Accessing Primary Care: HIV+ Caribbean Immigrants in the Bronx (original) (raw)
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Use of HIV primary care by HIV-positive Haitian immigrants in Miami, Florida
AIDS Care, 2011
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Desde hace poco tiempo la población latina se ha convertido en el grupo minoritario más grande de los Estados Unidos. Se espera que el crecimiento de este sector poblacional continúe también en el futuro debido a una elevada tasa de fertilidad y de inmigración. Comparados con la población blanca, los latinos experimentan una disparidad en cuanto a las tasas de VIH que puede estar asociada con el acceso a servicios de salud el cual se agrava ya que se trata de una población emergente con lengua y cultura diferentes a los conocidos por el sistema de salud. En este artículo se ofrecen ejemplos de una metodología que fue desarrollada para conocer y evaluar las necesidades de individuos que padecen VIH/SIDA y que tradicionalmente no han participado en este tipo de evaluaciones. Sobre esta base se discuten las implicaciones de los resultados y se elaboran una serie de recomendaciones para investigaciones futuras.
The impact of acculturation on Latinos' perceived barriers to HIV primary care
Ethnicity & disease, 2008
US Latino adults are disproportionately affected by the HIV epidemic and experience disparities in access to HIV care. However, relatively little is known about how acculturation affects perceived barriers to engagement in care among Latinos. This article examines factors that may be associated with engaging HIV-infected persons in primary care by using interview data from 651 Latino and non-Latino adults presenting for services at five agencies that participated in a multisite demonstration project Latinos (n=219) were more likely than non-Latino Whites (n=117) to be male, recently diagnosed with HIV, less educated, without health insurance, not on Medicaid, taking HIV medications, and in better physical health. In addition, Latinos were more likely to report facing numerous structural barriers, stigma-related worries/concerns, and belief barriers than were non-Latino Whites. Upon closer examination of the Latino subsample, acculturation (based on language) was associated with repo...
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US Latino adults are disproportionately affect-ed by the HIV epidemic and experience disparities in access to HIV care. However, relatively little is known about how accultura-tion affects perceived barriers to engagement in care among Latinos. This article examines factors that may be associated with engaging HIV-infected persons in primary care by using interview data from 651 Latino and non-Latino adults presenting for services at five agencies that participated in a multisite demonstration project. Latinos (n5219) were more likely than non-Latino Whites (n5117) to be male, recently diagnosed with HIV, less educated, without health insurance, not on Medicaid, taking HIV medications, and in better physical health. In addition, Latinos were more likely to report facing numerous structural barriers, stigma-related worries/concerns, and belief barriers than were non-Latino Whites. Upon closer examination of the Latino subsample, acculturation (based on language) was associ-ated with ...
Defining new communities: a challenge for immigrant health
Efforts to reduce HIV/AIDS vulnerability among U.S. Hispanics/Latinos can benefit from conceptualizing immigrant populations in ways that reflect their composition, social dynamics, economic and health status and permanency. This study employed qualitative methods to identify and describe HIV/AIDS and other health vulnerabilities among recent immigrants to the New York area from Guatemala, El Salvador, Honduras, the Dominican Republic and Mexico. Qualitative data collection involved: a) individual interviews (n = 51); b) 11 focusing groups (n = 86); c) key informant interviews (n = 26) and one focusing group with advocates and providers in health and social services; and d) ethnographic observation. Results indicate that migration and living conditions in receiving locations contribute to new immigrants' disconnection from a sense of "community" that may have negative effects on their physical and mental health. Data support the conclusion that public health policies and programs need to reach some consensus in defining these evolving immigrant "communities" in order to determine and provide culturally appropriate and effective prevention interventions.
Journal of immigrant health, 2003
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Objective Latino populations in the United States are disproportionately affected by substance use, HIV/AIDS, violence, and mental health issues (SAVAME). A growing body of evidence demonstrates the syndemic nature of SAVAME and the need for integrated strategies to reduce their impact. This study sought to understand the network of SAVAME services for Latino immigrants in a mid-Atlantic city to inform future interventions for SAVAME prevention and mitigation. Methodology: Key informant interviews (N = 30) were conducted with providers working in Latino-serving organizations providing SAVAME services. Interviews were analyzed using thematic coding and grounded theory. Results Latino-serving providers perceived a large need for, but important limitations in the availability, accessibility, and adequacy of SAVAME services for Latino immigrants. Gaps were seen as especially acute for mental health and substance use services, partly because of insufficient funding for these services. La...
Culture, Health & Sexuality, 2014
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“Where It Falls Apart”: Barriers to Retention in HIV Care in Latino Immigrants and Migrants
AIDS Patient Care and STDs, 2017
Latino immigrants in the United States are disproportionately affected by HIV. Barriers to consistent attendance (retention) in HIV primary care constrain opportunities for HIV treatment success, but have not been specifically assessed in this population. We conducted semistructured interviews with 37 HIV-infected Latinos (aged ‡18 years and born in Puerto Rico or a Latin American Spanish-speaking country) and 14 HIV providers in metropolitan Boston (total n = 51). The Andersen Model of Healthcare Utilization informed a semistructured interview guide, which bilingual research staff used to explore barriers to HIV care. We used thematic analysis to explore the processes of retention in care. Six ubiquitous themes were perceived to influence HIV clinic attendance: (1) stigma as a barrier to HIV serostatus disclosure; (2) social support as a safety net during negative life circumstances; (3) unaddressed trauma and substance use leading to interruption in care; (4) a trusting relationship between patient and provider motivating HIV clinic attendance; (5) basic unmet needs competing with the perceived value of HIV care; and (6) religion providing a source of hope and optimism. Cultural subthemes were the centrality of family (familismo), masculinity (machismo), and trusting relationships (confianza). The timing of barriers was acute (e.g., eviction) and chronic (e.g., family conflict). These cooccurring and dynamic constellation of factors affected HIV primary care attendance over time. HIV-infected Latino immigrants and migrants experienced significant challenges that led to interruptions in HIV care. Anticipatory guidance to prepare for these setbacks may improve retention in HIV care in this population.