رفتار جنسی مردان مهاجر مکزیکی متأهل در کارولینای شمالی

In the southern United States, North Carolina has attracted an unprecedented influx of Hispanic immigrants in the 1990s. Detailed data on the sexual behavior of these recent immigrants are lacking. This exploratory study used two methods, a survey and qualitative interviews. For both methods, participants were recruited using convenience sampling. All study participants were first-generation Mexican immigrants who had lived in North Carolina for at least six consecutive months. The survey, administered face-to-face, explored the sexual attitudes and behavior of 43 married Mexican men living in North Carolina. The qualitative interviews, conducted with men (n=20) and women (n=19), explored immigrants' perceptions of extramarital sex and sexually transmitted diseases (STDs). The study's results suggest that the sexual behavior of ‘unaccompanied’ married Mexican immigrant men, living alone in North Carolina, differs, at least in degree if not in kind, from that of ‘accompanied’ married men, residing in the state with their wives. Unaccompanied men who participated in the survey reported more lifetime sexual partners, more partners in the previous year, more extramarital partners and more contact with prostitutes than accompanied survey respondents. The qualitative interviews suggest that unaccompanied men's peculiar status as ‘single’ men in North Carolina may provide them with both motive and opportunity to have extramarital sexual relationships and that few married Mexican men and women perceive STDs as relevant to their lives. Overall, the study supports the need for male- and couple-focused STD prevention interventions for Hispanic immigrants.

In recent years, national surveys have highlighted gender differences in sexual behavior. Compared to women, men more often report having: multiple sexual partners (Leigh et al., 1993 and Catania et al., 1995); extramarital sex (Choi et al., 1994); sex with casual partners or prostitutes (Smith, 1991); and unprotected sex with primary and secondary partners (Dolcini et al., 1993). For many heterosexual women, the sexual practices of their male partners are likely to be the primary or sole source of risk for infection with HIV or other sexually transmitted diseases (STDs) (Soskolne et al., 1991, Dolcini et al., 1993, Marı́n et al., 1993, Sabogal et al., 1993, Weinstock et al., 1993, Choi et al., 1994 and Catania et al., 1995). Married Hispanic women may be especially vulnerable to partner-related STD exposures. In the 1990/91 National AIDS Behavioral Surveys (NABS), Hispanic men's reports of extramarital sex differed significantly from those of both non-Hispanic white men and Hispanic women (Sabogal et al., 1993 and Choi et al., 1994). Eight percent of married Hispanic men reported two or more partners in the previous year, versus two to three percent of married non-Hispanic white men and fewer than one percent of married Hispanic women (Choi et al., 1994). In a second study, a telephone survey of Hispanic and non-Hispanic white men and women in nine northeastern and southwestern states (Marı́n et al., 1993), twice as many married Hispanic as married non-Hispanic white men (18 vs. 9%) reported having more than one partner in the previous year (results for married women not presented). In both studies, differences in sexual behavior reflected an interaction between acculturation and gender, with acculturation crudely assessed by proxy measures of English and Spanish language use (Marı́n et al., 1993 and Sabogal et al., 1993). Whereas most female Hispanic NABS respondents who reported multiple partners were classified as ‘high acculturation’ (87%), Hispanic men (married and unmarried) who reported multiple partners were more likely to be ‘low acculturation’ (56%) (Sabogal et al., 1993). Similarly, Hispanic women who participated in the telephone survey were more likely to report two or more sexual partners in the previous year if they were moderately (OR=4.9) or highly (OR=8.4) acculturated, but highly acculturated Hispanic men were less likely to report multiple partners than less acculturated men (OR=0.56) (Marı́n et al., 1993). These and other studies (Zunzunegui et al., 1986) suggest that the sexual behavior of less acculturated, married Hispanic immigrant men may increase less acculturated immigrant women's risk of acquiring STDs. Married Hispanic men who travel alone to the US also may place their wives at risk when they temporarily visit or permanently return to their communities of origin (Salgado de Snyder et al., 1996). Organista et al. (1997) conducted a survey in five Mexican towns with 342 men who had lived and worked in the US, averaging six trips and five years in the US over a 12 year period (1982–1994). More than one-fourth (27%) of the married men included in the study reported multiple sex partners in the preceding year. Almost half (44%) of all men reported sex with US prostitutes; although the reported frequency of contact with prostitutes did not differ by marital status, married men were significantly less likely than unmarried men to report using condoms with US prostitutes (p<0.001) ( Organista et al., 1997). The incidence of HIV and other STDs has been shown to be higher in migrant populations and migration has been described as an independent risk factor for HIV infection (Gardner and Blackburn, 1997 and Mabey and Mayaud, 1997). Studies in sub-Saharan Africa, where there is significant labor migration between rural and urban areas both within and between countries, have shown that migrants are more likely than non-migrants to engage in behaviors such as having multiple sexual partners without using condoms (Jochelson et al., 1991, Pison et al., 1993, Campbell and Williams, 1996 and Gardner and Blackburn, 1997) and are at higher risk for becoming infected with HIV (Hunt, 1989, Pison et al., 1993 and Mabey and Mayaud, 1997). More specifically, men traveling without their wives are likely to engage in extramarital sex while away from home (Jochelson et al., 1991 and Pison et al., 1993), thereby placing their wives at risk for HIV and other STDs. The incidence of HIV seropositivity also has been shown to be higher in some groups of migrant farmworkers within the US than in the general population (Jones et al., 1991). Although some studies suggest that the incidence of HIV is higher in African American than Hispanic US farmworkers, this difference appears to be related to the fact that African American farmworkers are more likely to be single, while Hispanic farmworkers are more likely to travel with their wives and families (Organista and Organista, 1997). Detailed data on sexual behavior, a recognition of gender differences in behavior and an awareness of the “social, cultural and economic realities of people's lives” have been described as crucial guideposts in developing effective HIV and STD prevention programs (Ehrhardt, 1992, p. 1459). Such data are lacking for many segments of the US Hispanic population, including recent immigrants in rural southern states such as North Carolina, which is attracting an unprecedented influx of Hispanic workers (Rosen, 1998). Because women are often unaware of their partners' high-risk behaviors or have a limited ability to protect themselves from STDs, there is growing consensus regarding the need to study male sexual behavior so that STD prevention strategies that explicitly target men can be developed (Amaro, 1995 and Campbell, 1995). In this paper, we describe the sexual attitudes and behavior of married Mexican immigrant men in North Carolina, with the aim of considering the implications of men's behavior for their spouses' risk of acquiring an STD. Drawing on exploratory survey data, we examine behavioral and perceptual differences between men living with their wives (referred to as ‘accompanied’ men) and men whose wives are in Mexico (‘unaccompanied’ men). We also use qualitative data to explore men's and women's perceptions of extramarital sex and marital STD risks. Because the sexual behavior and attitudes of recent Hispanic immigrants to the rural South have not been well described, we sought the rich, detailed data that qualitative methods provide. To have some basis for comparison among sample subgroups, however, a structured survey was most appropriate and we therefore used both methods in this study. Our aims were to: • examine men's reported patterns of extramarital sexual behavior; • explore the STD risk perceptions of married men and women; • assess men's use of condoms within and outside their marital relationships; and • examine individual and structural factors influencing men's sexual behavior, attitudes and beliefs.