The methodological core of the study is what statisticians call multilevel latent class analysis, or MLCA. Traditional variable-centered approaches ask how single factors, such as partner age or substance use, relate to outcomes like condomless sex. Person-centered mixture models instead search for hidden subgroups within a population, defined by co-occurring patterns across many indicator variables simultaneously. The multilevel extension is crucial for sexual network data, because each participant, or ego, nominated multiple partners, or alters, creating a nested structure in which partnerships are clustered within individuals. Ignoring this nesting can distort estimates and obscure the fact that a single man may move fluidly between very different kinds of sexual encounters. The researchers modeled both levels at once: lower-level classes describing types of individual partnerships, and upper-level groups describing the overall composition of each man’s sexual network.

Data collection relied on an egocentric social network approach implemented through the Network Canvas platform, with participants recruited through a modified respondent-driven sampling strategy led by a community-based sexual health clinic. Each participant named the people with whom he had anal or vaginal sex in the past six months and reported detailed characteristics of each relationship: whether the partner was a main or casual partner, whether condoms were always used, which sexual positions involved condomless contact, whether the partner disclosed an HIV status, and how emotionally close the respondent felt to that person. Covariates included alcohol and other substance use when the dyad met to have sex, the respondent’s current PrEP use, country of nativity, and total sexual network size. Participants averaged 34.5 years of age, 88 percent were born outside the United States, and 57 percent reported currently using PrEP.

The analysis converged on a three-class, two-group solution. At the partnership level, three distinct sexual partner typologies emerged. The first, accounting for 37 percent of partnership contexts, was an elevated-risk context with a main sexual partner: seroconcordant dyads in which both partners disclosed being HIV-negative, marked by high emotional closeness, main partnership status, and a high probability of versatile condomless sex. The second class, 35 percent of contexts, was labeled selective and close casual partnerships, in which men reported condomless sex in only one position, such as insertive or receptive anal sex exclusively, alongside moderate emotional closeness. The third class, 27 percent, comprised low-exposure casual partnerships with little condomless sex, variable closeness, and a high probability that the partner’s HIV status was simply unknown. At the network level, two groups emerged: one dominated by casual partnerships, accounting for 54 percent of sexual partnerships, and one centered on a main sexual partner, accounting for 46 percent.

Perhaps the most striking finding concerns what these typologies reveal about trust. Consistent with the dyadic framework for HIV prevention developed by Karney and colleagues, the study found that risk behaviors clustered within emotionally close relationships rather than anonymous encounters. Condomless sex was most prevalent in main partnerships, where intimacy and trust may paradoxically substitute for barrier protection, and lowest in casual partnerships where serostatus was undisclosed. Partners in the low-exposure casual class frequently had unknown HIV seroconcordance, which may itself have prompted greater caution. Meanwhile, classes with higher perceived closeness involved partners who disclosed being HIV-negative, more versatile condomless practices, and more substance use when the dyad met for sex. This inversion of the intuitive risk hierarchy, in which the most trusted relationships carry the most condomless exposure, has been documented in prior research among Latino men and now receives a rigorous person-centered confirmation.

The multinomial logistic regression results sharpened the picture of who occupies which network context. Respondents currently using PrEP had 1.60 times greater odds of belonging to the group whose networks were composed primarily of main partnerships with elevated risk contexts, relative to the casual-network group. Latino men born outside the United States had 43 percent lower odds of having elevated-risk main-partner contexts compared to those born in the country. Network size mattered as well: every additional partner reduced the odds of belonging to the main-partnership group by 29 percent. Substance use when the dyad met to have sex was independently associated with roughly threefold higher odds of condomless sex in a random intercept model, and within the multilevel model, substance use sharply reduced the odds of membership in low-exposure casual classes relative to elevated-risk main-partner contexts.

These associations carry important caveats that the authors themselves emphasize. The data are cross-sectional, so the temporal direction of the PrEP finding remains unresolved: men may adopt PrEP because they are in higher-exposure partnerships, or their partnerships may take a particular shape because PrEP has reduced their perceived need for condoms. PrEP, when taken as directed, is extremely effective against HIV acquisition but does not prevent other sexually transmitted infections, and systematic reviews have documented elevated STI diagnosis rates among PrEP users, potentially reflecting both reduced condom use and increased testing frequency. The study also captured only the daily-pill form of PrEP, predating wider availability of long-acting injectable options, and the reporting window overlapped with the COVID-19 pandemic, when social distancing measures may have altered sexual network patterns in ways that differ from pre- and post-pandemic behavior.

Cultural and structural context adds further layers of complexity. Miami-Dade is a distinctive setting in which 69 percent of residents identify as Latino, more than half were born outside the United States, and 68 percent of adults speak Spanish. Approximately one-third of foreign-born participants had lived in the country for a year or less, a period that may be insufficient to establish close, serious partnerships and during which navigating new social and sexual environments can shape partner selection, communication, and trust. Prior research suggests that cultural values such as collectivism and familismo can support condom use, while acculturative processes, language barriers between partners, and hypermasculine norms may complicate safer-sex negotiation. The authors argue that future work should move beyond a simple US-born versus foreign-born dichotomy and apply syndemic theory or intersectional perspectives to capture how immigration experiences, stigma, substance use, and cultural values interact to shape vulnerability.

The practical implications point toward interventions designed at the level of the dyad and the network rather than the isolated individual. Couples-based programs can facilitate conversations about relationship agreements, the increasing openness of sexual partnerships, and the role of substances in sexual decision-making, while network interventions that engage opinion leaders can diffuse prevention messaging through the social structures the study has now characterized in detail. The researchers also propose expanding clinic screening tools to include brief egocentric sexual network modules, allowing providers to tailor recommendations, whether PrEP, doxycycline post-exposure prophylaxis, routine testing, or negotiated safety agreements, to the specific partnership typologies a patient actually experiences. By replacing blunt risk categories with empirically derived partnership profiles, the study offers a template for precision HIV and STI prevention that respects the fluid, context-dependent reality of Latino men’s sexual lives in one of America’s hardest-hit communities.

Subject of Research: Sexual partnership typologies and HIV/STI risk contexts among Latino men in Miami analyzed with multilevel latent class analysis of egocentric sexual network data

Article Title: Sexual Partner Typologies Among Latino Men Living in Miami, Florida: A Multilevel Latent Class Analysis

Article References: Despres, L., Rodriguez, E., Johnson, A. L., Bravo, A., Vilchez, L., Doblecki-Lewis, S., Fallon, S., & Kanamori, M. (2026). Sexual Partner Typologies Among Latino Men Living in Miami, Florida: A Multilevel Latent Class Analysis. Archives of Sexual Behavior. https://doi.org/10.1007/s10508-026-03441-1

Image Credits: AI Generated

DOI: 10.1007/s10508-026-03441-1

Keywords: HIV, sexually transmitted infections, Latino men, Miami-Dade County, multilevel latent class analysis, sexual networks, PrEP, condomless sex, substance use, dyadic prevention, immigration and acculturation, syndemic theory