Circumventing vs. Guiding: A Grounded Theory Study of Sexual Negotiation Among Hispanic Men Who Have Sex with Men

HIV infection continues to be a serious health concern, especially among men who have sex with men (MSM). MSM account for over one-half (57%) of the estimated 1.2 million cases in the United States. Hispanic/Latino individuals accounted for 24% of new HIV diagnoses, with male-to-male sexual contact responsible most cases. Effective sexual negotiation may be a way to decrease risk for HIV infection, but relatively little is known about sexual negotiation among Hispanic MSM. The purpose of this study was to describe the process by which sexual decision-making occurs among Hispanic MSM. Nineteen in-depth, semi-structured interviews were collected from participants (ages 25 to 65) living in South Florida using grounded theory methodology. Interviews were audio-recorded, transcribed verbatim, and were analyzed to identify categories and subcategories. A theory grounded in the data called Circumventing vs. Guiding emerged that described the sexual negotiation process. The theory consists of four main categories: Contextualizing Negotiation, Strategizing Sexual Negotiation, Negotiating Strategies, and Reviewing Consequences. Some Hispanic MSM may experience challenges in negotiating safer sex behaviors with partners. More research is needed to develop culturally-specific interventions to assist Hispanic MSM with sexual negotiation.