due to biological vulnerabilities. Sexual role-based identity among Latino men who have sex with men (MSM) often coincides with assumptions regarding power dynamics between sexual partners. Latino MSM often associate pasivo (receptive) roles with less power in the dyad whereas activo (insertive) roles are associated with more power. A more granular understanding of the role socio-economic status (SES) plays in power dynamics, and thus HIV risk, is warranted given the identity-based oppression faced by Latino MSM. Our study aimed to explore the implications of SES for sexual activities among Latino immigrant MSM.
Methods: Our sample included 350 Brazilian, Colombian, and Dominican immigrant MSM residing in New York City. We estimated SES differential using participants’ responses on questions gauging their sex partner’s education and income compared to their own. We categorized SES as favoring the participant, the partner, or equal between partners. Participants also reported their participation in a series of sexual activities during the most recent sexual encounter with a single partner.
Results: Regarding SES differentials, 24% of participants had a higher SES than their partner, 40.9% had a lower SES, and 35.1% reported equal SES. A series of logistic regressions revealed that, as compared to participants with higher or equal SES, participants with lower SES than their sexual partner were more likely to receive oral sex and manual stimulation of their penis and anus by their sexual partner. They were also less likely to penetrate or ejaculate in their partner’s anus. They were not more or less likely to receive anal penetration or ejaculation in their anus from their sexual partner.
Conclusions: Although participants with lower SES were more likely to receive oral and manual stimulation, it did not confer an increased risk of HIV through receptive anal intercourse. The conceptualization of dyadic power between activo and pasivo partners was not aligned with SES. To minimize the influence of SES on HIV risk, user-controlled forms of protection such as PrEP may be more of an acceptable option for Latino immigrant MSM.