Beyond Interpretation: The Unmet Need for Linguistically and Culturally Competent Care for Latinx People Living with HIV in a Southern Region with a Low Density of Spanish Speakers

Sherbuk, Jacqueline E.; Guex, Kristen Petros de; Añazco, Diego; Knight, Sarah; McManus, Kathleen A; Flickinger, Tabor; Dillingham, Rebecca

doi:10.1089/aid.2020.0088

Cited by 9 publications

(5 citation statements)

References 39 publications

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“… 23 Peer support has been shown to contribute to improved psychosocial and emotional health and wellness, and was maintained in the platform rebuild, as other cohorts demonstrated appreciation for this feature after using it. 30 …”

Section: Resultsmentioning

confidence: 99%

Process evaluation for the adaptation, testing and dissemination of a mobile health platform to support people with HIV and tuberculosis in Irkutsk, Siberia

et al. 2022

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ObjectivesWe developed and tested a mobile health-based programme to enhance integration of HIV and tuberculosis (TB) care and to promote a patient-centred approach in a region of high coinfection burden. Phases of programme development included planning, stakeholder interviews and platform re-build, testing and iteration.SettingIn Irkutsk, Siberia, HIV/TB coinfection prevalence is high relative to the rest of the Russian Federation.ParticipantsPilot testing occurred for a cohort of 60 people with HIV and TB.ResultsKey steps emerged to ensure the mobile health-based programme could be operational and adequately adapted for the context, including platform language adaptation, optimisation of server management, iteration of platform features, and organisational practice integration. Pilot testing of the platform rebuild yielded favourable patient perceptions of usability and acceptability at 6 months (n=47 surveyed), with 18 of 20 items showing scores above 4 (on a scale from 1 to 5) on average. Development of this mobile health-based programme for integrated care of infections highlighted the importance of several considerations for tailoring these interventions contextually, including language adaptation and technological capacity, but also, importantly, contextualised patient preferences related to privacy and communication with peers and/or providers, existing regional capacity for care coordination of different comorbidities, and infection severity and treatment requirements.ConclusionsOur experience demonstrated that integration of care for TB and HIV can be well served by using multimodal mobile health-based programmes, which can enhance communication and streamline workflow between providers across multiple collaborating institutions and improve continuity between inpatient and outpatient care settings. Further study of programme impact on contextual disease-related stigma and social isolation as well as evaluation of implementation on a broader scale for HIV care is currently under way.Trial registration numberNCT03819374.

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Section: Resultsmentioning

confidence: 99%

Process evaluation for the adaptation, testing and dissemination of a mobile health platform to support people with HIV and tuberculosis in Irkutsk, Siberia

et al. 2022

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“…This is also seen in race/ethnicity breakdowns of viral suppression [33]. Several strategies can be employed to improve viral suppression and CD4 þ cell count in people of color, including addressing the impact of social determinants of health, including racism, discrimination, and poverty, on HIV testing, care, treatment, and support services [31], providing culturally competent care to patients from diverse backgrounds [34], and using data to direct interventions designed to improve viral suppression to communities with low viral suppression [17].…”

Section: Discussionmentioning

confidence: 99%

Improvement in CD4 count among people with HIV in New York City, 2007-2021: a serial cross-sectional analysis

Xia,

Farovitch,

Bertolino

et al. 2023

Aids

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Background: A higher CD4 count among people with HIV (PWH) is associated with improved immune function and reduced HIV-related morbidity and mortality. The purpose of this analysis is to report the trend in CD4 count among PWH in New York City (NYC). Methods: We conducted a serial cross-sectional analysis using the NYC HIV registry data and reported the proportion of PWH with a CD4 count of 500 cells/mm3 or above, overall and by sex, race or ethnicity, and age. Results: The overall proportion of PWH in NYC with a CD4 count of 500 cells/mm3 or above increased from 38.1% in 2007 to 63.8% in 2021. Among males, the proportion increased from 36.7% in 2007 to 62.3% in 2021 with an annual percentage change (APC) of 6.6% (95% CI: 5.8, 7.5) in 2007–2013 and 2.6% (95% CI: 0.7, 4.4) in 2013–2017, and no changes in 2017–2021 (APC: 0.0%; 95% CI: -1.1, 1.0); among females, the proportion increased from 41.0% in 2007 to 67.6% in 2021 with an APC of 7.5% (95% CI: 5.2, 9.8) in 2007–2010, 4.5% (95% CI: 3.5, 5.4) in 2010–2015, and 0.8% (95% CI: 0.4, 1.2) in 2015–2021. White people had a higher proportion than other racial/ethnic groups, 70.9%, 59.3%, 60.9%, and 61.7%, respectively, among White, Black, Latino/Hispanic, and Asian/Pacific Islander males, and 69.8%, 68.0%, 66.3%, and 69.3%, respectively, among White, Black, Latina/Hispanic, and Asian/Pacific Islander females in 2021. Conclusions: CD4 count among PWH in NYC improved during 2007–2021, but the improvement slowed in recent years.

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“…For these populations, our clinic has an opportunity to improve our communication about safer sex practices. A mixed methods study in 2020 based in our clinic found that Spanish-speaking PWH with limited English language were dissatisfied with their care due to language and cultural barriers between patients and clinicians [ 26 ]. Therefore, language barriers accompanied by inadequate interpreter services may play a role in our clinicians’ communication and discussions about safer sex practices with Hispanic men with HIV.…”

Section: Discussionmentioning

confidence: 99%

A Missed Opportunity: Extragenital Screening for Gonorrhea and Chlamydia Sexually Transmitted Infections in People With HIV in a Southeastern Ryan White HIV/AIDS Program Clinic Setting

Geba

Powers

Williams

et al. 2022

Open Forum Infectious Diseases

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Background Guidelines recommend annual screening for gonorrhea/chlamydia in sexually active people with HIV at multiple sites (urogenital, oropharyngeal, rectal). In the first year of multisite screening at our Ryan White HIV/AIDS Program clinic, we studied (1) sexual history documentation rate, (2) sexually transmitted infection (STI) screening rate, (3) characteristics associated with STIs, (4) the percentage of extragenital STIs that would have been missed without multisite screening. Methods Participants were ≥14 years old with ≥1 in-person medical visit at our clinic in 2019. Descriptive analyses were performed, and adjusting for number of sites tested, a log-binomial model was used to estimate the association between characteristics and STI diagnosis in men. Results In this cohort (n = 857), 21% had no sexual history recorded. Almost all STI diagnoses were among males (99.3%). 68% (253/375) received appropriate urogenital testing, 63% (85/134) received appropriate oropharyngeal testing, and 69% (72/105) received appropriate rectal testing. In male participants with ≥1 STI test (n = 347), Hispanic ethnicity and detectable HIV viral load were associated with an STI diagnosis. Of those diagnosed with an STI who had multisite testing, 96% (n = 25/26) were positive only at an extragenital site. Conclusions Screening rates were similar across all anatomical sites indicating no obvious bias against extragenital testing. In males, STIs were more frequently diagnosed in people who identify as Hispanic and those with detectable viral loads which may indicate more condomless sex in these populations. Based on infections detected exclusively at extragenital sites, our clinic likely underdiagnosed STIs prior to implementation of multisite screening.

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Beyond Interpretation: The Unmet Need for Linguistically and Culturally Competent Care for Latinx People Living with HIV in a Southern Region with a Low Density of Spanish Speakers

Cited by 9 publications

References 39 publications

Process evaluation for the adaptation, testing and dissemination of a mobile health platform to support people with HIV and tuberculosis in Irkutsk, Siberia

Process evaluation for the adaptation, testing and dissemination of a mobile health platform to support people with HIV and tuberculosis in Irkutsk, Siberia

Improvement in CD4 count among people with HIV in New York City, 2007-2021: a serial cross-sectional analysis

A Missed Opportunity: Extragenital Screening for Gonorrhea and Chlamydia Sexually Transmitted Infections in People With HIV in a Southeastern Ryan White HIV/AIDS Program Clinic Setting

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