Enhancing HIV testing among Disengaged Immigrants: Contextual and Opportunity Structures

加强脱离移民的艾滋病毒检测：背景和机会结构

• 批准号: 9140959
• 负责人: Jane Jean-Hee Lee
• 金额: $ 4.14万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-06-16 至 2017-06-16
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9140959
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; Area; Attention; Attitude; Behavior; Caring; Classification; Communities; Continuity of Patient Care; Country; Cross-Sectional Studies; Decision Making; Development; Disease; Disease Outcome; Disease Progression; Ecology; Economics; Environment; Face; Future; Generations; Geographic Locations; Goals; Grouping; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Healthcare; Human immunodeficiency virus test; Immigrant; Individual; Infection; Injecting drug user; International; Intervention; Interview; Latino; Link; Los Angeles; Morbidity - disease rate; Motivation; New York City; Nomads; Outcome Study; Participant; Perception; Phase; Population; Populations at Risk; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Preventive service; Research; Research Infrastructure; Research Priority; Resources; Risk; Role; Services; Shapes; Social Network; Social Policies; Social Welfare; Social support; Staging; Structure; Testing; Time; Underinsured; Underserved Population; United States; United States National Institutes of Health; burden of illness; contextual factors; critical period; design; disorder prevention; disorder risk; expectation; health care service; health care service utilization; high risk; men who have sex with men; metropolitan; mortality; neglect; novel; pandemic disease; prevent; programs; psychosocial; public health relevance; response; sex; social; social capital; treatment adherence; uptake

 DESCRIPTION (provided by applicant): Immigrants comprise a growing population in the United States that is disproportionately impacted by HIV but has been historically disengaged from the HIV care continuum. Latinos constitute the largest foreign born population in the country with significant numbers residing in major metropolitan areas like New York City, which comprise HIV "hotspots" where HIV prevalence is high. Latinos are disproportionately impacted by HIV with infection rates more than three times that of Whites. Additionally, Latinos are more likely to get tested later in their disease. Curbing HIV among Latino immigrants is critical to reaching the goals of the National HIV/AIDS Strategy (NHAS), and a better understanding of factors that can influence HIV testing behaviors among this group and increase engagement in care is sorely needed. Recent contextual (social, political, and economic) shifts in the United States represent potentially impactful transitions in the broader healthcare context for immigrants. Specifically, shifts in access to social welfare and health care services may mark an unprecedented occasion where testing and linkage to care have never been more attainable for immigrants in the U.S. The proposed study seeks to understand Latino immigrants' contexts in relation to HIV testing and how they intersect with perceptions of recent macro contextual changes, synergistically expanding HIV testing opportunities and facilitating or preventing HIV testing behaviors. Phase 1 of this R36 involves in-depth interviews with Latino immigrants to obtain perspectives regarding HIV testing, perceptions of the healthcare environment and motivations for immigrants to get tested for HIV. The interviews seek to elicit perspectives on the feasibility and acceptability of targeted HIV prevention strategies for Latino immigrants to become engaged in HIV care. In Phase 2, a cross-sectional survey will be conducted with 300 Latino immigrants to examine associations between the social and resource contexts of Latino immigrants and engagement in HIV testing. Participants' receptivity to obtaining a rapid HIV test will also be assessed. The overall program of research addresses the National Institute of Health's AIDS research priorities to address the HIV pandemic through new strategies for disease prevention and improvement of disease outcomes by studying the continued disparities in HIV infection rates, access to testing and care, and treatment adherence to identify geographical, psychosocial and structural factors that could explain the disparities and suggest opportunities for novel and targeted interventions to reduce them. The primary goal of the study is to inform the future design of targeted interventions for Latino immigrants who reside in U.S. HIV "hotspots" across the country, by explicitly describing the role of broader contextual changes and specific HIV testing opportunities in engagement in the HIV care continuum.

 描述(由申请人提供)：移民构成了美国日益增长的人口，他们受到艾滋病毒的影响不成比例，但历史上一直与艾滋病毒护理连续体脱节。拉美裔人口是该国最大的外国出生人口，其中相当一部分人居住在纽约等主要大都市地区，这些地区包括艾滋病毒流行率较高的艾滋病毒“热点”。拉丁裔受艾滋病毒的影响不成比例，感染率是白人的三倍多。此外，拉美裔更有可能在以后的疾病中接受检测。遏制拉美裔移民中的艾滋病毒对实现国家艾滋病毒/艾滋病战略(NHAS)的目标至关重要，迫切需要更好地了解可能影响这一群体艾滋病毒检测行为的因素，并增加护理参与。美国最近的背景(社会、政治和经济)变化代表着对移民更广泛的医疗背景的潜在影响的转变。具体地说，获得社会福利和医疗保健服务的机会的转变可能标志着一个前所未有的时刻，对美国移民来说，检测和与护理的联系从未像现在这样容易。这项拟议的研究旨在了解拉美裔移民与艾滋病毒检测有关的背景，以及它们如何与最近宏观背景变化的看法相交，协同扩大艾滋病毒检测机会，促进或预防艾滋病毒检测行为。R36的第一阶段涉及对拉丁裔移民的深入采访，以获得关于艾滋病毒检测、对医疗保健环境的看法以及移民接受艾滋病毒检测的动机的观点。访谈旨在就拉美裔移民从事艾滋病毒护理的有针对性的艾滋病毒预防战略的可行性和可接受性提出看法。在第二阶段，将对300名拉美裔移民进行横断面调查，以检查拉美裔移民的社会和资源背景与参与艾滋病毒检测之间的联系。还将评估参与者对获得快速艾滋病毒检测的接受程度。总体研究计划针对国家卫生研究所的艾滋病研究重点，通过研究艾滋病毒感染率、获得检测和护理的机会以及治疗依从性方面的持续差异，通过疾病预防和改善疾病结果的新战略来应对艾滋病毒大流行，以确定可以解释差异的地理、心理社会和结构性因素，并提出新的和有针对性的干预措施来减少差异的机会。这项研究的主要目标是通过明确描述更广泛的背景变化和特定的艾滋病毒检测机会在参与艾滋病毒护理连续体系中的作用，为居住在全国各地的美国艾滋病毒“热点”的拉丁裔移民提供有针对性的干预设计。

项目成果

Complex Patterns Across the Migration Process and Associated HIV Testing and Risk Behaviors among Latino Immigrants.

整个移民过程的复杂模式以及拉丁裔移民中相关的艾滋病毒检测和风险行为。

• DOI: 10.1007/s12529-019-09768-5
• 发表时间: 2019
• 期刊: International journal of behavioral medicine
• 影响因子: 2.7
• 作者: Lee,Jane;Yu,Gary;Zhou,Yuanjin
• 通讯作者: Zhou,Yuanjin