Towards a Better Understanding of HIV Prevention Knowledge Among Latino MSM: A Latent Class Analysis Study

Latino men who have sex with men (LMSM) are disproportionately affected by HIV in the United States. Despite advances in HIV prevention options, LMSM have inequitably low access to knowledge about HIV, HIV testing, and pre-exposure prophylaxis (PrEP), contributing to disparities in prevention service use. We first identified subgroups of LMSM (N = 290) based on their patterns of knowledge related to HIV prevention by using latent class analysis. Secondly, following a three-step logistic regression procedure, we examined differences in class composition by demographics. Lastly, we evaluated the relationship between class membership and HIV prevention behaviors (e.g., PrEP engagement, HIV testing, and sexual behavior that could lead to HIV acquisition), using Lanza's method to estimate the probability of class membership. We identified three classes among LMSM based on HIV knowledge: Class 1: HIV/PrEP Experts (n = 112), Class 2: Moderate HIV/PrEP Knowledge (n = 140), and Class 3: HIV Knowledge Only (n = 38). We found no significant association between class membership and demographics (education, income, race, nativity). Class membership was associated with prevention behaviors: HIV testing (χ²(2) = 27.107, p <.001), PrEP use (χ²(2) = 137.672, p < .001), and sexual behavior that can lead to HIV (χ²(2) = 11.659, p < .05). Among HIV/PrEP Experts, 83% of LMSM tested recently, 57% were on PrEP, and 3% reported sexual behavior that could lead to HIV. By comparison, in the Moderate HIV/PrEP Knowledge class, a smaller proportion of participants tested recently (53%) and were on PrEP (8%), whereas more (17%) reported sexual behavior that could lead to HIV. In the HIV Knowledge Only class, the smallest proportion (compared to the other two classes) were recently tested (20%) and on PrEP (< 1%), although there were also relatively few (5%) who reported sexual behavior that could lead to HIV acquisition. Several class differences were statistically significant. This study identifies subgroups of LMSM with respect to the specific types of knowledge they do and do not have, which builds on prior research that traditionally only examines the absence or presence of PrEP/HIV knowledge. Further, the findings demonstrate that the type of knowledge LMSM have and do not have is associated with their HIV-prevention behaviors. Findings may inform future programs that address knowledge gaps to support HIV-prevention uptake among LMSM.