Kenyan immigrant men originate from sub-Saharan Africa with the highest HIV prevalence in the world. The study hypotheses were: 1) Attitude towards condom use differs between Kenya and the US, 2) Condom use behavior with primary sex partners differ between Kenya and the US, 3) Condom use behavior with casual sex partners differ between Kenya and the US, 4) Sexual behaviors with casual partners differ between Kenya and the US, 5)Age affects risky sexual behaviors in the US, 6) Age affects risky sexual behaviors during visits in Kenya, 7) Income affects risky sexual behaviors in the US, 8) Income affects risky sexual behaviors during visits in Kenya, 9) Education affects risky sexual behaviors in the US, 10) Education affects risky sexual behaviors during visits in Kenya.

The qualitative research questions were: 1) What are the social factors that promote risky sexual behaviors for HIV/AIDS among Kenyan males?, 2) What cultural values, beliefs and practices support risky sexual behaviors among Kenyan males?, 3) How do changes in the social and cultural contexts of Kenyan male immigrants affect their thoughts and behaviors about HIV/AIDS risk?, 4) What are the effects of urbanization and migration in risky sexual behaviors of Kenyan males?, and 5) What are the factors that create variability in sexual behaviors of Kenyan male immigrants?. The study was guided by Cultural Materialism (CM) model which posits that human behaviors are conditioned by practical conditions of daily life. For the quantitative data collection, a demographic survey and one instrument, the Sexual Risk Cognitions Questionnaire (SRCQ) were administered twice to elicit differences in attitudes and use of condoms and sexual behaviors in the US and during visits in Kenya. The qualitative component consisted of individual interviews to determine the influence of sociocultural changes associated with migration and urbanization in sexual behaviors.
Purposive sampling was used to obtain the quantitative sample of 89 Kenyan males to obtain adequate effect size who met the following criteria: a) between 18 and 65 years, b) self-identify as first generation Kenyan immigrant living in the US, c) have visited Kenya at least once within the last 2 years, and d) able to read and write in English. The qualitative sample of 20 participants was drawn from those who completed the quantitative survey.

The study revealed existence of push and pull factors related to risky sexual attitudes and behaviors. Demographic factors as age, income and education had a significant influence on risky sexual behaviors. Older age, higher income and education were push factors for change in decreasing casual partners and increasing condom use. The US value of gender equality, self-reliance and freedom in sexual expression countered indigenous values and practices supporting risky sexual behaviors. Access to economic opportunities, quality health services, technology and information created the possibility of a positive future that motivated participants to be healthy and engaged in responsible sex practices. Changes in human thoughts and behaviors (superstructural) are conditioned by related changes in the infrastructure and social, structural contexts of people's lives. The findings suggest use of initiatives that that include "social capital" in facilitating change towards health protective behaviors for immigrant populations.