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Cooke P, Morales-Alemán MM, Ferreti G. Healthcare Provider Perceptions of the Use of Medical Interpretation in Primary Care. South Med J 2024; 117:221-225. [PMID: 38701841 PMCID: PMC11168477 DOI: 10.14423/smj.0000000000001680] [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: 05/05/2024]
Abstract
OBJECTIVES Sixty-three percent of Latinos/as/x in Alabama, speak English "not well" or "not at all." Effective provider-patient communication is the foundation of successful clinical interactions. Medical interpretation is important to the healthcare provision for patients with limited English proficiency (LEP). We examined Alabama providers' perceptions of working with medical interpreters to identify strategies to improve healthcare provision for LEP patients. METHODS We conducted nine semistructured qualitative interviews with primary healthcare providers in western Alabama. We used NVivo to conduct thematic coding and content analysis. RESULTS Of the nine providers, one self-identified as Latina and the others identified as White. Four participants worked in community clinics and five worked at university-based clinics. Four themes emerged: preference for in-person interpreters over technology-based interpretation; providers' perceptions and expectations of the roles of professional interpreters; challenges in the communication process; and use of family members or other ad hoc interpreters. CONCLUSIONS To meet the needs of Latino/a/x communities, clinical settings should invest in adequate staffing of in-person interpreters, infrastructure and workflow improvements, and the hiring and training of polylingual providers. Capacity-building opportunities to establish team building between interpreters and providers could be useful tools in improving healthcare provision for LEP patients.
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Affiliation(s)
- Paris Cooke
- University of Alabama at Birmingham School of Medicine, Birmingham
| | | | - Gwendolyn Ferreti
- Department of Peace and Social Justice Studies, Berea College, Berea, Kentucky
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2
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Hamilton FL, Pleasant V. Obstetrics and Gynecology Care in Latinx Communities. Obstet Gynecol Clin North Am 2024; 51:105-124. [PMID: 38267122 DOI: 10.1016/j.ogc.2023.11.007] [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: 01/26/2024]
Abstract
The Latinx community represents the largest racial minority population in the nation. There are significant barriers to care and treatment as it relates to obstetrics and gynecology. Understanding cultural considerations is essential to improving care in this community. Public health strategies as well as policies to address racial health disparities facing the Latinx community are explored in this article.
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Affiliation(s)
- Felicia L Hamilton
- Department of Obstetrics & Gynecology, OB/Gyn Practice Committee, MedStar Washington Hospital Center, Georgetown University Medical Center, 110 Irving Street, Northwest Room 5B-45A, Washington, DC 20010, USA.
| | - Versha Pleasant
- Department of Obstetrics and Gynecology, Cancer Genetics & Breast Health Clinic, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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3
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Rahman T, Rogers CJ, Albers LD, Forster M, Unger JB. Adverse Childhood Experiences, Acculturation, and Risky Sexual Behaviors in Hispanic Young Adults: Findings from Project RED. JOURNAL OF SEX RESEARCH 2024; 61:105-118. [PMID: 36877805 PMCID: PMC10480355 DOI: 10.1080/00224499.2023.2184762] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
While adverse childhood experiences (ACE) are well-documented predictors of maladaptive behaviors in adulthood, including risky sexual behaviors (RSB), the influence of acculturation in this association remains unknown. Although Hispanics are a rapidly growing population in the United States and are disproportionately affected by adverse sexual health outcomes, there is a paucity of research examining the interplay of ACE, acculturation, and RSB in this population. We observed the ACE-RSB association and how this relationship varies across U.S. and Hispanic acculturation levels, in a sample of Hispanic young adults (n = 715). Data for this study were from Project RED, a longitudinal study of Hispanic health. We ran regression models to test associations between ACE (0, 1-3, 4+) and several RSB (e.g., early sexual initiation (≤14 years), condomless sex, lifetime sexual partners, and alcohol/drug use before intercourse), and assessed moderation by U.S./Hispanic acculturation. Compared with those without ACE, individuals with 4 + ACE had higher odds of early sexual initiation (AOR: 2.23), alcohol/drug use before last intercourse (AOR: 2.31), and condomless sex (AOR: 1.66), as well as a higher number of lifetime sexual partners (β: 0.60). For those reporting 4 + ACE, high U.S. acculturation was protective in the association between ACE and using alcohol/drugs before intercourse. Future research implications are discussed.
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Affiliation(s)
- Tahsin Rahman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
| | - Christopher J. Rogers
- Department of Health Sciences, California State University, Northridge, Los Angeles, United States
| | - Larisa D. Albers
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge, Los Angeles, United States
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, United States
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4
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Fava NM, Sanchez M, Wuyke G, Diez S, Vazquez V, Ravelo GJ, Villalba K, Rojas P. Associations Between Sexual Trauma and Sexual Relationship Power Among Latina Immigrant Farmworkers: The Moderating Role of Gender Norms. J Trauma Stress 2020; 33:1093-1101. [PMID: 32667079 PMCID: PMC7725861 DOI: 10.1002/jts.22561] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 02/02/2020] [Accepted: 06/03/2020] [Indexed: 11/05/2022]
Abstract
Sexual trauma is a national public health concern due to the alarming rates at which it occurs and decades of research supporting its long-term deleterious effects on health outcomes. We assessed the impact of gender norms and sexual trauma on power within sexual relationships among Latina immigrant farmworkers. At baseline, participants (N = 175) completed a survey examining demographic information, sexual trauma history, and gender norms; a follow-up was administered 6 months later. Past sexual trauma was associated with less power in sexual relationships, r = -.25, p < .001, as was endorsement of traditional Latina gender norms (i.e., marianismo): sexual relationship control, r = -.38, p < .001; sexual decision-making dominance, r = -.21, p = .005. In contrast, egalitarian gender norm endorsement was associated with higher levels of sexual relationship control, r = .37, p < .001, and sexual decision-making dominance, r = .17, p = .023. Gender norms moderated the association between sexual trauma and sexual relationship power. Specifically, women who subscribed more to marianismo and reported sexual trauma had less decision-making dominance in sexual relationships, whereas those with lower ratings of marianismo reported higher levels of decision-making dominance despite sexual trauma, R2 = .03, p = .022. Sexual trauma history coupled with higher ratings of egalitarian gender norms was associated with higher levels of sexual relationship control, DR2 = .02, p = .023. These results highlight the importance of culturally informed research to increase the sexual and overall health of vulnerable populations (e.g., Latina immigrant farmworkers).
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Affiliation(s)
- Nicole M. Fava
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mariana Sanchez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Gabriella Wuyke
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Stephanie Diez
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Vicky Vazquez
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Gira J. Ravelo
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Karina Villalba
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Patria Rojas
- Department of Health Promotion & Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
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5
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Morales-Alemán MM, Ferreti G, Scarinci IC. "I Don't Like Being Stereotyped, I Decided I Was Never Going Back to the Doctor": Sexual Healthcare Access Among Young Latina Women in Alabama. J Immigr Minor Health 2020; 22:645-652. [PMID: 31535273 PMCID: PMC7078038 DOI: 10.1007/s10903-019-00932-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Young Latina women (YLW) in the US and in Alabama are disproportionately affected by sexual health disparities. Our community based participatory research (CBPR) study's purpose was to examine YLW's perceptions and experiences of sexual healthcare access (SHCA) toward developing community-driven, multilevel intervention strategies. We conducted 20 semi-structured qualitative interviews with YLW between 15 and 19 years old and who had been in the US for 5 or more years. We content-analyzed the data guided by the Socioecological Model of Sexual Health (SEMSH). We began analyses by coding independently, built consensus on the codes, then finished coding transcripts independently. Sixty-five percent of participants were US-born and 60% had health insurance. Participants identified barriers/facilitators to SHCA including discrimination in clinical settings and embarrassment/stigma about SHCA. Our study is the first in AL to use CBPR to work with YLW. Interventions should consider the multi-level and intersectional nature of SHCA challenges.
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Affiliation(s)
- Mercedes M Morales-Alemán
- Department of Community Medicine and Population Health, The University of Alabama, Box 870326, Tuscaloosa, AL, 35487, USA.
- Institute for Rural Health Research, The University of Alabama, Tuscaloosa, USA.
| | - Gwendolyn Ferreti
- Institute for Rural Health Research, The University of Alabama, Tuscaloosa, USA
| | - Isabel C Scarinci
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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6
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Martinez I, Kershaw TS, Keene D, Perez-Escamilla R, Lewis JB, Tobin JN, Ickovics JR. Acculturation and Syndemic Risk: Longitudinal Evaluation of Risk Factors Among Pregnant Latina Adolescents in New York City. Ann Behav Med 2019; 52:42-52. [PMID: 28707175 DOI: 10.1007/s12160-017-9924-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Syndemics are co-occurring epidemics that synergistically contribute to specific risks or health outcomes. Although there is substantial evidence demonstrating their existence, little is known about their change over time in adolescents. Purpose The objectives of this paper were to identify longitudinal changes in a syndemic of substance use, intimate partner violence, and depression and determine whether immigration/cultural factors moderate this syndemic over time. Methods In a cohort of 772 pregnant Latina adolescents (ages 14-21) in New York City, we examined substance use, intimate partner violence, and depression as a syndemic. We used longitudinal mixed-effect modeling to evaluate whether higher syndemic score predicted higher syndemic severity, from pregnancy through 1 year postpartum. Interaction terms were used to determine whether immigrant generation and separated orientation were significant moderators of change over time. Results We found a significant increasing linear effect for syndemic severity over time (β = 0.0413, P = 0.005). Syndemic score significantly predicted syndemic severity (β = -0.1390, P ≤ 0.0001), as did immigrant generation (βImmigrant = -0.1348, P ≤ 0.0001; β1stGen = -0.1932, P = 0.0005). Both immigrant generation (βImmigrant = -0.1125, P = 0.0035; β1stGen = -0.0135, P = 0.7279) and separated orientation (β = 0.0946, P = 0.0299) were significantly associated with change in severity from pregnancy to 1 year postpartum. Conclusion Pregnancy provides an opportunity for reducing syndemic risk among Latina adolescents. Future research should explore syndemic changes over time, particularly among high-risk adolescents. Prevention should target syndemic risk reduction in the postpartum period to ensure that risk factors do not increase after pregnancy.
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Affiliation(s)
- Isabel Martinez
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Trace S Kershaw
- Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, New Haven, CT, USA
| | - Danya Keene
- Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, New Haven, CT, USA
| | - Rafael Perez-Escamilla
- Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, New Haven, CT, USA
| | - Jessica B Lewis
- Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, New Haven, CT, USA
| | | | - Jeannette R Ickovics
- Department of Chronic Disease Epidemiology, Yale University School of Public Health and Center for Interdisciplinary Research on AIDS, New Haven, CT, USA
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7
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Daniel-Ulloa J, Ulibarri M, Baquero B, Sleeth C, Harig H, Rhodes SD. Behavioral HIV Prevention Interventions Among Latinas in the US: A Systematic Review of the Evidence. J Immigr Minor Health 2018; 18:1498-1521. [PMID: 26467788 DOI: 10.1007/s10903-015-0283-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Compared to White women, Latinas are 4 times more likely to contract HIV. In an effort to determine the overall state of the science meant to address this disparity, we reviewed the current HIV prevention intervention literature for U.S. Latinas. We searched 5 online electronic databases from their inception through July, 2014, for HIV prevention interventions including a majority sample of Latinas. Of 1041 articles identified, 20 studies met inclusion criteria. We documented study designs, participant characteristics, outcomes, theories used, and other intervention characteristics. Overall, HIV knowledge and attitudes were the predominant outcome; a small minority of studies included self-reported condom use or STD incidence. Strategies used to address cultural factors specific to Latinas and HIV included; lay health advisors, using ethnographic narratives, or using the Theory of Gender and Power, however few of the interventions adopted these strategies. This study identified several gaps in the intervention literature that need to be addressed. In addition to including more direct measures of decreased HIV risk (ex. condom use), more systematic use of strategies meant to address gender and cultural factors that may place Latinas at increased risk (e.g., gender inequity, traditional gender role norms such as machismo and marianismo, and relationship power dynamics).
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Affiliation(s)
- Jason Daniel-Ulloa
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA. .,University of Iowa, Prevention Research Center, Iowa City, IA, USA. .,Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - M Ulibarri
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - B Baquero
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA.,University of Iowa, Prevention Research Center, Iowa City, IA, USA
| | - C Sleeth
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, CPHB, CBH N436, 145 Riverside Dr, Iowa City, IA, 52242, USA.,University of Arizona College of Medicine, Tucson, AZ, USA
| | - H Harig
- University of Iowa, Prevention Research Center, Iowa City, IA, USA
| | - S D Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Abstract
BACKGROUND In the United States (US), foreign-born persons are disproportionately affected by HIV and differ epidemiologically from US-born persons with diagnosed HIV infection. Understanding HIV transmission dynamics among foreign-born persons is important to guide HIV prevention efforts for these populations. We conducted molecular transmission network analysis to describe HIV transmission dynamics among foreign-born persons with diagnosed HIV. METHODS Using HIV-1 polymerase nucleotide sequences reported to the US National HIV Surveillance System for persons with diagnosed HIV infection during 2001-2013, we constructed a genetic distance-based transmission network using HIV-TRACE and examined the birth region of potential transmission partners in this network. RESULTS Of 77,686 people, 12,064 (16%) were foreign born. Overall, 28% of foreign-born persons linked to at least one other person in the transmission network. Of potential transmission partners, 62% were born in the United States, 31% were born in the same region as the foreign-born person, and 7% were born in another region of the world. Most transmission partners of male foreign-born persons (63%) were born in the United States, whereas most transmission partners of female foreign-borns (57%) were born in their same world region. DISCUSSION These finding suggests that a majority of HIV infections among foreign-born persons in our network occurred after immigrating to the United States. Efforts to prevent HIV infection among foreign-born persons in the United States should include information of the transmission networks in which these individuals acquire or transmit HIV to develop more targeted HIV prevention interventions.
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Valverde EE, Painter T, Heffelfinger JD, Schulden JD, Chavez P, DiNenno EA. Migration Patterns and Characteristics of Sexual Partners Associated with Unprotected Sexual Intercourse Among Hispanic Immigrant and Migrant Women in the United States. J Immigr Minor Health 2017; 17:1826-33. [PMID: 25403987 DOI: 10.1007/s10903-014-0132-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In 2011, Hispanic immigrant women comprised 44% of HIV diagnoses among Hispanic women in the United States but little is known about factors that may place these women at risk for infection with HIV or sexually transmitted diseases. From March 2005 to February 2007, women were recruited at community-based organizations offering services to immigrant and migrant communities in five U.S. states. We report factors independently associated with unprotected anal and vaginal sex in the past 12 months among Hispanic immigrant and migrant women. Greater work-related mobility was associated with unprotected anal sex, while recency of immigration and prior refusal of HIV testing were associated with women's reports of unprotected vaginal sex. Prior sex with an injection drug user was associated with reports of both unprotected anal and vaginal sex. Findings highlight the need for HIV/STD risk reduction interventions designed specifically for Hispanic immigrant and migrant women.
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Affiliation(s)
- Eduardo E Valverde
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Thomas Painter
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - James D Heffelfinger
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Jeffrey D Schulden
- National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH) Neuroscience Center, Bethesda, MD, USA.
| | - Pollyanna Chavez
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Elizabeth A DiNenno
- Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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10
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Mann L, Tanner AE, Sun CJ, Erausquin JT, Simán FM, Downs M, Rhodes SD. Listening to the voices of Latina women: Sexual and reproductive health intervention needs and priorities in a new settlement state in the United States. Health Care Women Int 2016; 37:979-994. [PMID: 27050775 PMCID: PMC5053913 DOI: 10.1080/07399332.2016.1174244] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Latina women in the United States are disproportionately affected by negative sexual and reproductive health outcomes. Our community-based participatory research partnership conducted in-depth interviews exploring sexual and reproductive health needs and priorities with 25 Latinas in North Carolina and identified themes through constant comparison, a grounded theory development approach. Participants described individual-, interpersonal-, and clinic-level factors affecting their sexual and reproductive health as well as potentially successful intervention characteristics. Our findings can be used to inform culturally congruent interventions to reduce sexual and reproductive health disparities among Latinas, particularly in new settlement states in the southeastern United States.
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Affiliation(s)
- Lilli Mann
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Amanda E. Tanner
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | - Christina J. Sun
- School of Community Health, Portland State University, Portland, Oregon, USA
| | - Jennifer Toller Erausquin
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, North Carolina, USA
| | | | - Mario Downs
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Scott D. Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Coughlin SS. Community-Based Participatory Research Studies on HIV/AIDS Prevention, 2005-2014. JACOBS JOURNAL OF COMMUNITY MEDICINE 2016; 2:019. [PMID: 28066841 PMCID: PMC5215619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The recent literature on community-based participatory research (CBPR) approaches to preventing HIV infection in diverse communities was systematically reviewed as part of the planning process for a new study. Published HIV prevention studies that employed CBPR methods were identified for the period January 1, 2005 to April 30, 2014 using PubMed databases and MeSH term and keyword searches. A total of 44 studies on CBPR and HIV or AIDS prevention were identified, of which 3 focused on adolescents, 33 on adults, and 8 on both adolescents and adults. A variety of at-risk populations were the focus of the studies including men who have sex with men, African American or Hispanic men, and African American or Hispanic women. Few studies focused on Asian/Pacific Islander or American Indian populations in the U.S. Six studies employed CBPR methods to address HIV prevention in church settings. Many of the studies were limited to formative research (ethnographic research, in-depth interviews of key informants, or focus groups). Other studies had a pre-/post-test design, quasi-experimental, or randomized design. Additional CBPR studies and faith-based interventions are needed with adequate sample sizes and rigorous study designs to address lack of knowledge of HIV and inadequate screening in diverse communities to address health disparities.
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Affiliation(s)
- Steven S Coughlin
- Department of Preventive Medicine, University of Tennessee College of Medicine, Memphis, TN
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12
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Sun CJ, Mann L, Eng E, Downs M, Rhodes SD. Once a Navegante, Always a Navegante: Latino Men Sustain Their Roles as Lay Health Advisors to Promote General and Sexual Health to Their Social Network. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2015; 27:465-73. [PMID: 26485235 PMCID: PMC6686176 DOI: 10.1521/aeap.2015.27.5.465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Little is known about the sustainability of male- and men's health-focused lay health advisors. HoMBReS Por un Cambio was a community-level social network intervention designed to improve sexual health among Latino men who were members of soccer teams. During the year after the intervention implementation, lay health advisors (Navegantes) continued to promote sexual health; over 84% (16 of the 19) Navegantes conducted 9 of 10 primary health promotion activities. Describing where to get condoms was the activity that the most Navegantes reported having conducted. Navegantes had broad reach with their social networks, although the number of Navegantes that conducted each activity differed across the categories of social network members (soccer teammates, nonteammates, and women). Results suggest that HIV-related health disparities may be addressed through lay health advisor interventions because they are sustained after the intervention ends and reach large numbers of community members.
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Affiliation(s)
- Christina J Sun
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, and now with the School of Community Health, Portland State University, Portland, Oregon
| | - Lilli Mann
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Eugenia Eng
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Mario Downs
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Scott D Rhodes
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
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13
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Mann L, Foley KL, Tanner AE, Sun CJ, Rhodes SD. Increasing Cervical Cancer Screening Among US Hispanics/Latinas: A Qualitative Systematic Review. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:374-387. [PMID: 25154515 PMCID: PMC4344418 DOI: 10.1007/s13187-014-0716-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Hispanic/Latina women experience the highest cervical cancer incidence rates of any racial/ethnic group in the USA and tend to present with more severe cases and experience higher mortality compared to most other populations. The goals of this qualitative systematic review were to explore existing interventions to increase cervical cancer screening among US Hispanics/Latinas and to identify characteristics of effective interventions and research gaps. Six online databases were searched from their inception through June 30, 2013, using designated search terms and keywords. Peer-reviewed articles that documented an intervention designed to improve screening for cervical cancer among Hispanics/Latinas ages 18 years and older living in the USA were reviewed. Data were abstracted using a standardized form to document intervention characteristics and results. Forty-five articles, describing 32 unique interventions, met inclusion criteria. Identified interventions consisted primarily of educational programs and/or provision of screening. Interventions used lay health advisors (LHAs), clinic-based outreach/delivery strategies, partnerships with churches, and mass media campaigns. Twelve interventions resulted in significant increases in cervical cancer screening rates. Interventions developed utilizing theory, applying community-based participatory research approaches, and using LHAs were identified as having the greatest potential for improving cervical cancer screening among Hispanics/Latinas. There continues to be a need for the development of interventions in geographic areas with new and emerging Hispanic/Latino populations and that are comprehensive, follow participants for longer periods of time, and broaden the roles and build the capacities of LHAs.
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Affiliation(s)
- Lilli Mann
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA,
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14
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Lechuga J, Garcia D, Owczarzak J, Barker M, Benson M. Latino community health workers and the promotion of sexual and reproductive health. Health Promot Pract 2015; 16:338-44. [PMID: 25663055 DOI: 10.1177/1524839915570632] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Community health worker (CHW) programs have existed for over 50 years across the world. However, only recently has research evidence documented their effectiveness. Research is still needed to identify issues related to implementation and sustainability of CHW programs. This article explores the role and challenges of U.S. Latino CHWs trained to deliver a comprehensive sexual and reproductive health educational intervention to Latino families. We conducted a semistructured interview with a purposive convenience sample of 19 CHWs. Findings suggest that CHWs occupy roles that go beyond those they were trained for. CHWs serve not only as educators but also as providers of social support, facilitators of access to resources, patient navigators, and civil rights advocates. Lack of clarity of the role of a CHW influenced perceptions of adequacy of compensation, training, and integration into the agency that trained them. Policy facilitating the standardization of the CHW occupational category and role expectations is imperative to ensure successful implementation and sustainability of U.S. CHW programs.
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Affiliation(s)
| | - Dina Garcia
- The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jill Owczarzak
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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15
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Larson KL, Ballard SM, Nuncio BJ, Swanson M. Testing the feasibility of ¡Cuídate! With Mexican and Central American youth in a rural region of a southern state. Res Nurs Health 2014; 37:409-22. [PMID: 25185453 DOI: 10.1002/nur.21621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2014] [Indexed: 11/07/2022]
Abstract
Regions of the US with growing Latino populations are in need of culturally sensitive sexual risk reduction programs. A Latino community, a public school district, and a university in eastern North Carolina collaborated to test the feasibility of ¡Cuídate!, a culturally tailored, evidence-based sexual risk reduction program, with Mexican and Central American youth. Ten male and 10 female adolescents, ages 13-17 years, participated in the ¡Cuídate! program and post-program focus groups. Early adolescent boys and girls (ages 13-15) gained the most from this program. A safe environment facilitated healthy sexual communication, and condom skills-building provided a context for shared partner responsibility. Grade-level and gender differences were significant. Analysis of the focus group data identified three important messages: Everybody needs sex education, We like this program better because it is hands-on, and I'm going to make better decisions about sex. The findings of this study support the need for community-based interventions that ensure cultural respect, trust, and a safe environment in which to discuss sexual issues.
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Affiliation(s)
- Kim L Larson
- Associate Professor, East Carolina University, College of Nursing, 3135 Health Science Building, Greenville, NC, 27858-4353
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16
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McCurdy SA, Stoecklin-Marois MT, Tancredi DJ, Hennessy-Burt TE, Schenker MB. Region of birth, sex, and reproductive health in rural immigrant latino farmworkers: the MICASA study. J Rural Health 2014; 31:165-75. [PMID: 25066185 DOI: 10.1111/jrh.12083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE Characterize sexual and reproductive health among immigrant Latino farmworkers. METHODS We surveyed 806 immigrant Latino farmworkers from Mexico and Central America in a rural agricultural community in California's Central Valley. FINDINGS A total of 556 respondents were born in Mexico (272 men, 284 women) and 250 in Central America (135 men, 115 women). The majority entered the United States as young adults, with median age at immigration ranging from 20 (Mexican-born men) to 24 (Central American-born women). Nearly 95% of respondents were married or cohabiting. Median age for sexual debut was 18 for women and was younger for men (adjusted mean difference: -2.1 years, 95% CI: -2.6 to -1.7). Median number of lifetime sexual partners was 1 for women and greater for men (adjusted mean difference: 2.0 partners, 95% CI: 1.3-2.7). Contraception use was less likely among men and among Central American women compared to Mexico-born women. Among sexually active persons not using contraception, the most common reasons for nonuse were "Don't want to"/"Don't like any" followed by desire to become or being pregnant. Women reported a median of 3 pregnancies; there were no significant differences based on respondents' region of birth. CONCLUSIONS This group of Latino immigrants demonstrated behaviors conducive to reproductive health: late sexual debut, few lifetime sexual partners, and high prevalence of marriage. Preventive education campaigns should focus on maintaining healthy behaviors, especially in men. Identifying groups with common provenance and cultural heritage may aid in maximizing acceptability and effectiveness of prevention programs.
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Affiliation(s)
- Stephen A McCurdy
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California
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17
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Alio AP, Fields SD, Humes DL, Bunce CA, Wallace SE, Lewis C, Elder H, Wakefield S, Keefer MC. Project VOGUE: A partnership for increasing HIV knowledge and HIV vaccine trial awareness among House Ball leaders in Western New York. JOURNAL OF GAY & LESBIAN SOCIAL SERVICES 2014; 26:336-354. [PMID: 25642120 PMCID: PMC4308092 DOI: 10.1080/10538720.2014.924892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Men who sleep with men (MSM) and transgender individuals of color, the largest demographic in the House Ball community (HBC) are amongst the group at highest risk for HIV infection in the United States. The HBC have limited access to culturally appropriate HIV education. This study aimed to develop a partnership with HBC leaders to uncover strategies for increasing HIV prevention knowledge, including participation in HIV vaccine trials. To this end a research institution-community-HBC partnership was established. In-depth qualitative and quantitative data were collected from the 14 HBC leaders in western New York, revealing that knowledge of HIV and related vaccine trials was limited. Barriers to increasing HIV knowledge included fear of peer judgment, having inaccurate information about HIV, and lack of education. Among the HBC, community partnerships will further aid in the development of future HIV prevention programs and increase individuals' willingness to participate in future HIV vaccine trials.
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Affiliation(s)
- Amina P Alio
- University of Rochester School of Medicine & Dentistry, Department of Public Health Sciences
| | - Sheldon D Fields
- Florida International University, College of Nursing and Health Sciences
| | | | - Catherine A Bunce
- University of Rochester School of Medicine & Dentistry, Department of Medicine, Division of Infectious Diseases
| | | | - Cindi Lewis
- University of Rochester School of Medicine & Dentistry, Department of Public Health Sciences
| | - Heather Elder
- University of Rochester School of Medicine & Dentistry, Department of Public Health Sciences
| | | | - Michael C Keefer
- University of Rochester School of Medicine & Dentistry, Department of Medicine, Division of Infectious Diseases
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18
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Dolwick Grieb SM, Desir F, Flores-Miller A, Page K. Qualitative Assessment of HIV Prevention Challenges and Opportunities Among Latino Immigrant Men in a New Receiving City. J Immigr Minor Health 2013; 17:118-24. [DOI: 10.1007/s10903-013-9932-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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19
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Alcohol use as a determinant of HIV risk behaviors among recent Latino immigrants in south Florida. J Assoc Nurses AIDS Care 2013; 25:135-44. [PMID: 23706771 DOI: 10.1016/j.jana.2013.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 02/01/2013] [Indexed: 11/23/2022]
Abstract
Information on the association between alcohol use and Latino sexual risk behavior prior to immigrating to the United States is scarce. Given this population's rapid growth, documenting the influence of alcohol use on recent Latino immigrants' (RLI) sexual risk behaviors is essential. Data prior to immigration were retrospectively collected from 527 RLI ages 18-39 years. Quantity and frequency of alcohol use during the 90 days prior to immigration and pre-immigration sexual risk behaviors were measured. Structural equation modeling was used to examine the relationships. Males, single participants, and participants with higher incomes reported more alcohol use. Higher alcohol use was associated with lower condom use frequency, having sex under the influence, and more sexual partners among all participants. Results point to the importance of creating interventions targeting adult RLI men, given their likelihood to engage in alcohol consumption, sex under the influence of alcohol, and sex with multiple partners without using condoms.
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20
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Rhodes SD, Tanner A, Duck S, Aronson RE, Alonzo J, Garcia M, Wilkin AM, Cashman R, Vissman AT, Miller C, Kroeger K, Naughton MJ. Female sex work within the rural immigrant Latino community in the southeast United States: an exploratory qualitative community-based participatory research study. Prog Community Health Partnersh 2013; 6:417-27. [PMID: 23221286 DOI: 10.1353/cpr.2012.0054] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about the structure and context of, and the risks encountered in, sex work in the United States. OBJECTIVE This community-based participatory research (CBPR) study explored female sex work and the feasibility of conducting a larger study of sex work within the immigrant Latino community in North Carolina. METHODS Twelve abbreviated life story interviews were conducted with Latina women who sold sex, other women who sold sex to Latino men, and Latino men who hired sex workers. Content analysis was used to analyze narrative data. RESULTS Themes emerged to describe the structure of sex work, motivations to sell and hire sex, and the sexual health-related needs of sex workers. Lessons learned included the ease of recruiting sex workers and clients, the need to develop relationships with controllers and bar owners/managers, and the high compensation costs to reimburse sex workers for participation. CONCLUSIONS Study findings suggest that it is possible to identify and recruit sex workers and clients and collect formative data within this highly vulnerable and neglected community; the prevention of HIV and STDs is a priority among sex workers, and the need for a larger study to include non-Latino men who report using Latina sex workers, other community insiders (e.g., bartenders), and service providers for Latina sex workers.
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21
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Rhodes SD, Daniel J, Alonzo J, Vissman AT, Duck S, Downs M, Gilbert PA. A snapshot of how latino heterosexual men promote sexual health within their social networks: process evaluation findings from an efficacious community-level intervention. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2012; 24:514-526. [PMID: 23206201 PMCID: PMC3959878 DOI: 10.1521/aeap.2012.24.6.514] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Hombres Manteniendo Bienestar y Relaciones Saludables (HoMBReS) was a community-level social network intervention designed to increase sexual health among Latino heterosexual men who were members of a multicounty soccer league. Process data were collected each month during 18 months of intervention implementation from each of 15 trained Latino male lay health advisors (known as Navegantes) to explore the activities that Navegantes conducted to increase condom and HIV testing among their social network members. The Navegantes reported conducting 2,364 activities, for a mean of 8.8 activities per Navegante per month. The most common activity was condom distribution. Most activities were conducted with men; about 2% were conducted with women. Among activities conducted with men, half were conducted with soccer teammates and half with nonteammates. Results suggest that Latino men's social networks can be leveraged to promote sexual health within the community. Innovative methods that reach large numbers of community members are needed given the lack of prevention resources for populations disproportionately impacted by HIV and STDs.
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Affiliation(s)
- Scott D Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina 27157-1063, USA.
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22
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Using community-based participatory research (CBPR) to develop a community-level HIV prevention intervention for Latinas: a local response to a global challenge. Womens Health Issues 2012; 22:e293-301. [PMID: 22483581 DOI: 10.1016/j.whi.2012.02.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Revised: 02/17/2012] [Accepted: 02/21/2012] [Indexed: 11/21/2022]
Abstract
INTRODUCTION AND BACKGROUND The arsenal of interventions to reduce the disproportionate rates of HIV and sexually transmitted disease (STD) infection among Latinos in the United States lags behind what is available for other populations. The purpose of this project was to develop an intervention that builds on existing community strengths to promote sexual health among immigrant Latinas. METHODS Our community-based participatory research (CBPR) partnership engaged in a multistep intervention development process. The steps were to (1) increase Latina participation in the existing partnership, (2) establish an intervention team, (3) review the existing sexual health literature, (4) explore health-related needs and priorities of Latinas, (5) narrow priorities based on what is important and changeable, (6) blend health behavior theory with Latinas' lived experiences, (7) design an intervention conceptual model, (8) develop training modules and (9) resource materials, and (10) pretest and (11) revise the intervention. RESULTS The MuJEReS intervention contains five modules to train Latinas to serve as lay health advisors (LHAs) known as "Comadres." These modules synthesize locally collected data with other local and national data, blend health behavior theory with the lived experiences of immigrant Latinas, and harness a powerful existing community asset, namely, the informal social support Latinas provide one another. CONCLUSION This promising intervention is designed to meet the sexual health priorities of Latinas. It extends beyond HIV and STDs and frames disease prevention within a sexual health promotion framework. It builds on the strong, preexisting social networks of Latinas and the preexisting, culturally congruent roles of LHAs.
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Medications for sexual health available from non-medical sources: a need for increased access to healthcare and education among immigrant Latinos in the rural southeastern USA. J Immigr Minor Health 2012; 13:1183-6. [PMID: 20890659 DOI: 10.1007/s10903-010-9396-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study documented the types and quality of sexual health medications obtained by immigrant Latinos from non-medical sources. Samples of the medications were purchased from non-medical sources in the rural Southeast by trained native Spanish-speaking "buyers". Medications were screened the presence of active pharmaceutical ingredients using mass spectrometry. Eleven medications were purchased from tiendas and community members. Six were suggested to treat sexually transmitted diseases, one was to treat sexual dysfunction, one was to prevent pregnancy, and two were to assist in male-to-female transgender transition or maintenance. All medications contained the stated active ingredients. Findings suggest that medications are available from non-medical sources and may not be used as indicated. Interventions that target immigrant Latinos within their communities and rely on existing structures may be effective in reducing barriers to medical and healthcare services and increasing the proper use of medications to reduce potential harm.
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Hernandez AM, Zule WA, Karg RS, Browne FA, Wechsberg WM. Factors That Influence HIV Risk among Hispanic Female Immigrants and Their Implications for HIV Prevention Interventions. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2012; 2012:876381. [PMID: 22518308 PMCID: PMC3296155 DOI: 10.1155/2012/876381] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 10/13/2011] [Accepted: 10/31/2011] [Indexed: 05/23/2023]
Abstract
Hispanics are the fastest growing minority group in North Carolina with increasing incidence of HIV infection. Gender roles, cultural expectations, and acculturation of women may explain some of Hispanic women's risks. The perspectives of Hispanic female immigrants and community-based providers were sought to identify services they offer, understand HIV risk factors, and support the adaptation of a best-evidence HIV behavioural intervention for Hispanic women. Two sets of focus groups were conducted to explicate risks and the opportunities to reach women or couples and the feasibility to conduct HIV prevention in an acceptable manner. Salient findings were that Hispanic female immigrants lacked accurate HIV/AIDS and STI knowledge and that traditional gender roles shaped issues surrounding sexual behaviour and HIV risks, as well as condom use, partner communication, and multiple sexual partnerships. Intervention implications are discussed such as developing and adapting culturally appropriate HIV prevention interventions for Hispanics that address gender roles and partner communication.
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Affiliation(s)
- Amy M. Hernandez
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - William A. Zule
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - Rhonda S. Karg
- Behavioral Health Epidemiology Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - Felicia A. Browne
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
| | - Wendee M. Wechsberg
- Substance Abuse Treatment Evaluations and Interventions Program, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA
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A randomized controlled trial of a culturally congruent intervention to increase condom use and HIV testing among heterosexually active immigrant Latino men. AIDS Behav 2011; 15:1764-75. [PMID: 21301948 DOI: 10.1007/s10461-011-9903-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This randomized controlled trial tested the efficacy of an HIV prevention intervention to increase condom use and HIV testing among Spanish-speaking, heterosexually active immigrant Latino men. A community-based participatory research partnership developed the intervention and selected the study design. Following baseline data collection, 142 immigrant Latino men were randomized to the HIV prevention intervention or the cancer education intervention. Three-month follow-up data were collected from 139 participants, for a 98% retention rate. Mean age of participants was 31.6 years and 60% reported being from Mexico. Adjusting for baseline behaviors, relative to their peers in the cancer education comparison, participants in the HIV prevention intervention were more likely to report consistent condom use and receiving an HIV test. Community-based interventions for immigrant Latino men that are built on state of the art prevention science and developed in partnership with community members can greatly enhance preventive behaviors and may reduce HIV infection.
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