To date, there is little research to validate empirically differences between nonsuicidal self-injurious behavior (NSSI) and attempted suicide among Latina adolescents. Understanding the characteristics and contextual features of self-harmful behaviors among Latina teens is a critical public health and social justice matter given the disproportionate rates of attempted suicide and anticipated population growth of this vulnerable group. In this article, we draw on an ecodevelopmental model to focus attention on factors in the sociocultural environment that shape suicidal behaviors and NSSIs. Through analysis of qualitative interviews conducted with girls who used NSSI (n ϭ 18), attempted suicide (n ϭ 29), used NSSI and attempted suicide (n ϭ 8,) and had no reported lifetime history of self-harm (n ϭ 28), we describe the sociocultural factors that shaped psychosocial vulnerabilities and gave rise to decisions to use NSSI or attempt suicide. Our analysis revealed that adolescents who engaged in NSSI perceived their negative feelings as something that could be controlled through self-injurious acts, whereas powerlessness was a theme underlying the emotional states of girls who attempted suicide. When NSSI ceased to function as a mechanism for control, girls came to sudden decisions to attempt suicide. Most teens identified specific, and often multiple, situations that induced intense affective states and shaped decisions to inflict self-harm. Two situational experiences emerged as particularly salient and promising for subsequent studies on self-harmful behaviors among Latina adolescents: transnational stress and bullying. We describe each of these and offer suggestions for future research and practice.

This study examined the relationship between familism and family environment type as well as the relationship between family environment type and suicide attempts among Latina youth. Latina teen attempters (n=109) and non-attempters (n=107) were recruited from the NYC area. Latent class analysis revealed three family environment types: tight-knit; intermediate-knit; and loose-knit. Tight-knit families (high cohesion and low conflict) were significantly less likely to have teens that attempted suicide as compared to intermediate-knit families or loose-knit families. Moreover, familism increased the odds of being in the tight-knit family vs. the loose-knit family and the odds of being in the tight-knit family vs. the intermediate-knit. Results suggest that familism may protect against suicide behavior among Latinas via its influence on family environment. Keywordssuicide; adolescent; Hispanic; familism; family Over the past two decades, adolescent Latinas have had elevated rates of suicidal behaviors compared to their White female counterparts with as many as 1 in 9 Latina high school students reporting a suicide attempt during the past year (Eaton et al., 2006;Eaton et al., 2008;Eaton et al., 2010;Grunbaum et al., 2002;Grunbaum et al., 2004;Johnson et al., 2008;Kann et al., 1996;Kann et al., 1998;Kann et al., 2000). These rates are troubling given the gravity of such an act and its association with increased risk for future attempts, hospitalization, and death by suicide Suokas, Suominen, Isometsa, Ostamo, & Lonnqvist, 2001). Moreover, this disparity has not been restricted to one or two Latino subgroups. Elevated rates of suicidal behavior have been documented in Colombian, Cuban, Dominican, Ecuadorian, Mexican, Nicaraguan, and Puerto Rican adolescents (Fortuna, Perez, Canino, Sribney, & Alegria, 2007;Garcia, Skay, Sieving, Naughton, & Bearinger, 2008;Garofalo, Wolf, Wissow, Woods, & Goodman, 1999;Rew, Thomas, Horner, Resnick, & Beuhring, 2001;Tortolero & Roberts, 2001;Zayas, Bright, Alvarez-Sanchez, & Cabassa, 2009).Among the risk and protective factors associated with suicidal behavior, family cohesion and family conflict are identified as important areas of focus for Latina teens (Brent et al., 1988;Marttunen, Aro, & Lonnqvist, 1993;Wagner, 1997). We define family cohesion as the "degree of commitment, help and support family members provide for one another", and family conflict as the "amount of openly expressed anger, aggression, and conflict among , 1986). Although low family cohesion and high family conflict are associated with suicidal behavior among many young Latinas and other female teens (Brent et al., 1988;Garcia et al., 2008;Herrera, Dahlblom, Dahlgren, & Kullgren, 2006;Marttunen et al., 1993;Wagner, 1997;Zayas & Pilat, 2008), there is a paucity of research examining how these related domains may combine to create types of family environments that are associated with suicidal behavior among Latinas. For the purpose of this report, we define family environment as a composite of the socialen...

Objective Syndemic theory has been proposed as a framework for understanding the role of multiple risk factors driving the HIV epidemic among sexual and gender minority individuals. As yet, the framework has been relatively absent in research on Latinos/as. Methods We used logistic regression to assess relationships among cumulative syndemic conditions – including clinically significant depression, high-risk alcohol consumption, discrimination, and childhood sexual abuse – engagement with multiple partners and condomless anal intercourse (CAI) in a sample of 176 Latino men who have sex with men (MSM) in New York City. Results In bivariate analyses, an increase in the number of syndemic factors experienced was associated with an increased likelihood of reporting multiple partners and CAI. In multivariable analyses, participants with 2, 3, and 4 factors were significantly more likely to report multiple partners than those with 0 (aOR=4.66, 95% CI [1.29, 16.85); aOR=7.28, 95% CI [1.94, 27.28] and aOR=8.25, 95% CI [1.74, 39.24] respectively; p<.05). Regarding CAI, only participants with 3 and 4 factors differed from those with 0 (aOR=7.35, 95% CI [1.64, 32.83] and OR=8.06, 95% CI [1.39, 46.73] respectively. Conclusions Comprehensive approaches that address syndemic factors, and capitalize on resiliency, are needed to address the sexual health needs of Latino MSM.

Implementation research has tremendous potential to bridge the research-practice gap; however, we know more about barriers to evidence-based care than the factors that contribute to the adoption and sustainability of evidence-based treatments (EBTs). This qualitative study explores the experiences of clinicians (N = 11) who were implementing EBTs, highlighting the factors that they perceived to be most critical to successful implementation. The clinicians’ narratives reveal many leverage points that can inform administrators, clinical supervisors, and clinicians who wish to implement EBTs, as well as other stakeholders who wish to develop and test strategies for moving EBTs into routine care.

One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals' likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.