Behavioral Social and Cultural Determinants of HIV Risk in Hispanic Women

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The overallaims of the study are to identify and better understandthe epidemiologic,psychosocial, cultural, structural and behavioral factors associated with HIV/STD transmission and infection among culturally diverse high-risk Hispanicwomen in Miami. Our goals include:!) establishing an outreach program to enroll participants at high risk for HIV infection, 2) assessing social, cultural and environmental factors associated with risk behaviors; 3) evaluatingand monitoringthe impact of HIV counseling,testing, and referral on risk behaviors; 4) linking participants to appropriate medical, preventive and psychosocial support services in thecommunity. Among the Southeastern United States, Miami-Dade County has one of the highest and most diverse Spanish speaking populations:of 2.3 million, 61% are Hispanic. Fifty percent of the general population is foreign born (77% born in Latin America). In 2003, Florida ranked first in the US for prevalence of HIV cases among women. In 2004, Miami-Dadeaccountedfor 13,903 HIV cases, of which 34% were Hispanic. The prevalence of HIV in Miami-Dade was over 30 per 100,000 in 2004. Using targetedsampling,we will recruit 500 high risk Hispanic women representative of the various Hispanic subgroups (e.g., Cuban, Mexican, Puerto Rican, Carribean, Central and South American) in South Florida and identify factorsassociatedwith HIV/STD infection and transmission.We will assess environmental (poverty, access to care, social support and domestic violence) and individual factors (culture, self efficacy, communication,sexual barrier acceptability,and alcohol and drug use) as facilitatorsor impediments to risk reduction. In collaboration with the other grantees associated with this cooperative agreement and the CDC, sharing of informationand strategieswill facilitate the developmentof both common and site-specific assessments to better understand the underlying factors associated with high-risk behaviors. Along with our partner CBO, Care Resource, we will collect qualitative data through focusgroups and interviews with Hispanic health professionals, community leaders and recipients of community services, in an effort to achieve the ultimate goal of establishing strong links between HIV+ and high risk Hispanic women and social, medical, and mental health resources in the community.