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Laguna‐Torres A, Velosa L, Barreto A, Lorch SA, Virudachalam S, Montoya‐Williams D. Overcoming barriers to the recruitment of immigrant Hispanic people in perinatal research. Health Serv Res 2023; 58:543-548. [PMID: 36600513 PMCID: PMC10154151 DOI: 10.1111/1475-6773.14127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Alicia Laguna‐Torres
- Division of NeonatologyChildren's Hospital of Philadelphia, Roberts Building for Pediatric ResearchPhiladelphiaPennsylvaniaUSA
| | - Leo Velosa
- Division of NeonatologyChildren's Hospital of Philadelphia, Roberts Building for Pediatric ResearchPhiladelphiaPennsylvaniaUSA
| | | | - Scott A. Lorch
- Division of NeonatologyChildren's Hospital of Philadelphia, Roberts Building for Pediatric ResearchPhiladelphiaPennsylvaniaUSA
| | - Senbagam Virudachalam
- Division of General PediatricsChildren's Hospital of Philadelphia, Roberts Building for Pediatric ResearchPhiladelphiaPennsylvaniaUSA
| | - Diana Montoya‐Williams
- Division of NeonatologyChildren's Hospital of Philadelphia, Roberts Building for Pediatric ResearchPhiladelphiaPennsylvaniaUSA
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2
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Alessi EJ, Kahn S, Giwa S, Cheung S. 'Those tablets, they are finding an empty stomach': a qualitative investigation of HIV risk among sexual and gender minority migrants in Cape Town, South Africa. ETHNICITY & HEALTH 2022; 27:800-816. [PMID: 32894689 DOI: 10.1080/13557858.2020.1817342] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
ABSTRACTObjectives: HIV prevalence among sexual and gender minority (SGM) individuals in South Africa is among the highest in the world; however, SGM migrants, an especially vulnerable subgroup of both the SGM and migrant populations, have frequently been overlooked in the country's robust public health response. This qualitative study, guided by syndemics theory, explored the processes by which SGM migrants in South Africa are exposed to HIV risk and those that may reduce this risk.Design: We conducted 6 focus groups with a total of 30 SGM migrants living in Cape Town. Participants were men who have sex with men, women who have sex with women, and transgender women. Transcripts were analyzed using grounded theory.Results: Participants identified a number of interrelated factors (insecure immigration status, financial and housing instability, food insecurity, stigma and discrimination, and lack of social support) contributing to HIV risk. While some took PrEP or HIV medication, adherence could be affected by structural and psychosocial barriers.Conclusion: Interventions that respond to the syndemic impacts on HIV outcomes are needed to reduce disease burden among SGM migrants in South Africa.
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Affiliation(s)
- Edward J Alessi
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Sarilee Kahn
- School of School Social Work, McGill University, Montreal, Canada
| | - Sulaimon Giwa
- School of Social Work, Memorial University of Newfoundland, St. John's, Canada
| | - Shannon Cheung
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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3
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Causevic S, Salazar M, Orsini N, Kågesten A, Ekström AM. Sexual risk-taking behaviors among young migrant population in Sweden. BMC Public Health 2022; 22:625. [PMID: 35354452 PMCID: PMC8969344 DOI: 10.1186/s12889-022-12996-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 03/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background Migration is a complex process of high uncertainty with adjustments to new contexts and experiences influencing individuals’ health. This study aims to assess the prevalence of self-reported sexual risk-taking behaviors among migrant youth population in Sweden, fulfilling the research gap in that field. Methods A pre-tested, web-based self-administered cross-sectional survey was used to collect data among 1563 migrant youth (15–25 years old) in Sweden. The survey was conducted in high schools and Swedish language schools for foreigners between December 2018 and November 2019. Pearson chi-square and t-tests were used to compare whether sociodemographic characteristics and migration status varied between those engaging in sexual risk behaviors or not. Multivariate logistic regression was used to determine the adjusted odds ratio of the key outcome variable and independent variables. Results There is a profound heterogeneity in migrant youth characteristics related to engagement in different sexual risk-taking behaviors. Those engaging in condomless sex were older, coming from the Americas and Europe, living longer in Sweden and came to live with their family. Belonging to the Islamic religion was a protective factor. Sex under the influence of drugs was related to those from Europe, and Middle East and North Africa (MENA) and coming to Sweden to work/study, where age was a protective factor. Living longer in Sweden, coming for work/study or to live with family had higher odds to engage in sex in exchange for gifts/money. Conclusion The results highlight the needed reconsideration of the broader system response that can influence migrant youth health outcomes and public health implications. The approach should consider and relate to sexual risk-taking behavior’s long-term consequences. Migrant youth background needs and knowledge should guide this response. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12996-2.
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Affiliation(s)
- Sara Causevic
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. .,Swedish Institute for Global Health Transformation (SIGHT) at the Royal Swedish Academy of Sciences, Stockholm, Sweden.
| | - Mariano Salazar
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Nicola Orsini
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Kågesten
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Daniel NA, Hassan SA, Mohamed F, Sheikh N, Basualdo G, Schwartz R, Gebreselassie BT, Beyene YK, Gabreselassie L, Bayru K, Tadesse B, Libneh HA, Shidane M, Benalfew S, Ali A, Rao D, Kerani RP, Patel RC. Harambee! 2.0: The Impact of HIV-Related and Intersectional Stigmas on HIV Testing Behaviors Among African Immigrant Communities in Seattle, Washington. AIDS Behav 2022; 26:149-164. [PMID: 34368910 PMCID: PMC8349708 DOI: 10.1007/s10461-021-03396-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 02/07/2023]
Abstract
African immigrants are disproportionately affected by HIV compared to U.S.-born individuals, and early HIV testing is the key challenge in ending the HIV epidemic in these communities. HIV-related stigma appears to be the most significant barrier to testing for HIV among African communities in King County, WA. In this formative study, we conducted thirty key informant interviews and five focus group discussions (n = total 72 participants) with Ethiopian, Somali, and Eritrean people living with HIV, health professionals, religious and other community leaders, and lay community members in King County to better understand HIV-related and intersectional stigmas' impact on HIV testing behaviors. We used inductive coding and thematic analysis. Participants from all communities reported similar themes for HIV-related and intersectional stigmas' influences on HIV testing behaviors. Misconceptions or poor messaging, e.g., regarding treatability of HIV, as well as normative or religious/moral beliefs around pre/extramarital sex contributed to HIV-related stigma. Intersecting identities such as immigrant status, race/ethnicity, and having a non-English language preference, all intermingle to further influence access to the U.S. healthcare system, including for HIV testing. These findings can be used to inform future research on community-led approaches to addressing early HIV testing amongst African immigrant communities.
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Affiliation(s)
| | - Shukri A Hassan
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Farah Mohamed
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
- Somali Health Board, Tukwila, WA, USA
| | - Najma Sheikh
- Department of Global Health, UW, Seattle, WA, USA
| | | | - Rahel Schwartz
- Ethiopian Community in Seattle, Seattle, WA, USA
- Ethiopian Health Board, Seattle, WA, USA
| | | | | | | | | | | | | | | | | | - Ahmed Ali
- Somali Health Board, Tukwila, WA, USA
- Department of Global Health, UW, Seattle, WA, USA
| | - Deepa Rao
- Department of Global Health, UW, Seattle, WA, USA
| | - Roxanne P Kerani
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA
| | - Rena C Patel
- Department of Medicine, UW, 325 9th Ave, Seattle, WA, 98105, USA.
- Department of Global Health, UW, Seattle, WA, USA.
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Alessi EJ, Cheung S, Kahn S, Yu M. A Scoping Review of the Experiences of Violence and Abuse Among Sexual and Gender Minority Migrants Across the Migration Trajectory. TRAUMA, VIOLENCE & ABUSE 2021; 22:1339-1355. [PMID: 34812109 DOI: 10.1177/15248380211043892] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Violence against sexual and gender minority (SGM) individuals has continued to proliferate globally. Yet, less is known about victimization among subgroups of SGM individuals, especially SGM immigrants, refugees, and asylum seekers. There has been a steady increase in this vulnerable group of migrants over the years, and emerging evidence has pointed to their heightened risk of victimization. We conducted a scoping review of the peer-reviewed literature that examined violence, abuse, and mental health among SGM individuals who migrate internationally. One hundred ninety-nine articles were identified by searching five scholarly databases and hand searching. Twenty-six articles met inclusion criteria. We first used the migration framework, which outlines the distinct phases of the migration trajectory (predeparture, travel, interception, destination, and return), to categorize findings and then identified four overarching themes to capture SGM migrants' experiences at each phase: severe and prolonged violence and abuse related to sexual orientation or gender identity (predeparture); continued victimization and high-risk for sexual violence (travel); detainment- and deportation-related violence and abuse (interception and return); and new manifestations of violence and abuse while living with past trauma (destination). Violence and abuse began in childhood and continued in the host country, where they faced discrimination while managing posttraumatic stress disorder and depression. Findings indicate that SGM migrants are extremely vulnerable to victimization. There is an immediate need for policies to protect SGM individuals worldwide and for affirmative, culturally informed practices to help SGM migrants manage trauma and the structural barriers impeding recovery.
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Affiliation(s)
| | | | | | - Melanie Yu
- Rutgers University, New Brunswick, NJ, USA
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Wandschneider L, Batram-Zantvoort S, Razum O, Miani C. Representation of gender in migrant health studies - a systematic review of the social epidemiological literature. Int J Equity Health 2020; 19:181. [PMID: 33054755 PMCID: PMC7556985 DOI: 10.1186/s12939-020-01289-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background Gender as a social construct contributes to determine who migrates and which migration-related risks and opportunities emerge in all phases of the migration trajectory. Simultaneously, migration influences the individual as well as societal definition and perception of gender roles. An explicit gender perspective in migration-related epidemiological research can contribute to adequately analyse and interpret the health of migrants. This systematic review gives a comprehensive overview on how gender has been conceptualised, operationalised and measured in social epidemiologic studies aiming to assess the influence of gender on health among migrants. Methods We searched PubMed, Embase, CINAHL, the Cochrane Library, EconLit and PsycINFO and conducted backward reference searching. Reviewers independently selected studies, extracted data and conducted the quality assessment. Eligible studies actively aimed to understand, identify or explain the influence of gender on migrants’ health, whereby the role of gender can encompass a variety of mechanisms, processes or states of differentiation, discrimination and/or inequality. Results Almost all of the 43 studies were cross-sectional and focussed on health outcomes in the post-migration phase. The most common theme of research was the health of male migrants in the US, and in particular of men who have sex with men (MSM). All studies treated gender as a binary variable (men vs. women), without discussing additional types of gender identities. A minority of studies differentiated clearly between sex and gender. Gender was mostly operationalised through attitudes toward gender roles and gender-based discrimination, experienced at the individual level. Community and societal level gender measures capturing structural gender determinants were underrepresented. Conclusions The intersections of migration and gender suggested synergistic effects on health that only become visible when considering those two social determinants together. Future research needs to embrace a multilevel and non-binary understanding of gender and reflect on the influence of gender in the different phases of the migration journey. Systematic review registration PROSPERO CRD42019124698.
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Affiliation(s)
- Lisa Wandschneider
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany.
| | - Stephanie Batram-Zantvoort
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany
| | - Céline Miani
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, POB 10 01 31, 33501, Bielefeld, Germany
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Ogunbajo A, Anyamele C, Restar AJ, Dolezal C, Sandfort TGM. Substance Use and Depression Among Recently Migrated African Gay and Bisexual Men Living in the United States. J Immigr Minor Health 2020; 21:1224-1232. [PMID: 30552541 DOI: 10.1007/s10903-018-0849-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Immigrant African gay and bisexual men (GBM) are at risk for substance use and adverse mental health outcomes due to negative experiences in home and host countries. Little is known about correlates of substance use and mental health outcomes in this population. We explored pre- and post-migratory factors associated with substance use and depression in recently migrated African GBM. Participants (N = 70) were recruited between July and November 2015 in NYC. Eligible participants were administered a structured questionnaire. Correlates of substance use and depression were identified using bivariate and multivariable analyses. Factors independently associated with current substance use were age, openness about sexual orientation, homophobic experiences in home country, forced sex in home country, current housing instability, and internalized homophobia. Factors independently associated with depression were post-traumatic stress disorder symptoms and alcohol use. Substance use and depression were associated with negative experiences in home and host country.
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Affiliation(s)
- Adedotun Ogunbajo
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Chukwuemeka Anyamele
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Arjee J Restar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
| | - Theodorus G M Sandfort
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
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Yamanis TJ, Zea MC, Ramé Montiel AK, Barker SL, Díaz-Ramirez MJ, Page KR, Martinez O, Rathod J. Immigration Legal Services as a Structural HIV Intervention for Latinx Sexual and Gender Minorities. J Immigr Minor Health 2019; 21:1365-1372. [PMID: 30465116 PMCID: PMC6551294 DOI: 10.1007/s10903-018-0838-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Lack of legal immigration status is associated with poor HIV-related outcomes for immigrant Latinx sexual and gender minorities (LSGM). LSGM often meet eligibility criteria for legal immigration relief. A Medical-Legal Partnership (MLP) may thus be strategic to improve their health. We know little about the challenges LSGM face during the immigration legal process. We conducted in-depth interviews with six key informants and sixteen LSGM who recently applied for immigration legal relief. We coded and analyzed the data for emergent themes. Challenges to instituting an MLP for LSGM included lack of specialized training on working with SGM for immigration attorneys, and for clients: knowledge about legal deadlines, lack of housing and family support, and re-traumatizing experiences. Clients' outcomes were positive when attorneys and mental health providers collaborated. For LSGM, the benefits of immigration relief included reduced HIV risk. An MLP that addresses the surmountable challenges could improve HIV-related outcomes among LSGM.
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Affiliation(s)
- Thespina J Yamanis
- School of International Service, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
| | - Maria Cecilia Zea
- Department of Psychology, The George Washington University, Washington, DC, USA
| | - Ana Karen Ramé Montiel
- School of International Service, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Suyanna L Barker
- Health Equity and Community Action Department, La Clínica del Pueblo, Washington, DC, USA
| | - Manuel J Díaz-Ramirez
- Health Equity and Community Action Department, La Clínica del Pueblo, Washington, DC, USA
| | - Kathleen R Page
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Omar Martinez
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Jayesh Rathod
- Washington College of Law, American University, Washington, DC, USA
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Allen SH, Leslie LA. Considering the Role of Nativity in the Health and Psychological Wellbeing of Black LGBT Adults. JOURNAL OF HOMOSEXUALITY 2018; 66:1769-1796. [PMID: 30222074 DOI: 10.1080/00918369.2018.1511134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Recent scholars have underscored how the experiences of LGBT people of color cannot be fully understood by considering only the independent contributions of race and sexual orientation. Framed by an intersectional lens, the current study seeks to address this gap in understanding by considering the role of nativity on the health and wellbeing of Black sexual minority adults; we also examined the moderating effects of family support and racial community climate on this relationship. Using national data from the Social Justice Sexuality Project (N = 2,166), we discovered that foreign-born Black LGBT adults had similar levels of psychological wellbeing and physical health as their native counterparts; family support and racial community climate did not moderate this relationship. Our findings did, however, substantiate the importance of family and community support for all Black LGBT adults, regardless of immigration status. Implications of this finding, in addition to directions for future intersectional work on racial minority LGBT people, are discussed.
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Affiliation(s)
- Samuel H Allen
- Department of Family Science, University of Maryland , College Park , Maryland , USA
| | - Leigh A Leslie
- Department of Family Science, University of Maryland , College Park , Maryland , USA
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