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Brooks RA, Nieto O, Rosenberg-Carlson E, Morales K, Üsküp DK, Santillan M, Inzunza Z. Barriers and Facilitators to Accessing PrEP and Other Sexual Health Services Among Immigrant Latino Men Who Have Sex with Men in Los Angeles County. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02928-z. [PMID: 38977534 DOI: 10.1007/s10508-024-02928-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 07/10/2024]
Abstract
In the United States, immigrant Latino men who have sex with men (ILMSM) are, compared to white MSM, disproportionately burdened by HIV and lack access to highly effective HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). Qualitative research centered on exploring barriers that ILMSM experience in accessing PrEP and other sexual services is extremely limited, despite a high prevalence of HIV in this population. In this study, a purposive sample of ILMSM (n = 25) was recruited to participate in a semi-structured in-depth interview to identify the distinct barriers and facilitators ILMSM experience in accessing sexual health services given their complex intersectional identities of being an immigrant, Latino, and a sexual minority man. Using a thematic analysis approach, nine themes were generated from the data representing barriers and facilitators. Barriers included: (1) cost and a lack of health insurance, (2) complexity of PrEP assistance programs; (3) challenges related to the immigrant experience; (4) impact of gay stigma; and (5) communication challenges. Facilitators included: (1) improving affordability and accessibility of PrEP services; (2) receiving services from LGBT- or Latine LGBT-centered clinics; (3) receiving services from medical providers who are gay and/or Latino; and (4) providing targeted community outreach, education, and promotion of PrEP to ILMSM. While many of the barriers illuminated in the study were structural (e.g., cost and lack of health insurance), and not easy to overcome, the findings highlight a range of facilitators that can support access to PrEP and other sexual health services for ILMSM. Considering these findings, we suggest strategies that may enhance access to needed sexual health services among ILMSM.
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Affiliation(s)
- Ronald A Brooks
- Department of Family Medicine, University of California, Los Angeles, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA, 90024, USA.
- Center for HIV Identification, Prevention, and Treatment Services, University of California, Los Angeles, Los Angeles, CA, USA.
- Department of Research and Evaluation, Bienestar Human Services, Los Angeles, CA, USA.
| | - Omar Nieto
- Department of Family Medicine, University of California, Los Angeles, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA, 90024, USA
| | - Elena Rosenberg-Carlson
- Department of Family Medicine, University of California, Los Angeles, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA, 90024, USA
- Center for HIV Identification, Prevention, and Treatment Services, University of California, Los Angeles, Los Angeles, CA, USA
| | - Katherine Morales
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Dilara K Üsküp
- Department of Family Medicine, University of California, Los Angeles, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA, 90024, USA
- Center for HIV Identification, Prevention, and Treatment Services, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
- UCLA-CDU Center for AIDS Research, Los Angeles, CA, USA
| | - Martin Santillan
- Department of Research and Evaluation, Bienestar Human Services, Los Angeles, CA, USA
| | - Zurisadai Inzunza
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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2
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Guise A. Stigma power in practice: Exploring the contribution of Bourdieu's theory to stigma, discrimination and health research. Soc Sci Med 2024; 347:116774. [PMID: 38537331 DOI: 10.1016/j.socscimed.2024.116774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/08/2024] [Accepted: 03/08/2024] [Indexed: 04/20/2024]
Abstract
Stigma and discrimination are increasingly understood as shaping health, and in turn conceptualised as social processes shaped by power and structural inequities. A challenge to analysis and implementing interventions is developing theory that can integrate analysis of structure, agency and power. One theoretical framework already promoted by prominent scholars as supporting this need is Bourdieu's social practice theory. This paper explores the application to date of Bourdieu's theory on stigma, discrimination and health. The paper describes how existing health literature has used concepts of symbolic violence, fields, capitals and habitus to develop insight into stigma power. The discussion explores how this theoretical framework is though underutilised and there has been little consideration of new programmatic approaches based on this theory. Directions for future research include the need for integrated approaches to analysis, especially using habitus to explore stigma power, and addressing processes of change. Directions for conceptualising interventions address how a mismatch of field and habitus could foster change and then the role for prophets in fostering symbolic revolutions. All these potential directions must in turn be integrated within the vast scholarship on stigma. In conclusion, further application and development of Bourdieu's social practice theory could help address the theoretical challenges facing the field of stigma, discrimination and health research.
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Affiliation(s)
- Andy Guise
- King's College London, 5(t,h) Floor, Addison House, Guy's Campus, London, SE1 3UL, UK.
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3
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D'Costa ZU, Neibart SS, Jones LE, Shah MK, Page K, Jacob S. Delayed Diagnosis of Human Immunodeficiency Virus in the Latino Population at a Federally Qualified Community Health Center in New Jersey. J Immigr Minor Health 2024; 26:294-303. [PMID: 38147283 DOI: 10.1007/s10903-023-01544-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 12/27/2023]
Abstract
Late diagnosis of human immunodeficiency virus (HIV) is associated with early progression to acquired immunodeficiency syndrome (AIDS). We examined racial/ethnic differences in presentation with advanced HIV/AIDS at a community health center in New Jersey. Records of patients diagnosed with HIV between 1990 and 2018 were reviewed. Odds ratios (OR) of presenting with AIDS at HIV diagnosis were computed in unadjusted and adjusted models. There were 182 (48.3%) Latino, 48 (12.7%) non-Latino White (NLW), 130 (34.5%) non-Latino Black, and 17 (4.5%) non-Latino of other race/ethnicity included in the analysis. Over 75% of the Latinos were foreign-born. Latino patients had higher odds of presentation with AIDS at time of HIV diagnosis than NLW in unadjusted (OR = 4.85, 95% confidence interval (95% CI): 2.28-10.31) and adjusted models (OR = 3.71, 95%CI: 1.60-8.59). Latino patients, particularly foreign-born and bisexual, had higher odds of being diagnosed with AIDS at presentation with HIV in this cohort.
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Affiliation(s)
- Zoee U D'Costa
- Robert Wood Johnson Medical School, Rutgers University, 277 George St, Piscataway, NJ, 08901, USA
| | - Shane S Neibart
- Robert Wood Johnson Medical School, Rutgers University, 277 George St, Piscataway, NJ, 08901, USA
| | - Laura E Jones
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Mansi K Shah
- School of Arts and Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Kathleen Page
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sneha Jacob
- Robert Wood Johnson Medical School, Rutgers University, 277 George St, Piscataway, NJ, 08901, USA.
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4
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Leite BO, Magno L, Bastos FI, Dourado I. Association between in-country migration and HIV infection among transgender women from northeastern Brazil: a respondent-driven sampling survey. BMC Public Health 2024; 24:589. [PMID: 38395804 PMCID: PMC10893649 DOI: 10.1186/s12889-024-17956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Migration is common among transgender women (TGW), often driven by the desire to escape stigma, find acceptance, establish new connections, access body modifications, or enter new avenues of sex work. Given the heightened mobility of TGW, they are mostly vulnerable to human immunodeficiency virus (HIV) due to migration. This study aimed to evaluate the association between in-country migration and HIV infection among TGW in Northeast Brazil. METHODS The DIVAS was a cross-sectional, multicity study investigating risk behaviors and sexually transmitted infections (STI) among TGW in 2016-2017. A total of 864 TGW were recruited through respondent-driven sampling from three capital cities in Northeast Brazil. Logistic regression estimating odds ratios (OR) and 95% confidence intervals (CI) was used to assess the relationship between in-country migration and HIV infection. RESULTS The prevalence of HIV among TGW was 24.5%, 21.4% among those aged 18-34 and 36.1% among those ≥ 35 years old. In-country migration increased the odds of HIV infection among TGW aged 18-34 years (OR = 1.84; 95%CI:1.04-3.27) and even higher among those aged ≥ 35y old (OR = 3.08; 95%CI:1.18-8.04). CONCLUSIONS These data reinforce the pressing need for public health policies that provide comprehensive access and strategies for demand creation for HIV/AIDS prevention and care for TGW who are already highly vulnerable to infection.
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Affiliation(s)
- Beo Oliveira Leite
- Collective Health Institute, Federal University of Bahia, Av. Basílio da Gama, s/n, Campus Universitário do Canela, 40110-040, Salvador, Bahia, Brazil.
| | - Laio Magno
- Collective Health Institute, Federal University of Bahia, Av. Basílio da Gama, s/n, Campus Universitário do Canela, 40110-040, Salvador, Bahia, Brazil
- Life Sciences Department, Bahia State University, Campus1, Salvador, Bahia, Brazil
| | | | - Ines Dourado
- Collective Health Institute, Federal University of Bahia, Av. Basílio da Gama, s/n, Campus Universitário do Canela, 40110-040, Salvador, Bahia, Brazil
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Kerr J, Smith A, Nzama N, Bullock NAA, Chandler C, Osezua V, Johnson K, Rozema I, Metzger IW, Harris LM, Bond K, LaPreze D, Rice BM. Systematic Review of Neighborhood Factors Impacting HIV Care Continuum Participation in the United States. J Urban Health 2024; 101:31-63. [PMID: 38093034 PMCID: PMC10897076 DOI: 10.1007/s11524-023-00801-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 01/07/2024]
Abstract
Social determinants have been increasingly implicated in accelerating HIV vulnerability, particularly for disenfranchised communities. Among these determinants, neighborhood factors play an important role in undermining HIV prevention. However, there has been little research comprehensively examining the impact of neighborhood factors on HIV care continuum participation in the US. To address this, we conducted a systematic review (PROSPERO registration number CRD42022359787) to determine neighborhood factors most frequently associated with diminished HIV care continuum participation. Peer-reviewed studies were included if published between 2013 - 2022, centralized in the US, and analyzed a neighborhood factor with at least one aspect of the HIV care continuum. The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Study quality was guided by LEGEND (Let Evidence Guide Every New Decision) evaluation guidelines. Systematic review analysis was conducted using Covidence software. There were 3,192 studies identified for initial screening. Forty-four were included for review after eliminating duplicates, title/abstract screening, and eligibility assessment. Social and economic disenfranchisement of neighborhoods negatively impacts HIV care continuum participation among persons living with HIV. In particular, five key neighborhood factors (socioeconomic status, segregation, social disorder, stigma, and care access) were associated with challenged HIV care continuum participation. Race moderated relationships between neighborhood quality and HIV care continuum participation. Structural interventions addressing neighborhood social and economic challenges may have favorable downstream effects for improving HIV care continuum participation.
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Affiliation(s)
- Jelani Kerr
- Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY, USA.
| | - Adrienne Smith
- Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY, USA
| | - Nqobile Nzama
- Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY, USA
| | - Nana Ama Aya Bullock
- Department of Health Promotion and Behavioral Sciences, University of Louisville, Louisville, KY, USA
| | - Cristian Chandler
- Department of Medicine, Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Victory Osezua
- Public Health Program, Gwynedd Mercy University, Gwynedd Valley, PA, USA
| | - Karen Johnson
- School of Social Work, University of Alabama, Tuscaloosa, AL, USA
| | - Isabel Rozema
- University of Louisville Health, Louisville, KY, USA
| | - Isha W Metzger
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Lesley M Harris
- Kent School of Social Work and Family Science, University of Louisville, Louisville, KY, USA
| | - Keosha Bond
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY, USA
| | - Dani LaPreze
- Kornhauser Health Sciences Library, University of Louisville, Louisville, KY, USA
| | - Bridgette M Rice
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA, USA
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Chaudhry A, Hebert-Beirne J, Hanneke R, Alessi EJ, Mitchell U, Molina Y, Chebli P, Abboud S. The Health Needs of Sexual and Gender Minority Migrant Women in the United States: A Scoping Review. LGBT Health 2024; 11:1-19. [PMID: 37540144 DOI: 10.1089/lgbt.2022.0392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Purpose: This scoping review characterizes the peer-reviewed evidence on the health of first-generation sexual and gender minority (SGM) migrant women to the United States and identifies research gaps and future priorities. Methods: On February 1, 2022, the following databases were searched: PubMed (MEDLINE), Embase, CINAHL Plus with Full Text, APA PsycINFO, and PAIS Index. Primary research studies based in the United States, in English, on first-generation SGM migrants (i.e., immigrants, refugees, asylum seekers) were included. Gray literature and review articles were excluded. Health outcome data were not extracted from nonbinary populations nor transgender men. Themes were generated using qualitative content analysis. Results: Thirty-three studies were reviewed, most were qualitative, and 11 focused on transgender women migrants (especially from Latin America), while only one was exclusively on sexual minority women (SMW) migrants. Premigration experiences of violence and discrimination were linked to high prevalence rates of post-traumatic stress disorder, depression, and anxiety. Postmigration stressors included lack of educational and employment opportunities, reduced access to social services, and experiences of stigma and discrimination, which were also associated with the development of depressive symptoms. Transgender women migrants reported not seeking formal medical care, given a lack of gender-affirming services and insurance resulting in reliance on unsafe informal care networks for hormone therapy and feminization procedures. Conclusion: Future interventions should focus on fostering social support networks of SGM migrant women to help improve their mental health outcomes. Research priorities should include studies on SMW migrants and more quantitative research that could identify additional health needs (i.e., sexual health) of SGM migrant women.
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Affiliation(s)
- Aeysha Chaudhry
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Jeni Hebert-Beirne
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Rosie Hanneke
- Department of Information Services & Research, Library of the Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA
| | - Edward J Alessi
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Uchechi Mitchell
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Yamile Molina
- Division of Community Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Perla Chebli
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Sarah Abboud
- Department of Human Development Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
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7
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Lyons N, Bhagwandeen B, Edwards J. Examining the Correlates of HIV Testing for Venezuelan Migrants in Trinidad. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2148. [PMID: 36767515 PMCID: PMC9916155 DOI: 10.3390/ijerph20032148] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 06/18/2023]
Abstract
An important preventive measure in the fight against the HIV epidemic is the adoption of HIV testing. The government of the Republic of Trinidad and Tobago conducted a registration exercise in 2019 for undocumented migrants and refugees from Venezuela residing in the country. These migrants were allowed access to the public health system. In this study, we observed the correlates of HIV testing in Venezuelan migrants residing in Trinidad. A convenience sample of n = 250 migrants was collected via telephone survey from September through December 2020. Variables of interest included social factors, health needs, and uptake of HIV testing. Pearson χ2 tests examined the associations between study variables, and multivariable logistic regression with backward elimination produced the odds of taking an HIV test. In our study, 40.8% of migrants reported having received an HIV test since arriving in Trinidad. Persons who migrated with family or friends had greater odds of getting an HIV test relative to persons who arrived alone (OR = 2.912, 95% CI: 1.002-8.466), and migrants who knew where to get an HIV test also greater odds of getting a test relative to person who did not know where to get a test (OR = 3.173, 95% CI: 1.683-5.982). Migrants with known physical health problems had greater odds of getting an HIV test relative to migrants without these health problems (OR = 1.856, 95% CI: 1.032-3.337). Persons who arrived with family or friends had greater odds of experiencing difficulties accessing public health care relative to persons who arrived alone (OR = 3.572, 95% CI: 1.352-9.442). Migrants earning between $1000 and $2999 TT per month had greater odds of experiencing trouble accessing public health services relative to persons who had monthly earnings of less than $1000 TT (OR = 2.567, 95% CI: 1.252-5.264). This was the first quantitative study on HIV testing among Venezuelan migrants in Trinidad. Migrants still experience difficulties accessing healthcare, which, in turn influences national HIV prevention and control efforts. The results gathered may help in developing HIV prevention plans that are led by a national health policy that takes migrant communities' needs into account.
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Affiliation(s)
- Nyla Lyons
- Medical Research Foundation of Trinidad and Tobago, 7 Queen’s Part E, Port-of-Spain, Trinidad and Tobago
| | - Brendon Bhagwandeen
- School of Mathematical and Computer Sciences, Heriot Watt University Malaysia, 1 Jalan Venna P5/2, Precinct 5, Putrajaya 62200, Malaysia
| | - Jeffrey Edwards
- Medical Research Foundation of Trinidad and Tobago, 7 Queen’s Part E, Port-of-Spain, Trinidad and Tobago
- Department of Para-Clinical Sciences, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago
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Rocha-Jiménez T, Morales-Miranda S, Fernández-Casanueva C, Silverman JG, Zúñiga ML, Goldenberg SM, Crespo N, Brouwer KC. Migration and Mobility: Correlates of Recent HIV Testing Among Substance Using Female Sex Workers at the Mexico-Guatemala Border. AIDS Behav 2022; 26:1467-1476. [PMID: 34982320 PMCID: PMC9001206 DOI: 10.1007/s10461-021-03501-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 12/04/2022]
Abstract
The goal of this paper is to determine the association between traveling to engage in sex work in another country and recent access to HIV testing among substance-using female sex workers (FSWs) in the Mexico-Guatemala border region. From 2012 to 2015, through modified time-location sampling and peer referral, 255 FSWs were recruited at Mexico's southern border. Participants completed questionnaires on sociodemographics, migration and mobility experiences, work environment factors, and substance use. A conceptual framework, as depicted by a directed acyclic graph (DAG), guided our analysis. Crude and adjusted logistic regression models were used to evaluate the relationships between mobility experiences and HIV testing in the past year. Overall HIV testing was low (41%); after considering relevant covariates (i.e., interaction with health services and organizations, and sex work characteristics) traveling to engage in sex work in another country was found to be positively associated with HIV testing in the past year. Future efforts need to consider voluntary and non-stigmatizing prevention HIV services and focus on reaching out to less mobile women.
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Affiliation(s)
- Teresita Rocha-Jiménez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA USA
- Society and Health Research Center, Faculty of Humanities, Universidad Mayor, Santiago, Chile
| | | | - Carmen Fernández-Casanueva
- Centro de Investigaciones y Estudios Superiores en Antropología Social CIESAS, San Cristóbal de las Casas, Chiapas Mexico
| | - Jay G. Silverman
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA USA
| | | | - Shira M. Goldenberg
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA USA
- Division of Epidemiology and Biostatistics, San Diego State, San Diego, CA USA
| | - Noe Crespo
- School of Public Health, San Diego State University, San Diego, CA USA
| | - Kimberly C. Brouwer
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA USA
- Department of Family Medicine & Public Health, University of California San Diego, La Jolla, CA USA
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Pullen E, Gupta A, Stockman JK, Green HD, Wagner KD. Association of social network characteristics with HIV knowledge, stigma, and testing: findings from a study of racial and ethnic minority women in a small Western city. AIDS Care 2022; 34:39-46. [PMID: 33856953 PMCID: PMC8517041 DOI: 10.1080/09540121.2021.1913717] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Black and Latina women are disproportionately impacted by HIV/AIDS. Despite existing research linking social networks and HIV risk among men who have sex with men (MSM) and other high-risk populations, little research has examined how ethnic/racial minority women's social networks shape HIV prevention and intervention targets. Using interviews with a sample of 165 predominantly Black and Latina-identifying women from a small city in the Western U.S., this research examines the relationship between egocentric network characteristics and HIV knowledge, attitudes, and testing history. Results reveal that network characteristics play a significant role in shaping HIV-related knowledge, prejudice, and testing intention but not HIV testing history. Individual-level factors like homelessness and perceptions of testing barriers are more salient for explaining testing behaviors than network characteristics. Intervention efforts to improve knowledge and reduce prejudice among Black and Latina women may benefit from mobilizing network ties.
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Affiliation(s)
- Erin Pullen
- Indiana University Network Science Institute (IUNI), Indiana University, Bloomington, Indiana
| | - Akrati Gupta
- Department of Health Administration, Midwestern State University, Wichita Falls, Texas
| | - Jamila K. Stockman
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California
| | - Harold D. Green
- Department of Applied Health Sciences, Indiana University, Bloomington, Indiana
| | - Karla D. Wagner
- School of Community Health Sciences, University of Nevada, Reno, Reno, Nevada
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Ruiz-Sánchez HC, Macia L, Boyzo R, Documet PI. Community health workers promote perceived social support among Latino men: Respaldo. J Migr Health 2021; 4:100075. [PMID: 34927112 PMCID: PMC8646959 DOI: 10.1016/j.jmh.2021.100075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/30/2022] Open
Abstract
Promotores or community health workers are trusted community members who offer information and support to marginalized groups in society. Latinx immigrants in new growth communities or emerging communities (areas with a small yet growing Latinx population) confront many challenges in their settling processes. De la Mano con la Salud was a community-based participatory project that trained Latino immigrant men as promotores. Promotores recruited 182 Latino immigrant men helped them to attain their own goals, connected them with health and social services and connected them to the larger community. We present data from 23 in-depth interviews with project participants conducted after six months of enrollment. Qualitative analysis confirmed participants’ vulnerabilities and showed that promotores addressed many of the health, legal, and occupational needs of participants. Emerging themes showed that 1) participants had a thirst for a united Latinx community; and 2) felt that promotores had their back (respaldo). The need for community may reflect the current invisibility of this Latinx population, as well as the desires for recognition and ethnic identity affirmation. Respaldo strongly resembles perceived social support, which is the kind of support most associated with health outcomes. Future research can determine what intervention components best foster respaldo.
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11
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Barrington C, Davis DA, Villa-Torres L, Carcano J, Hightow-Weidman L. Intersectionalities and the HIV continuum of care among gay Latino men living with HIV in North Carolina. ETHNICITY & HEALTH 2021; 26:1098-1113. [PMID: 31109189 DOI: 10.1080/13557858.2019.1620177] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Latino men who have sex with men (MSM) are disproportionately affected by HIV in the US and only half of Latinos diagnosed with HIV are virally suppressed. Little is known about the determinants of HIV care and treatment outcomes among Latinos. We used theories of intersectionality to assess the HIV testing, care and treatment experiences of gay Latino men living with HIV in a new immigrant destination. DESIGN We conducted qualitative in-depth interviews with US and foreign-born gay Latino men living with HIV (n = 14) recruited through referrals from HIV care providers and case managers. We used Maxwell and Miller's theory of qualitative analysis to guide our approach to data analysis, integrating narrative techniques and thematic coding. We used theories of intersectionality - including both intersecting identities and structures - as an interpretive framework to understand participants' outcomes and experiences. RESULTS All participants were engaged in HIV care at the time of the interviews. The mental health burden of diagnosis and managing life with HIV was a salient theme across all interviews. Most participants had experienced interruptions in their care due to both intersecting stigmatized identities (e.g. being gay, Latino, undocumented) and intersecting structures (healthcare, immigration policy, institutionalized homophobia). Undocumented participants directly connected their immigration status to their ability to get work, which then affected their retention in HIV care and treatment adherence. CONCLUSIONS Examining the interplay between identities and structures provides a contextualized understanding of outcomes along the HIV care continuum among gay Latino men that goes beyond behavioral and cultural explanations. There is a need to assess long-term experiences of navigating HIV care and treatment given the intersecting structures of mobility, housing instability, and immigration policy.
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Affiliation(s)
- Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Dirk A Davis
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Laura Villa-Torres
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Joaquin Carcano
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA
| | - Lisa Hightow-Weidman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA
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12
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Glasman LR, Dickson-Gomez J, Corbett AM, Rosado NA, Galletly CL, Salazar J. Contextual influences on Latino men's sexual and substance use behaviors following immigration to the Midwestern United States. ETHNICITY & HEALTH 2021; 26:827-844. [PMID: 30592225 PMCID: PMC6599544 DOI: 10.1080/13557858.2018.1562051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Objectives: Latinos in the United States experience a disproportionate number of HIV and other sexually transmitted infections (STIs) and higher use of alcohol and illegal drugs, which has been attributed to increases in risk behaviors following immigration. Whereas substantial research documents these behavioral changes, little is known about how immigrants increase their risk or why some immigrants increase their risk and other immigrants do not. This study explored how the social and normative context affects sexual and substance use behaviors among Latino immigrant men in a midsized Midwestern city of the United States.Methods: We interviewed 64 Latino immigrant men recruited from community sites in Milwaukee, Wisconsin (mean age = 32.6 years). Participants reported the social and normative contexts preceding and following immigration, including social networks and support, perceptions of the law, and familiar and peer normative influences.Results: Immigrants attributed changes in their sexual and substance use behaviors to their immigration goals, social support, peer and familial normative influences, and restrictions related to their immigrant status. Immigration for economic and personal advancement was generally protective from behaviors that would interfere with those goals as were extended familial networks that could provide support, resources, and normative control. The need to stay under the radar of authorities, the proportion of Latinos in the community, the social and normative changes associated with immigrants' age, and the higher perceptions of risk for HIV in the United States compared with their home countries also influenced immigrants' sexual and substance use behaviors.Conclusions: Changes in risk behavior after immigration to the United States reflect a combination of social and normative factors and personal goals. Interventions and policies aiming to prevent HIV and substance use among Latino immigrants should understand the contextual conditions that decrease or increase their risk behaviors in the United States.
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Affiliation(s)
- Laura R. Glasman
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Julia Dickson-Gomez
- Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - A. Michelle Corbett
- Center for Urban Population Health, University of Wisconsin School of Medicine & Public Health, Milwaukee, Wisconsin, United States
| | - Noel A. Rosado
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - Carol L. Galletly
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, United States
| | - José Salazar
- Sixteenth Street Community Health Centers, Milwaukee, Wisconsin, United States
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13
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Farvid P, Vance TA, Klein SL, Nikiforova Y, Rubin LR, Lopez FG. The health and wellbeing of transgender and gender
non‐conforming
people of colour in the United States: A systematic literature search and review. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2021. [DOI: 10.1002/casp.2555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Panteá Farvid
- Psychology, Schools of Public Engagement The New School New York New York USA
| | - Thomas A. Vance
- Psychology, Schools of Public Engagement The New School New York New York USA
- Boys and Girls Clubs of America Atlanta Georgia USA
| | - Samantha L. Klein
- Psychology, School for Social Research The New School New York New York USA
| | | | - Lisa R. Rubin
- Psychology, School for Social Research The New School New York New York USA
| | - Felix G. Lopez
- Psychology, School for Social Research The New School New York New York USA
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14
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Hightow-Weidman L, Carcano J, Choi SK, Sampson L, Barrington C. Enlaces Por La Salud: A Personal Health Navigator Intervention Grounded in the Transnational Framework. J Immigr Minor Health 2021:10.1007/s10903-021-01192-w. [PMID: 33835380 PMCID: PMC8033285 DOI: 10.1007/s10903-021-01192-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 10/31/2022]
Abstract
Despite the disproportionate burden of HIV among Latinxs, there is a paucity of culturally appropriate interventions that have shown efficacy at increasing their engagement and retention in HIV care. We describe the development and implementation of Enlaces, a six-session, individual-level intervention, guided by the transnational framework, to improve HIV care outcomes for newly diagnosed and out-of-care Mexican men and transgender women (TW). Descriptive statistics summarizing baseline data and implementation outcomes are provided. 91 participants enrolled between October 2014 and August 2017. Intervention engagement and satisfaction was high; 81.3% completed all six sessions and 100% were very satisfied/satisfied with their experience. Successful implementation of the ENLACES intervention was the result of establishing client trust and maintaining a flexible, supportive approach to intervention delivery. Use of the transnational framework provided a contextualized approach to engaging with Mexican men and TW living with HIV that can be adapted to other Latino populations.
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Affiliation(s)
- Lisa Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA.
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.
| | | | - Seul Ki Choi
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Lynne Sampson
- Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA
| | - Clare Barrington
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
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15
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Felsher M, Koku E, Lankenau S, Brady K, Bellamy S, Roth AM. Motivations for PrEP-Related Interpersonal Communication Among Women Who Inject Drugs: A Qualitative Egocentric Network Study. QUALITATIVE HEALTH RESEARCH 2021; 31:86-99. [PMID: 32869694 PMCID: PMC7864555 DOI: 10.1177/1049732320952740] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
A qualitative egocentric social network approach was taken to explore motivations for pre-exposure prophylaxis (PrEP)-related communication between women who inject drugs and network members. Eligible participants were HIV-negative, 18 years or older, and participating in a PrEP demonstration project in Philadelphia, PA, USA. The study employed content analysis of in-depth interviews to identify themes related to contextual and relational factors impacting PrEP communication within networks. Participants (n = 20) named on average three network members, resulting in a total of 57 unique relationships. PrEP conversations occurred within 30 of the 57 relationships, and motivations were to benefit others, to benefit themselves, and due to a sense of obligation. Some conversations also occurred when a peer unexpectedly found their pills. Taking a qualitative approach to network analysis provided a nuanced understanding of how interpersonal characteristics motivated PrEP conversations. Network interventions that facilitate information diffusion and social support may increase PrEP uptake and adherence among women who inject drugs.
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Affiliation(s)
| | | | | | - Kathleen Brady
- Philadelphia Department of Public Health, Philadelphia, PA, USA
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16
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Ramírez-Ortiz D, Sheehan DM, Moore MP, Ibañez GE, Ibrahimou B, De La Rosa M, Cano MÁ. HIV Testing Among Latino Emerging Adults: Examining Associations with Familism Support, Nativity, and Gender. J Immigr Minor Health 2020; 22:1039-1048. [PMID: 32222904 PMCID: PMC7442717 DOI: 10.1007/s10903-020-01000-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Research examining factors associated with low uptake of HIV testing among Latino emerging adults is scarce. Thus, this study examined the association between familism support and lifetime history of HIV testing among Latino emerging adults, and whether nativity status and gender moderated this association. A cross-sectional online survey of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida was conducted and data were analyzed using robust Poisson regression models. Results indicated that 59.9% of participants reported a lifetime history of HIV testing. Higher familism support was associated with a decreased prevalence of lifetime history of HIV testing (aPR = 0.81, 95% CI: 0.68- 0.95). Nativity status moderated the association between familism support and lifetime history of HIV testing, with this negative association, only found among immigrants (aPR = 0.46, 95% CI: 0.28-0.74). Gender did not moderate this association. Familism support plays a role in HIV testing behaviors, and thus should be considered when developing programs to increase HIV testing among Latinos.
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Affiliation(s)
- Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
| | - Diana M Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Research Center in Minority Institutions, Florida International University, Miami, FL, USA
| | - Melanie Paige Moore
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gladys E Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Department of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA.
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
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17
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Outcomes from a Male-to-Male Promotores Intervention in an Emerging Latino Community. J Immigr Minor Health 2019; 22:717-726. [PMID: 31617052 DOI: 10.1007/s10903-019-00939-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Emerging Latino communities experience social isolation and lack services tailored to their culture. Few male-to-male promotores (community health workers in Spanish) interventions exist. This 6-month participatory study aimed to improve social support, healthcare access, depressive symptoms, and decrease alcohol consumption among Latino immigrant men. Promotores delivered non-directive social support to participants recruited from community venues. We analyzed baseline and 6-month questionnaires data (n = 89) using paired chi square tests. All participants were immigrants; 47% had not finished high school, 29% had depression symptoms, 35% reported past month binge drinking and 93% were uninsured. The intervention significantly improved having a usual source of care (24 to 43%), doctor's visits (41 to 62%) and dentist's visits (27 to 42%) in the past year. Other outcomes did not improve. Male promotores increased healthcare access among vulnerable Latino men. Addressing drinking behavior and depression may require longer interventions or specialized providers.
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18
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Page KR, Grieb SD, Nieves-Lugo K, Yamanis T, Taylor H, Martinez O, Yamasaki Y, Limaye R, Davis W, Beyrer C, Zea MC. Enhanced immigration enforcement in the USA and the transnational continuity of HIV care for Latin American immigrants in deportation proceedings. Lancet HIV 2018; 5:e597-e604. [PMID: 29997050 PMCID: PMC6211169 DOI: 10.1016/s2352-3018(18)30074-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 04/09/2018] [Accepted: 04/16/2018] [Indexed: 06/08/2023]
Abstract
In our work as clinicians, researchers, and immigrant rights advocates, we have noted increased anxiety about the possibility of deportation and disruptions in care among immigrants with HIV. Before the 2016 US elections, patients rarely asked about HIV treatment in their home countries. However, since the increase in anti-immigrant rhetoric and arrests by US Immigration and Customs Enforcement, patients have voiced concerns about the availability of HIV treatment in their home countries much more frequently. Although antiretroviral therapy is available throughout Latin America, access depends on economic, social, and political circumstances. Maintaining uninterrupted continuity of care among immigrants held in detention or deported to their home countries is challenging. In this Viewpoint, we identify periods of particular vulnerability for immigrants during deportation proceedings, from initial detention to deposition in their country of origin. We discuss the effect of enhanced immigration enforcement on the health and wellbeing of HIV-infected immigrants, and on public health. Finally, we also discuss recommendations for clinicians, immigration authorities, and public health institutions in the USA and in receiving countries.
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Affiliation(s)
- Kathleen R Page
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Suzanne Dolwick Grieb
- Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Holly Taylor
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Rupali Limaye
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Chris Beyrer
- Bloomberg Johns Hopkins School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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19
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Conserve DF, Alemu D, Yamanis T, Maman S, Kajula L. "He Told Me to Check My Health": A Qualitative Exploration of Social Network Influence on Men's HIV Testing Behavior and HIV Self-Testing Willingness in Tanzania. Am J Mens Health 2018; 12:1185-1196. [PMID: 29808781 PMCID: PMC6142152 DOI: 10.1177/1557988318777674] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Men continue to test for HIV at a low rate in sub-Saharan Africa. Recent quantitative evidence from sub-Saharan Africa indicates that encouragement to test for HIV from men’s network members is associated with higher previous HIV testing and HIV self-testing (HIVST) willingness. Leveraging this positive network influence to promote HIVST among men is a promising strategy that could increase HIV testing. This study investigated the reasons and strategies men used to encourage their peers to test for HIV and the outcomes in order to inform the development of a social network-based HIVST intervention for men called STEP (Self-Testing Education and Promotion). Twenty-three men from networks locally referred to as “camps” were interviewed to explore reasons for encouraging HIV testing, strategies to encourage HIV testing, and outcomes of HIV testing encouragement. Reasons men reported for encouraging their peers to test for HIV included awareness of their peers’ risky sexual behavior, knowing an HIV-positive peer, and having HIV testing experience. Strategies for encouraging testing included engaging in formal and informal conversations and accompanying friends to the clinic. Encouragement outcomes included HIV testing for some men while others remained untested due to lack of privacy in the clinic and fear of HIV stigma. Willingness to self-test for HIV and an interest to educate peers about HIVST were other outcomes of HIV testing encouragement. These findings underscore the potential of leveraging men’s existing HIV testing encouragement strategies to promote HIVST among their peers.
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Affiliation(s)
- Donaldson F Conserve
- 1 Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Dawit Alemu
- 1 Arnold School of Public Health, Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Thespina Yamanis
- 2 School of International Service, American University, Washington, DC, USA
| | - Suzanne Maman
- 3 Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lusajo Kajula
- 4 Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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