Ethnic Identity Commitment as a Moderator for Perceived Access to Health Care Among Latinx Sexual Minority Men

Objective: Gay, bisexual, and other sexual minority men (SMM) face more barriers to accessing health care compared to other men. In comparison to other SMM populations, Latinx SMM (LSMM) report having less access to health care. The purpose of the present study is to elucidate how theorized environmental-societal-level (i.e., immigration status, education level, and income level), community-interpersonal-level (i.e., social support and neighborhood collective efficacy [NCE]), and social-cognitive-behavioral-level factors (i.e., age, heterosexual self-presentation [HSP], sexual identity commitment, sexual identity exploration [SIE], and ethnic identity commitment [EIC]) may relate with perceived access to health care (PATHC) in a sample of 478 LSMM. Method: We conducted a hierarchical regression analysis examining the hypothesized predictors of PATHC, as well as EIC as a moderator of the direct association between predictors and PATHC. We hypothesized that Latinx EIC would moderate relations between the aforementioned multilevel factors and PATHC. Results: LSMM perceived greater access to care when indicating the following: higher education level, more NCE, more HSP, more SIE, and more EIC. Latinx EIC acted as a moderator of four predictors of PATHC, including education, NCE, HSP, and SIE. Conclusions: Findings inform outreach interventions of researchers and health care providers about psychosocial and cultural barriers and facilitators of health care access.Public Significance StatementLatinx sexual minority men (LSMM) as dual minorities may face homophobia and/or racism in health care settings while utilizing health services. Stronger ethnic identity commitment (EIC) for LSMM may buffer against perceptions of low health care access for this multiply marginalized group based on the premise of minority stress theory, where LSMM may develop an expectation of adverse experiences in health care settings. EIC in this group was found to moderate other predictors of perceived access to health care, including education, neighborhood collective efficacy, heterosexual self-presentation, and sexual identity exploration.