Information on titles, abstracts, and links to articles in a special issue ofAIDS Education & Prevention on Hispanics/Latinos and HIV/AIDS

[Guest guest]

FYI....

Among the articles in this issue, which was e-published two days ago, are several that include migrants, immigrants, and border area populations.

The supplement issue of the journal was organized by the Hispanic/Latino Executive Committee of CDC's Division of HIV/AIDS Prevention.

Thanks to Rob Malow, you have an opportunity below to review the titles and abstracts of all the articles in the special issue.

Thanks,

Tom

From: Malow [mailto:rmalow@...] Sent: Wednesday, October 14, 2009 9:06 PM' Malow'Subject: HIV Lserv: Hisp/Latinos-Free AIDS Ed & Prev Issue- on Epid/Beh/Eco Factors/Best Practices: CDC editors

Below are the summaries/full text links to 16 free access articles in a new supplemental issue of AIDS Educ. & Prev. (Oct. 09) on Hispanics/Latinos and HIV/AIDS: Epidemiologic, Behavioral and Ecological Influences of Risk and Best Practices for Prevention. At the bottom is the full text of the introductory overview article by the editors, mostly CDC scientists.

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AIDS Educ. & Prev. Oct. 09 Supplement on Hispanics/Latinos and HIV/AIDS: Epidemiologic, Behavioral and Ecological Influences of Risk and Best Practices for Prevention

Free access to each article using the links included with each article summary below or access the full text of each articles using the link in the table of contents at

http://www.atypon-link.com/GPI/toc/aeap/21/supplement+b?ai=rs & ui=rzo

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Foreword: HIV/AIDS Prevention in the Hispanic/Latino Community

Hazel D. Dean

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 1-2

Hazel D. Dean

Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. HDean@...

Excerpts below – Full text free at http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.1

The HIV/AIDS crisis affects many communities, and Hispanics/Latinos experience a significant portion of the burden. In 2006, Hispanics/Latinos accounted for 17% of the estimated 56,300 new HIV infections (Hall et al, 2008). The rate of new HIV infections among Hispanic men (43.1 per 100,000) is more than double that of white men (19.6 per 100,000), and the rate among Hispanic women (14.4 per 100,000) is nearly four times that of white women (3.8 per 100,000). In 2007, the rate of new AIDS diagnoses among Hispanics/Latinos (15.2 per 100,000) was three times as high as that among whites (5.2 per 100,000) (CDC, 2008). Although Hispanics/ Latinos comprise 14% of the US population, they account for 18% of persons living with HIV/AIDS (CDC, 2009)…

For Hispanic males living with HIV/AIDS, the most common modes for becoming HIV-infected were sexual contact with other males, injection drug use, and highrisk heterosexual contact. For Hispanic females living with HIV/AIDS, the most common modes for becoming HIV-infected were high-risk heterosexual contact and injection drug use [CDC, 2009]. HIV testing rates were slightly higher for Hispanics/ Latinos and blacks than for persons of other races or ethnicities. In a 2002 study, 50% of Hispanics aged 15–44 had ever been tested for HIV and 18% had been tested during the past year ( et al, 2005).

These numbers underscore the need to understand complex risk factors and social determinants of health contributing to the rates of HIV/AIDS among Hispanics/ Latinos and the need to raise awareness among Hispanics/Latinos about the effects of HIV/AIDS. Some key determinants may include structural and social factors … Prevention efforts, such as HIV testing, remains the key element for curtailing the spread of HIV among Hispanics/Latinos, and getting tested is the essential first step in turning the tide. Early testing allows people who are HIV-positive to take advantage of treatment, thereby staying healthier longer and taking steps to protect their partners from infection. To overcome barriers to HIV testing, care and treatment, stigma associated with HIV testing and homophobia must be addressed.

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Intro Overview Article

INTRODUCTION

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 3-6

JoAna M. Stallworth, H. Herbst, E. Alvarez, Raúl A. Romaguera, Hortensia Amaro, Hazel D. Dean4

Capacity Building Branch, Division of HIV/AIDS Prevention, NCHHSTP, 1600 Clifton Rd. NE, Mailstop E-40, Atlanta, GA 30333; e-mail: jstallworth@...

No abstract- excerpt below Free http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.3

15%, of the total U.S. population (including Puerto Rico) in 2008 and accounted for

nearly half of the nation’s population growth from 2000 to 2007. Individuals who

consider themselves to be Hispanic/Latino1 are diverse in terms of country of origin,

race, culture, language, and religion. Many Hispanics/Latinos are members of families

that have lived in the United States for many generations while others were born

in numerous other countries including Mexico, Cuba, the Dominican Republic, and

the countries of Central and South America.

Myriad cultural, behavioral, socioeconomic, and health-related factors impact

the HIV/AIDS epidemic among Hispanics/Latinos (Espinoza, Hall, Selik & Hu,

2008; Loue, 2006). Structural factors, such as access to health care (Rajabiun et al.,

2008), homelessness (Reyes et al., 2005), migration patterns (Deren, Shedlin, Decena,

& Mino, 2005) and poverty (Nyamathi & Vasquez, 1995), and mental health

risk factors such as childhood sexual abuse (Arreola, Neilands, Pollack, , &

Catania, 2005) can increase risk for HIV infection among Hispanics/Latinos. Recent

reports also highlight the increasing HIV prevention needs of Hispanics/Latinos who

reside in areas in the United States that are currently experiencing rapid growth of

Hispanic populations (Latino Commission on AIDS, 2008; Painter, 2008)…

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Summary of Comments and Recommendations from the CDC Consultation on the HIV/AIDS Epidemic and Prevention in the Hispanic/Latino Community

E. Alvarez | Priya Jakhmola | M. Painter | Julio Dicent Taillepierre | Raúl A. Romaguera | H. Herbst | J. Wolitski

Office of the Director and Capacity Building Branch, Division of HIV/AIDS Prevention, NCHHSTP, CDC, 1600 Clifton Road NE, Mailstop E-40, Atlanta, GA, 30333; e-mail: malvarez@...

PDF http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.7

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 7-18

Abstract

In April 2008, the U.S. Centers for Disease Control and Prevention (CDC) hosted a national consultation meeting of academic researchers, public health officials, service providers, and community leaders to examine the HIV/AIDS epidemic and prevention needs of Hispanics/Latinos in the United States and its territories. The consultation engaged key stakeholders to review available information on HIV-related behavioral research and prevention efforts, describe gaps in current HIV prevention programs and research on Hispanics/Latinos, and identify community and societal-level factors that can increase vulnerability of Hispanics/Latinos for acquiring or transmitting HIV infection. Recommendations were also made to CDC for future collaboration with the Hispanic/Latino community in areas of HIV prevention research and prevention programs. This article summarizes participants' recommendations for HIV prevention research, program and capacity building, policy and planning, and partnerships and communication. These recommendations will be used by CDC to inform the development of a National Plan of Action for HIV/AIDS prevention among Hispanics/Latinos, and can provide a framework for use by other federal and non-federal agencies, academic researchers, community-based organizations, and policymakers as they seek to curtail the HIV epidemic among Hispanics/Latinos.

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Part One: Surveillance and Epidemiology

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Increases in HIV Diagnoses at the U.S.–Mexico Border, 2003–2006

Espinoza | H. Irene Hall | Xiaohong Hu

DDS, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd., Mailstop E-47, Atlanta, GA, 30333; e-mail LEspinoza@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 19-33

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.19

Abstract

The population at the U.S.-Mexico border has experienced growth, more than double the U.S. national average. Movements of populations in this region have contributed to increased incidence of certain infectious diseases. We used information on persons diagnosed with HIV during 2003 to 2006 and aged 13 years or older (n = 4,279) reported to the Centers for Disease Control and Prevention for 45 U.S. border counties. We estimated the annual percent change and rates with Poisson regression. Overall, 47% of persons diagnosed with HIV in the border region were Hispanic; 39% nonHispanic white; and 10% nonHispanic black. During 2003 to 2006, HIV diagnoses increased 7.8% per year. Increases were observed among males, particularly among men who have sex with men. Among females, HIV diagnoses remained stable but decreased among females in nonborder regions. The number of HIV diagnoses at the border has increased. To decrease incidence of HIV disease it is necessary to develop prevention and education programs specific to this region.

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Methamphetamine and Cocaine Use among Mexican Migrants in California: The California-Mexico Epidemiological Surveillance Pilot

María Hernández, A. , Ayala, Magis-Rodríguez, D. Ruiz, C. , Bart K. Aoki, Alvaro H. Garza, F. Lemp1

Applied Community Research and Evaluation, Public Health Practice, School of Public Health, University of California, Berkeley, 141 University Hall, Berkeley, CA 94720-7360; e-mail: maria.hernandez@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 34-44

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.34

Abstract

Methamphetamine and cocaine use have been associated with a vulnerability to HIV infection among men who have sex with men and among men who have sex with women but not specifically among Mexican migrants in the United States. The California-Mexico Epidemiological Surveillance Pilot was a venue-based targeted survey of male and female Mexican migrants living in rural and urban areas in California. Among men (n = 985), the percentage of methamphetamine/cocaine use in the past year was 21% overall, 20% in male work venues, 19% in community venues, and 25% in high-risk behavior venues. Among women, 17% reported methamphetamine/cocaine use in high-risk behavior venues. Among men, methamphetamine/cocaine use was significantly associated with age less than 35 years, having multiple sex partners, depressive symptoms, alcohol use, sexually transmitted infections (including HIV), and higher acculturation. Prevention interventions in this population should be targeted to specific migrant sites and should address alcohol, methamphetamine, and cocaine use in the context of underlying psychosocial and environmental factors.

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Part Two: Socio-ecological Determinants of HIV Risk

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Drug Use and Hispanic Men Who Have Sex with Men in South Florida: Implications for Intervention Development

M. Isabel Fernández, Robin J. s, C. Warren, Jesus , G. Bowen1

Public Health and Preventive Medicine, Nova Southeastern University, College of Osteopathic Medicine, 4th Floor Terry Bldg., 3200 S. University Dr., Fort Lauderdale, FL 33314; e-mail: mariafer@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 45-60

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.45

Abstract

Despite continued high HIV risk among Hispanic men who have sex with men (HMSM), culturally tailored, theoretically based interventions have yet to be developed and tested. As a first step toward intervention development, we collected quantitative and qualitative data on sociocultural and psychological factors associated with drug use and risky sex among 566 HMSM recruited from community and Internet venues. Participants reported high rates of drug use (43%), unprotected anal sex (45%), and multiple sex partners (median 4) in the past 6 months. In multivariate analyses, use of drugs was associated with HIV seropositivity, less orientation to the Hispanic community, stronger attachment to the gay community, lower levels of homophobia, higher numbers of sex partners and more unprotected anal sex. The need for acceptance and desire to please partners emerged as core drivers of HIV risk in the qualitative data. Findings were used to guide development of Proyecto SOL, a theoretically grounded intervention that targets core determinants of HIV risk, builds on protective cultural influences, and strengthens positive social connections.

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Familial and Cultural Influences on Sexual Risk Behaviors among Mexican, Puerto Rican, and Dominican Youth

Guilamo-Ramos, Alida Bouris, Jaccard, Lesesne, Ballan

Associate Professor, School of Social Work, Columbia University, 1255 Amsterdam Ave., New York, NY 10027; email: rg650@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 61-79

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.61

Abstract

The present study examined the relationship among acculturation, familismo, and HIV-related adolescent sexual risk behavior. Data were collected from Latino mother-adolescent dyads to permit parent and adolescent analyses of familismo for predicting oral, vaginal, and anal sexual behaviors. A random sample of 702 Latino eighth-grade students and their mothers was recruited from New York City. The sample included Mexicans (n = 203), Puerto Ricans (n = 239), and Dominicans (n = 260). Acculturation was unrelated to sexual behavior, but adolescent familismo was related to girls' but not boys' sexual behavior. The most important facet of familismo was subjugation to the family, which was negatively associated with girls' sexual behavior. The implications for HIV prevention programs for Latino youth are discussed.

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Condom Attitudes, Perceived Vulnerability, and Sexual Risk Behaviors of Young Latino Male Urban Street Gang Members: Implications for HIV Prevention

A. , Sung-Jae Lee, N. Stover, W. Barkley Jr.2

UCLA Center for Community Health, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024; e-mail: rbrooks@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 80-87

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.80

Abstract

We examined condom attitudes, perceived vulnerability to HIV, HIV testing experiences, and sexual and substance use risk behaviors of 161 active Latino male gang members, aged 18–26 years old, living in Los Angeles, California. Gang members reported negative condom attitudes and a perceived vulnerability to HIV. The majority (53%) of gang members reported unprotected vaginal intercourse (UVI) in the previous 12 months. Multivariate analyses indicated that participants who engaged in the following behaviors were more likely to report UVI: had sex with someone they just met (adjusted odds ratio [AOR] = 3.66), received money or drugs for sex (AOR = 5.05), or had sex with someone who had a sexually transmitted disease (AOR = 4.99). Participants with a higher perceived vulnerability to HIV were less likely to report UVI (AOR = 0.82). Our findings offer implications for development of an HIV prevention intervention for Latino male gang members.

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Part Three: Behavioral Interventions

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Parental Protectiveness and Unprotected Sexual Activity among Latino Adolescent Mothers and Fathers

Janna Lesser, Deborah Koniak-, Rong Huang, Sumiko Takayanagi, G. Cumberland5

University of Texas Health Science Center at San , 7703 Floyd Curl Dr., Mail Code 7951, San , TX 78229-3900, e-mail: Lesser@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 88-102

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.88

Abstract

Latino pregnant and parenting adolescents living in inner cities are one of the populations at risk for acquiring HIV. Although teen parenthood has been predominantly looked at with a focus on potential adverse physical, emotional, and socioeconomic outcomes for the mother and child; a growing body of literature has documented the strengths and resiliency of young parents. Respeto/Proteger: Respecting and Protecting Our Relationships is a culturally rooted couple-focused and asset-based HIV prevention program developed for young Latino parents. In this program, parental protectiveness (defined as the parent-child emotional attachment that positively influences parental behavior) is viewed as an intrinsic and developing critical factor that supports resiliency and motivates behavioral change. The primary purpose of this article is to describe the longitudinal randomized study evaluating the effect of this intervention on unprotected vaginal sex 6 months post intervention and to determine whether parental protectiveness had a moderating effect on the intervention. The unique features of our database allow for examination of both individual and couple outcomes.

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Outcomes From a Community-Based, Participatory Lay Health Adviser HIV/STD Prevention Intervention for Recently Arrived Immigrant Latino Men in Rural North Carolina

Author(s): D. , C. Hergenrather, Fred R. Bloom, Jami S. Leichliter, Montaño4

Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157-1063; e-mail: srhodes@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 103-108

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.103

Abstract

Latinos in the United States are at increased risk for HIV and sexually transmitted disease (STD) infection. We evaluated the efficacy of a pilot lay health adviser (LHA) intervention designed to increase condom use and HIV testing among Latino men. Fifteen LHAs (mean age = 35.6; range 23–60 years) from 15 Latino soccer teams were trained and worked with their teammates for 18 months. Another 15 teams served as the control group. Data were collected at baseline and at 18 months post-LHA training from a random sample of teammates from intervention and control teams. Data were collected from 222 men (mean age = 29 years) who participated in one of the 30 teams. Relative to the control condition, participants in the intervention reported more consistent condom use in the 30 days preceding follow-up (unadjusted analysis, intervention, 65.6% vs. control, 41.3%; p < .001). Participants in the intervention were more likely to report condom use (adjusted odds ratio [AOR] = 2.3; confidence interval [CI = 1.2–4.3) and HIV testing (AOR = 2.5; CI = 1.5–4.3). LHA interventions for Latino men that are developed in partnership with community members, rely on male-centered intrapersonal networks, and are culturally congruent can enhance preventive behaviors and may reduce HIV infection.

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A Quasi-Experimental Evaluation of a Community-Based HIV Prevention Intervention for Mexican American Female Adolescents: The Shero's Program

W. Harper, Audrey K. Bangi, Bernadette , Mimi Doll, Ana Pedraza4

Department of Psychology, De University, 2219 N. Kenmore Ave., Rm. 420, Chicago, IL 60614; e-mail: gharper@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 109-123

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.109

Abstract

This article describes a quasi-experimental evaluation of a community-based, culturally and ecologically tailored HIV prevention intervention for Mexican American female adolescents grounded in the AIDS risk reduction model. A total of 378 Mexican American female adolescents (mean age = 15.2) participated in either the nine-session SHERO's (a female-gendered version of the word hero) intervention or a single session information-only HIV prevention intervention. Assessment data were collected at pretest, posttest, and 2-month follow up. Significant improvements across all time points were revealed on measures of self-esteem, condom attitudes, beliefs regarding a woman's control of her sexuality, beliefs regarding sexual assault, perceived peer norms, and HIV/AIDS and STI knowledge. At posttest SHERO's participants were more likely to carry condoms and to report abstaining from vaginal sex in the previous 2 months; and at 2-month follow up they reported using condoms more often in the preceding 2 months and planned on using them more frequently in the coming 2 months. Findings support the development of community-based adolescent HIV prevention interventions that address culturally specific ecological factors.

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Hombres Sanos: Exposure and Response to a Social Marketing HIV Prevention Campaign Targeting Heterosexually Identified Latino Men Who Have Sex with Men and Women

Ana P. Martínez-Donate, A. Zellner, Araceli Fernández-Cerdeño, Sañudo, Melbourne F. Hovell, Carol L. Sipan, Moshe Engelberg, Ming Ji

Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin–Madison, 610 Walnut St., 605 WARF, Madison, WI 53726-2397; e-mail: martinezdona@...

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 124-136

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.124

Abstract

This study examined the reach and impact of a social marketing intervention to reduce HIV risk among heterosexually identified (HI) Latino men who have sex with men and women (MSMW). Repeated cross-sectional intercept surveys were conducted in selected community venues during and after the campaign with 1,137 HI Latino men. Of them, 6% were classified as HI Latino MSMW. On average, 85.9% of the heterosexual respondents and 86.8% of the HI MSMW subsample reported exposure to the campaign. Responses to the campaign included having made an appointment for a male health exam that included HIV testing and using condoms. Campaign exposure was significantly associated with HIV testing behavior and intentions and with knowledge of where to get tested. The campaign reached its underserved target audience and stimulated preventive behaviors. Social marketing represents a promising approach for HIV prevention among HI Latinos, in general, and HI Latino MSMW, in particular.

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Part Four: Capacity Building

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The Change Approach to Capacity-Building Assistance

Miriam Y. Vega

Director of Research and Evaluation, Latino Commission on AIDS, 24 W. 25th St., 9th floor, New York, NY 10010; e-mail: mvega@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 137-151

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.137

Abstract

The CHANGE approach to capacity-building assistance (CBA), developed over 4 years by the Latino Commission on AIDS Manos Unidas' Program to assist Latino-serving community-based HIV prevention programs in eight northern U.S. states, Puerto Rico, and the U.S. Virgin Islands, is a system for providing community-based organizations (CBOs) with not only the skills to implement interventions from the Centers for Disease Control and Prevention's Diffusion of Effective Behavioral Interventions (DEBI) project, but also the capacity to reorient to the disruptive innovation of the DEBIs. The CHANGE (customized, holistic, analytical, network-building, grassroots, evaluatory) approach entails an integrated CBA-model emphasizing community and programmatic diagnosis and reflection and the enhancement of staff skills through tailored curricula in six areas: community-assessment, target-refinement, recruitment and retention, basic skills, program implementation, and evaluation. The CHANGE model encourages active CBO participation in the learning process rooted in the experiences of the organization as a member of its community. http://www.atypon-link.com/GPI/doi/abs/10.1521/aeap.2009.21.5_supp.137

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Diffusion of Effective Behavioral Interventions and Hispanic/Latino Populations

JoAna M. Stallworth | Jonny F. Andía | Rashad Burgess | E. Alvarez |

Capacity Building Branch, Division of HIV/AIDS Prevention, NCHHSTP, 1600 Clifton Road NE, Mailstop E-40, Atlanta, GA 30333; e-mail: jstallworth@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 152-163

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.152

Abstract

The national HIV/AIDS prevention program, the Diffusion of Effective Behavioral Interventions (DEBI), is described in the context of addressing Hispanics/Latinos at risk for HIV/AIDS in the United States and Puerto Rico. The eight-step DEBI model is referenced in terms of the interventions and Division of HIV/AIDS Prevention/Capacity Building Branch (DHAP/CBB) Latino Diffusion Team activities. A summary of activities and examples addressing diffusion needs for the diverse Hispanic/Latino populations is discussed. Challenges and successes in diffusion and partner collaborations are also presented, with comment on future directions such as translations and trainings to serve the needs of the Hispanic/Latino-serving community-based organizations and their communities. http://www.atypon-link.com/GPI/doi/abs/10.1521/aeap.2009.21.5_supp.152

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The Implementation of a Culturally based HIV Sexual Risk Reduction Program for Latino Youth in a Denver Area High School

Trisha E. Mueller, Charlene Angel Castaneda, Sainer, Donna ez, H. Herbst, Aisha L. Wilkes, Antonia M. Villarruel

Division of Reproductive Health, Centers for Disease Control and Prevention, 4770 Buford Hwy. MS K-22, Atlanta, GA 30341; e-mail: tmueller@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 164-170

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.164

Abstract

In the United States, Latino youth experience disproportionately higher rates of teen pregnancy and sexually transmitted infections (STIs) than non-Latino Whites. As a result, organizations serving Latino youth seek culturally appropriate evidence-based prevention programs that promote sexual abstinence and condom use. ¡Cuídate! is an efficacious HIV sexual risk reduction program for Latino youth aged 13–18. The program incorporates cultural beliefs that are common among Latino youth and associated with sexual risk behavior, and uses these beliefs to frame abstinence and condom use as culturally accepted and effective ways to prevent unintended pregnancy and STIs, including HIV/AIDS. ¡Cuídate! has been successfully delivered in community agencies and after-school programs but has not been integrated into an existing school curriculum. This brief case study describes efforts to implement ¡Cuídate! in a predominantly Latino urban high school in Denver. Ninety-three youth participated in the program from October 2007 to May 2008. ¡Cuídate! was adapted to accommodate the typical class period by delivering program content over a larger number of sessions and extending the total amount of time of the program to allow for additional activities. Major challenges of program implementation included student recruitment and the “opt in” policy for participation. Despite these challenges, ¡Cuídate! was implemented with minor adaptations in a school setting. http://www.atypon-link.com/GPI/doi/abs/10.1521/aeap.2009.21.5_supp.164

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From Research to Community-Based Practice—Working with Latino Researchers to Translate and Diffuse a Culturally Relevant Evidence-Based Intervention: The Modelo de Intervención Psicomédica (MIP) Experience

Gisele Pemberton, Jonny Andía, a Robles, , Colón-Cartagena, Pérez Del Pilar, Soto Vega

Behavioral Scientist of the Science Application Team, Capacity Building Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, MS E-40, Atlanta, GA 30333; e-mail: efn4@....

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 171-185

Free

http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.171

Abstract

Efforts to translate, package, and diffuse HIV/AIDS research into practice have gained momentum with the Centers for Disease Control and Prevention's (CDC's) launch of three projects: the Prevention Research Synthesis Project, which identifies evidence-based interventions studies; the Replicating Effective Programs Project, which supports the translation of evidence-based interventions into materials suitable for use in local prevention programs; and the Diffusion of Effective Behavioral Interventions Project, which moves behavioral interventions into full-scale practice across the United States. This article describes the CDC's fast-track process of translation, packaging, and diffusion of an HIV intervention for Hispanic/Latino injection drug users, the Modelo de Intervención Psicomédica conducted by the Diffusion of Effective Behavioral Interventions Project in collaboration with a CBA organization and the original researchers. http://www.atypon-link.com/GPI/doi/abs/10.1521/aeap.2009.21.5_supp.171

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Intro Overview Article by the Editors

INTRODUCTION

JoAna M. Stallworth, H. Herbst, E. Alvarez, Raúl A. Romaguera, Hortensia Amaro, and Hazel D. Dean

INTRODUCTION

AIDS Education & Prevention, Oct. 2009, Vol 21, 5, Supplement 1, p. 3-6

JoAna M. Stallworth, H. Herbst, E. Alvarez, Raúl A. Romaguera, Hortensia Amaro, Hazel D. Dean4

Capacity Building Branch, Division of HIV/AIDS Prevention, NCHHSTP, 1600 Clifton Rd. NE, Mailstop E-40, Atlanta, GA 30333; e-mail: jstallworth@...

No abstract- excerpt below Free http://www.atypon-link.com/GPI/doi/pdfplus/10.1521/aeap.2009.21.5_supp.3

Hispanics/Latinos are the largest, youngest, and fastest growing ethnic minority group in the United States (U.S. Census Bureau, 2008). According to data released by the U.S. Census Bureau (2008), Hispanics numbered 46.7 million persons, or 15%, of the total U.S. population (including Puerto Rico) in 2008 and accounted for nearly half of the nation’s population growth from 2000 to 2007. Individuals who consider themselves to be Hispanic/Latino1 are diverse in terms of country of origin, race, culture, language, and religion. Many Hispanics/Latinos are members of fami­lies that have lived in the United States for many generations while others were born in numerous other countries including Mexico, Cuba, the Dominican Republic, and the countries of Central and South America.

Myriad cultural, behavioral, socioeconomic, and health-related factors impact the HIV/AIDS epidemic among Hispanics/Latinos (Espinoza, Hall, Selik & Hu, 2008; Loue, 2006). Structural factors, such as access to health care (Rajabiun et al., 2008), homelessness (Reyes et al., 2005), migration patterns (Deren, Shedlin, De­cena, & Mino, 2005) and poverty (Nyamathi & Vasquez, 1995), and mental health risk factors such as childhood sexual abuse (Arreola, Neilands, Pollack, , & Catania, 2005) can increase risk for HIV infection among Hispanics/Latinos. Recent reports also highlight the increasing HIV prevention needs of Hispanics/Latinos who reside in areas in the United States that are currently experiencing rapid growth of Hispanic populations (Latino Commission on AIDS, 2008; Painter, 2008).

SPECIAL SUPPLEMENT ON HISPANICS/LATINOS AND HIV/AIDS

The purpose of this supplement is to provide a diverse audience—including aca­demic researchers, health departments, health educators, community-based orga­nizations, governmental agencies and officials, and other members of the HIV pre­vention workforce—with a comprehensive resource to better understand the HIV/ AIDS epidemic among Hispanics/Latinos in the United States. The supplement be­gins with a summary of the proceedings of a community consultation sponsored by the Centers for Disease Control and Prevention (CDC). Alvarez et al. describe how consultation participants examined various facets of the HIV/AIDS epidemic among the U.S. Hispanic/Latino population, including the identification of gaps in current HIV prevention services and research; community and societal-level factors placing Hispanics/Latinos at disproportionate risk for HIV; and ways that CDC and leaders in the Hispanic/Latino community can work together to implement effective HIV prevention activities. The article also includes a set of recommendations gener­ated by consultation participants that CDC can use to inform the development of a national plan of action for HIV/AIDS prevention among Hispanics/Latinos. The remaining articles in this supplement describe the epidemiology of the HIV epidemic among subgroups of Hispanics/Latinos, illustrate structural or socioecologic ante­cedents of HIV risk, report findings from the implementation and evaluation of HIV prevention interventions for Hispanics/Latinos conducted in the United States or Puerto Rico, and describe national efforts to build HIV prevention capacity within Hispanic/Latino communities.

The first part of the supplement includes two articles that describe the HIV epidemic among groups of Hispanic/Latinos. Espinoza et al. use HIV surveillance data reported to the CDC to identify trends in diagnoses of new HIV infections in the four states along the United States and Mexico border. From 2003 to 2006, almost half of the new HIV diagnoses in the region were among Hispanics/Lati­nos, the highest proportion of HIV diagnoses occurred among Hispanic men who have sex with men (MSM), and shorter intervals for progression from HIV to AIDS were found among male and female Hispanics compared with non-Hispanic Whites. These findings document an increased burden of HIV infection in a traditionally poor and medically underserved region. Hernández et al. describe results from the California-Mexico Epidemiological Surveillance Pilot (CMESP). CMESP is a venue-based survey of 1,283 male and female Mexican migrants living in rural and urban areas of California. High rates of methamphetamine and cocaine use were reported by male migrants in several venues. Multivariate analyses indicate that drug use was associated with several psychosocial and environmental factors, including younger age, multiple sex partners, alcohol use, depressive symptoms, and greater accultura­tion to the mainstream U.S. culture.

The second part of the supplement includes three articles describing socio-eco­logic factors associated with HIV-related risk behaviors. Fernández et al. report how socio-cultural and psychological factors experienced by Hispanic MSM are associ­ated with club drug use (e.g., poppers, ecstasy, cocaine and methamphetamine). In addition to sex risk behaviors, significant predictors of drug use include being HIV-positive, being less oriented to Hispanic/Latino culture, having a strong attachment to the gay community, and not experiencing homophobia as a child or adult. Next, Guilamo-Ramos et al. report how Latino cultural beliefs influence HIV-related sex risk behaviors among adolescents in the Entre Familias Study. In a sample of Mexi­can, Puerto Rican and Dominican youth, the cultural value of familismo (or famil­ialism), and more specifically respect for one’s family, was protective of sexual risk behaviors among adolescent females; no significant associations were found among adolescent males. Finally, et al. report on sexual risk and protective factors of Latino male gang members. Multivariate analyses indicated that gang members who had sex with someone they just met, received money or drugs for sex, or had sex with someone with a sexually transmitted disease were more likely to report engaging in unprotected vaginal intercourse. However, gang members with a higher perceived vulnerability to HIV were less likely to report engaging in risky sex. The authors of each of these studies describe how their findings can be used to inform the development of culturally relevant HIV prevention interventions.

The third part of the supplement includes four articles reporting outcomes of HIV behavioral prevention interventions. Lesser et al. report the findings of a couple-focused HIV prevention intervention program for young Latino parents, Respeto/Proteger: Respecting and Protecting Our Relationships. In addition to the intervention significantly reducing unprotected sexual activity for both males and females, the parental protectiveness of the fathers improved intervention efficacy for the mothers. et al. report findings from a pilot HIV/STD prevention intervention study focused on using a lay health adviser for immigrant Latino men known as HoMBReS: Hombres Manteniendo Bienestar y Relaciones Saludables (Men Maintaining Well-Being and Healthy Relationships). Participants in the in­tervention reported significantly greater HIV-related knowledge, rates of condom use self-efficacy, consistent condom use, and HIV testing than control participants. Harper et al. report outcomes for the SHERO’s program, a community-based HIV prevention intervention for Mexican American female adolescents. Relative to par­ticipants in the control group, SHERO participants reported greater intentions for condom use and used condoms more often at follow-up. Martínez-Donate et al. re­port the impact of a social marketing campaign--Hombres Sanos (Healthy Men)--to reduce HIV risk among heterosexually identified Latino men who have sex with men and women. Exposure to the campaign was successful in reaching the target popula­tion, and was associated with significant increases in testing for HIV infection.

The fourth and final part of this supplement includes four articles describing local and national efforts to build HIV prevention capacity within Hispanic/Latino­serving organizations. Vega presents an integrated model of capacity-building assis­tance (CBA) to develop community-based organization programmatic capacity and to enhance staff skills. Stallworth et al. describe the CDC’s national HIV prevention program, Diffusion of Effective Behavioral Interventions (CBA) and diffusion of effective HIV behavioral interventions in regard to Hispanics/Latinos. The article describes successes and challenges experienced by the DEBI project and explains how collaboration with a national network of CBA providers has facilitated the de­velopment of linguistically and culturally appropriate translations of and trainings on evidence-based interventions. Mueller et al. present a case study on how an effica­cious intervention for Hispanic/Latino youth was integrated into an existing school curriculum. Finally, Pemberton et al. describe how a community-based participatory research approach was used to successfully package an efficacious HIV prevention intervention for injection drug users.

Throughout this special supplement, evidence is presented on the diverse needs of Hispanic/Latino populations at risk for HIV. The work presented here is a mere sample of research activities and programs that address the HIV epidemic among Hispanics/Latinos in the United States. The guest editors hope that this supplement will stimulate future HIV/AIDS prevention research and prevention practice among at-risk Hispanic/Latino populations, with particular emphasis on relevant biologi­cal, behavioral, psychological, social and cultural factors.

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