Exploring a peer-led strategy to link recent Latino immigrants to HIV testing

描述(由申请人提供)：探索将最近的拉美裔移民与艾滋病毒检测联系起来的同行领导战略这项R21申请提出了为期2年的探索性研究，将为设计同行链转介战略提供信息，以吸引最近的拉美裔移民男性(RLIM)参与自愿咨询和检测(VCT)。RLIM往往是健康的，来自低患病率地区的黄金工作年龄。然而，在美国，RLIM迅速采用了高风险的做法，并受到艾滋病毒的不成比例的影响。RLIM对艾滋病毒的脆弱性被归因于结构性和激励性因素，包括移民身份不确定、缺乏资源、与服务脱节、严重的耻辱以及对艾滋病毒风险的不了解，这些因素也阻碍了RLIM利用场馆和外展艾滋病毒预防工作。虽然传统的艾滋病毒预防方法无法接触到RLIM，但他们与其他RLIM建立了联系，以获取信息和转介，并应对与美国的语言、技能和法律地位相关的障碍。社交网络方法使用这些关联来渗透隐藏的群体，并将他们与服务和研究联系起来。该项目将探索同行链转诊的可行性，将RLIM与VCT联系起来，VCT是预防艾滋病毒的基本工具，也是“检测和治疗”战略的基石。我们还努力找出可以增加这种方法接触风险RLIM的能力的因素，否则他们不会获得VCT。我们将为VCT招募250名RLIM，并采用同行链推荐策略。我们将把它们与在常规VCT程序中测试的125个RLIM进行比较。我们将确定被同行转介的RLIM感染艾滋病毒的风险程度，与服务几乎没有联系，感觉到高水平的耻辱和低艾滋病毒风险，以及拥有风险更高和支持性较低的社交网络。我们将在他们转介同龄人后采访RLIM，以探索最有希望将最不利的RLIM转介到VCT的关系、环境和沟通。调查结果将有助于加强同行链转介战略，使RLIM参与VCT。 与公共卫生相关：最近的拉美裔移民男子(RLIM)在抵达美国后的几年内增加了他们感染艾滋病毒的风险，但仍与自愿咨询和检测服务脱节。在RLIM中增加自愿咨询和检测的战略可以防止他们艾滋病毒风险的进一步增加，并有助于识别感染艾滋病毒的RLIM，而他们并不知道自己的状况，这对个人和公众的健康都有利。

DESCRIPTION (provided by applicant): Exploring a peer-led strategy to link recent Latino immigrants to HIV testing This R21 application proposes 2 years of exploratory research that will inform the design of a peer chain referral strategy to engage recent Latino immigrant men (RLIM) in voluntary counseling and testing (VCT). RLIM tend to arrive in the US healthy and at prime working age from low prevalence areas. However, in the US, RLIM rapidly adopt risky practices and become disproportionally affected by HIV. The vulnerability to HIV among RLIM has been attributed to structural and motivational factors, including uncertain immigration status, lack of resources, disconnection from services, high levels of stigma, and unawareness of HIV risk, factors that also hamper RLIM's access to venue- based and outreach HIV prevention efforts. Whereas RLIM are not reached by traditional HIV prevention approaches, they form associations with other RLIM to obtain information and referrals and cope with barriers associated with language, skills, and legal status in the US. Social networks approaches use these associations to penetrate hidden groups and link them to services and research. This project will explore the feasibility of peer chain referral to link RLIM to VCT, an essential tool to prevent HIV, and the cornerstone of "test and treat" strategies. We also endeavor to identify factors that can increase the ability of this method to reach at risk RLIM who would not otherwise have accessed VCT. We will recruit 250 RLIM for VCT with a peer chain referral strategy. We will compare them with 125 RLIM tested in customary VCT programs. We will identify the degree to which peer-referred RLIM are at risk for HIV, have few connections with services, perceive high levels of stigma and low risk for HIV, and have riskier and less supportive social networks. We will interview RLIM after they referred their peers to explore the relationships, settings and communications that are most promising to refer the most disadvantaged RLIM to VCT. Findings will serve to inform an enhanced peer chain referral strategy to engage RLIM in VCT. PUBLIC HEALTH RELEVANCE: Recent Latino Immigrant Men (RLIM) increase their risk for HIV in the few years after arrival in the US but remain disconnected from voluntary counseling and testing services. Strategies to increase voluntary counseling and testing among RLIM can prevent further increases in their HIV risk and help to identify HIV-infected RLIM unaware of their status, benefiting both the individuals and the health of the public.