Ethnic Identity as a Moderator for Perceived Access to Healthcare Among LMSM

The Centers for Disease Control and Prevention (2017) note that gay, bisexual, and other men who have sex with men (collectively referred to as MSM) face more barriers to accessing health care compared to other men. Such barriers include, lack of cultural- and sexual identity-appropriate medical and support services, concerns about confidentiality, and fear of discussing sexual practices or orientation in a medical setting. In comparison to other MSM populations, Latino MSM (LMSM) report having the least amount of access to health care (McKirnan et al., 2012). The purpose of the present study is to elucidate how individual- (i.e., age, education level, and income level), community- (i.e., social support and neighborhood collective efficacy), and sociocultural-level factors (i.e., immigration status, heterosexual self-presentation, sexual identity commitment, sexual identity exploration, and ethnic identity affirmation and belonging) may relate with perceived access to healthcare. It is hypothesized that ethnic identity affirmation and belonging will moderate relations between the aforementioned predictors and perceived access to health care based on increasing evidence that ethnic identity, or one’s sense of affirmation and belonging to one’s ethnic group, may be a health protective factor. Among a sample of 469 LMSM, this study found that there were several predictors across all three levels (i.e., individual, community, and sociocultural) of perceived access to healthcare. Additionally, data supported evidence that ethnic identity affirmation and belonging (Phinney, 2003) acts as a moderator of other predictors of perceived access to healthcare in this sample. These findings can inform outreach interventions of researchers and healthcare providers about psychosocial and cultural barriers and facilitators of access to healthcare.