Perceived Immigration Laws and Infectious Disease Control Measures

超过4400万移民生活在美国，其中近一半(44%)是拉丁裔。从历史上看，美国移民 一直不愿从事公共卫生传染病控制措施等检测、接触 追踪、接种疫苗和及时的医疗护理。然而，公众的合作是必不可少的，如果传染病 控制措施要取得成功，特别是在拉丁裔移民等被边缘化的亚群体中。 越来越多的评论人士注意到了移民法的潜力以及人们对移民法的担忧 来自从事传染病控制措施的移民。这可能尤其适用于 具有移民意义的条件，可能被负面的法律和社会内涵所掩盖。 我们对拉丁裔移民移民问题的研究结果主要与个人层面的公众有关 卫生干预--特别是艾滋病毒检测、药物使用障碍和亲密伴侣服务的使用 暴力--证实了评论员的担忧(1R01MD011573 PI：Galletly)和我们对拉丁裔的初步研究 移民在COVID检测、接触者追踪和治疗方面的法律关切(R01MH091875-S1 PI： 加莱利)强烈建议这种影响也适用于大规模、人口层面的疾病控制努力。 拟议的研究将扩展我们对实际的、重要的是感知的影响的研究， 移民相关法律对拉丁裔移民使用艾滋病毒预防服务的影响 这些关于拉丁裔移民参与人口层面疾病控制工作的能力和意愿 政府导向更加突出。具体地说，我们建议利用最近增加的公众 了解公共卫生疾病控制措施，检查实际和感知的影响 关于拉丁裔移民愿意从事检测、接触者追踪和治疗的移民相关法律 当被诊断为肺结核、丙型肝炎和新冠肺炎时，由公共卫生代表推荐。 我们由研究人员、律师、社区卫生工作者和公共卫生人员组成的跨学科团队 代表们将在这项混合方法、社区参与的研究中进行合作。形成性法律和 定性调查，以确定与移民相关的法律问题的性质、范围和影响，将为 制定一项新移民法涉及对1200名拉丁裔实行管理的措施。 居住在美国两个不同移民环境地区的移民。参与者具有不同的 文件状态、原籍国、在美国停留的时间以及在农村/农业和城市居住的情况 我们将有目的地对设置进行采样，以便进一步分析这些复杂的行为。 确定移民参与疾病控制措施的实际和感知的法律障碍 只有在结果付诸实践的情况下才有用。我们将与公共卫生人员一起探索如何最好地 以支持将研究成果迅速转化为实践。鉴于美国公共卫生部门进行，财政， 或者为几乎所有的传染病控制工作提供建议，它们是实现这一目标的理想渠道。

Over 44 million immigrants live in the US, and nearly half (44%) are Latinx. Historically, US immigrants have been reluctant to engage in public health infectious disease control measures such as testing, contact tracing, vaccination, and prompt medical care. Yet the public's cooperation is essential if infectious disease control measures are to succeed, especially among a marginalized subpopulation such as Latinx immigrants. Increasingly, commentators have noted the potential for immigration laws and concerns to deter immigrants from engaging in communicable disease control measures. This may be especially true for conditions of immigration significance that can be shrouded with negative legal and social connotations. Findings from our studies of Latinx immigrants' immigration concerns related to largely individual-level public health interventions--specifically use of services for HIV testing, substance use disorders and intimate partner violence--confirms commentators' concerns, (1R01MD011573 PI: Galletly) and our preliminary study of Latinx immigrants' legal concerns relevant to COVID testing, contact tracing, and treatment (R01MH091875-S1 PI: Galletly) strongly suggest this influence applies to large scale, population-level disease control efforts as well. The proposed study will extend our research on the influence of actual, and importantly, perceived, immigration-related laws on Latinx immigrants' use of HIV prevention services to examine the influence of these on Latinx immigrants' ability and willingness to engage in population-level disease control efforts where government direction is more prominent. Specifically, we propose to leverage the recent increased public awareness of public health disease control measures to examine the influence of actual and perceived immigration-related laws on Latinx immigrants' willingness to engage in testing, contact tracing, and treatment as recommended by public health representatives when indicated for tuberculosis, hepatitis C, and COVID-19. Our interdisciplinary team of researchers, attorneys, community health workers and public health representatives will collaborate on this mixed-methods, community-engaged study. Formative legal and qualitative inquiry to identify the nature, extent, and influence of immigration-related law concerns will inform the development of a de novo immigration law concerns measure to be administered to 1200 Latinx immigrants living in two US regions with diverse immigration environments. Participants with diverse documentation statuses, countries of origin, time spent in the US, and residence in rural/agricultural and urban settings will be purposively sampled to further inform analysis of these complex behaviors. Identifying actual and perceived legal barriers to immigrants' engagement in disease control measures can only be useful if results are transferred to practice. We will explore, with public health personnel, how best to support the rapid transfer of findings to practice. Given that US public health departments conduct, finance, or advise virtually all communicable disease control efforts, they are an ideal conduit for this.