Fear of immigration enforcement policies is generalized across counties. Interventions are needed to increase immigrant Hispanics/Latinos' understanding of their rights and eligibility to utilize health services. Policy-level initiatives are also needed (e.g., driver's licenses) to help undocumented persons access and utilize these services.
Estimates suggest that only about 30% of all individuals living with HIV in the US have achieved viral suppression. Men who have sex with men (MSM), particularly racial/ethnic minority young MSM, are at increased risk for HIV infection and may have even lower viral suppression rates. HIV testing rates among MSM are low, and when tested, racial/ethnic minority young MSM have disproportionately lower rates of retention in care and viral suppression compared to other subgroups. This paper describes the design and development of weCare, our social media-based intervention to improve care linkage and retention and health outcomes among racially and ethnically diverse MSM, ages 13-34, living with HIV that will be implemented and evaluated beginning in late 2016. The intervention harnesses established social media that MSM between these ages commonly use, including Facebook, text messaging, and established GPS-based mobile applications ("apps"). We are using community-based participatory research (CBPR) to enhance the quality and validity of weCare, equitably involving community members, organization representatives, healthcare providers, clinic staff, and academic researchers.
Little is known about the immigrant Latino/a transgender community in the southeastern United States. This study used photovoice, a methodology aligned with community-based participatory research, to explore needs, assets, and priorities of Latina transgender women in North Carolina. Nine immigrant Latina male-to-female transgender women documented their daily experiences through photography, engaged in empowerment-based photo-discussions, and organized a bilingual community forum to move knowledge to action. From the participants’ photographs and words, 11 themes emerged in three domains: daily challenges (e.g., health risks, uncertainty about the future, discrimination, and anxiety about family reactions); needs and priorities (e.g., health and social services, emotional support, and collective action); and community strengths and assets (e.g., supportive individuals and institutions, wisdom through lived experiences, and personal and professional goals). At the community forum, 60 influential advocates, including Latina transgender women, representatives from community-based organizations, health and social service providers, and law enforcement, reviewed findings and identified ten recommended actions. Overall, photovoice served to obtain rich qualitative insight into the lived experiences of Latina transgender women that was then shared with local leaders and agencies to help address priorities.
Little is known about immigrant Latino sexual minorities' health seeking behaviors. This study examined factors associated with perceptions of access and actual care behaviors among this population in North Carolina.
Methods
A community-based participatory research partnership recruited 180 Latino sexual minority men and transgender individuals within preexisting social networks to participate in a sexual health intervention. Mixed-effects logistic regression models examined factors influencing health care access perceptions and use of services (HIV testing and routine check-ups).
Results
Results indicate that perceptions of access and actual care behaviors are low and affected by individual and structural factors, including: years living in NC, reported poor general health, perceptions of discrimination, micro-, meso-, and macro-level barriers, and residence in a Medically Underserved Area.
Discussion
To improve Latino sexual minority health, focus must be placed on multiple levels, individual characteristics (e.g., demographics), clinic factors (e.g., provider competence and clinic environment), and structural factors (e.g., discrimination).
Purpose
Hispanic/Latina women experience the highest cervical cancer incidence rates of any racial/ethnic group in the United States (US), and tend to present with more severe cases and experience higher mortality compared to most other populations. The goal of this qualitative systematic review was to explore existing interventions to increase cervical cancer screening among US Hispanics/Latinas and to identify characteristics of effective interventions and research gaps.
Materials and Methods
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 US were reviewed. Data were abstracted using a standardized form to document intervention characteristics and results.
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.
Conclusions
Interventions developed utilizing theory, applying community-based participatory research approaches, and using lay health advisors 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.
The HOLA intervention was a lay health advisor intervention designed to reduce the disproportionate HIV burden borne by Latino sexual and gender identity minorities (gay, bisexual, and other men who have sex with men, and transgender persons) living in the United States. Process evaluation data were collected for over a year of intervention implementation from 11 trained Latino male and transgender lay health advisors (Navegantes) to document the activities each Navegante conducted to promote condom use and HIV testing among his or her 8 social network members enrolled in the study. Over 13 months, the Navegantes reported conducting 1,820 activities. The most common activity was condom distribution. Navegantes had extensive reach beyond their enrolled social network members, and they engaged in health promotion activities beyond social network members enrolled in the study. There were significant differences between the types of activities conducted by Navegantes depending on who was present. Results suggest that lay health advisor interventions reach large number of at-risk community members and may benefit populations disproportionately impacted by HIV.
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