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

描述（由申请人提供）：探索一种以同伴为主导的策略，将最近的拉丁裔移民与艾滋病毒检测联系起来。这项R21申请提出了2年的探索性研究，将为同伴链推荐策略的设计提供信息，使最近的拉丁裔移民男性（RLIM）参与自愿咨询和检测（VCT）。从低流行地区来到美国的RLIM往往身体健康，处于最佳工作年龄。然而，在美国，RLIM迅速采取了危险的做法，并不成比例地受到艾滋病毒的影响。RLIM感染艾滋病毒的脆弱性归因于结构性和动机因素，包括不确定的移民身份、缺乏资源、与服务脱节、高度耻辱和对艾滋病毒风险的不认识，这些因素也阻碍了RLIM获得基于场所和外联的艾滋病毒预防工作。虽然传统的艾滋病预防方法无法覆盖到RLIM，但他们与其他RLIM形成联系，以获取信息和转诊，并应对与语言、技能和美国法律地位相关的障碍。社会网络方法利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。该项目将探索将RLIM与VCT相联系的对等链转诊的可行性，VCT是预防艾滋病毒的重要工具，也是“检测和治疗”战略的基石。我们还努力确定可以提高该方法到达危险RLIM的能力的因素，否则这些RLIM将无法使用VCT。我们将以对等链推荐策略为VCT招聘250名RLIM。我们将把它们与常规VCT程序中测试的125个RLIM进行比较。我们将确定同行推荐的RLIM感染艾滋病毒的风险程度，与服务的联系很少，感知到高水平的耻辱和低风险的艾滋病毒，并有更危险和更少的支持社会网络。我们将在RLIM转介同伴后对其进行访谈，探讨最有可能将最弱势的RLIM转介到VCT的关系、环境和沟通。研究结果将有助于提高同行链推荐策略，使RLIM参与VCT。

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.