Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers

Mark Padilla, Daniel Castellanos, Vincent Guilamo, Armando Matiz Reyes, Leonardo E. Sánchez Marte, Martha Arredondo Soriano

Research output: Contribution to journalArticle

Abstract

Some quantitative behavioral studies in the USA have concluded that bisexually behaving Latino men are less likely than White men to disclose to their female partners that they have engaged in same-sex risk behavior and/or are HIV-positive, presumably exposing female partners to elevated risk for HIV infection. Nevertheless, very little theoretical or empirical research has been conducted to understand the social factors that promote or inhibit sexual risk disclosure among Latino men who have sex with men (MSM), and much of the existing literature has neglected to contextualize disclosure patterns within broader experiences of stigma and social inequality. This paper examines decisions about disclosure of sex work, same-sex behavior, and sexual risk for HIV among male sex workers in two cities in the Dominican Republic. Data derive from long-term ethnography and qualitative in-depth interviews with 72 male sex workers were used to analyze the relationships among experiences of stigma, social inequality, and patterns of sexual risk disclosure. Thematic analysis of interviews and ethnographic evidence revealed a wide range of stigma management techniques utilized by sex workers to minimize the effects of marginality due to their engagement in homosexuality and sex work. These techniques imposed severe constraints on men's sexual risk disclosure, and potentially elevated their own and their female partners' vulnerability to HIV infection. Based on the study's findings, we conclude that future studies of sexual risk disclosure among ethnic minority MSM should avoid analyzing disclosure as a decontextualized variable, and should seek to examine sexual risk communication as a dynamic social process constrained by hierarchical systems of power and inequality.

Original languageEnglish (US)
Pages (from-to)380-388
Number of pages9
JournalSocial Science and Medicine
Volume67
Issue number3
DOIs
StatePublished - Aug 2008

Fingerprint

Social Stigma
Sex Workers
Disclosure
social inequality
HIV
worker
sex behavior
Sex Work
Hispanic Americans
Sexual Behavior
HIV Infections
Dominican Republic
risk communication
Interviews
Cultural Anthropology
marginality
Empirical Research
interview
social process
homosexuality

Keywords

  • Bisexuality
  • Dominican Republic
  • HIV/AIDS
  • Male sex work
  • Sexual risk disclosure
  • Social inequality
  • Stigma

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

Cite this

Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers. / Padilla, Mark; Castellanos, Daniel; Guilamo, Vincent; Reyes, Armando Matiz; Sánchez Marte, Leonardo E.; Soriano, Martha Arredondo.

In: Social Science and Medicine, Vol. 67, No. 3, 08.2008, p. 380-388.

Research output: Contribution to journalArticle

Padilla, M, Castellanos, D, Guilamo, V, Reyes, AM, Sánchez Marte, LE & Soriano, MA 2008, 'Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers', Social Science and Medicine, vol. 67, no. 3, pp. 380-388. https://doi.org/10.1016/j.socscimed.2008.03.014
Padilla, Mark ; Castellanos, Daniel ; Guilamo, Vincent ; Reyes, Armando Matiz ; Sánchez Marte, Leonardo E. ; Soriano, Martha Arredondo. / Stigma, social inequality, and HIV risk disclosure among Dominican male sex workers. In: Social Science and Medicine. 2008 ; Vol. 67, No. 3. pp. 380-388.
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