Background
Conceptual Framework
Description
Methods
Eligible Participants
Data Collection
Measures
Data Analysis
Results
Baseline Demographic Characteristics
Variables | Descriptive statistics (n = 66) |
---|---|
Current age | m = 38.2 (sd = 8.4), range 22–63 |
Preferred Gender Cis Men | 100% (66) |
Education I haven’t gone to school Grade 4 or less Primary and two years of secondary (5th-8th) Third year of secondary and two years of prep (9–11) Grade 12 or GED (or prep exam) Some college, associates or technical degree Bachelors degree | 1.5% (1) 9.1% (6) 33.3% (22) 21.2% (14) 24.2% (16) 9.1% (6) 1.5% (1) |
Marital status single In relationship – living together In relationship – not living together Married | 60.6% (40) 16.7% (11) 13.6% (9) 9.1% (6) |
Income in last 12 months < $600 $600–2900 $3000–5999 $6000–11,490 $11,491–15,282 $15,283–35,999 Don’t know | 21.2% (14) 19.7% (13) 15.2% (10) 10.6% (7) 15.2% (10) 3% (2) 15.2% (10) |
Homelessness/Housing instability in last 6 months never Rarely or only a few times Sometimes Often | 74.2% (49) 13.6% (9) 10.6% (7) 1.5% (1) |
Insurance No Yes Don’t know | 62.1% (41) 33.3% (22) 4.5% (3) |
Sexual attraction only females Mostly males Only males Equally males & females Mostly females | 30.3% (20) 25.8% (17) 24.2% (16) 12.1% (8) 7.6% (5) |
Sexual orientation gay No selection Straight Bisexual Multi (gay and bisexual) Other | 36.4 (24) 24.2% (16) 16.7 (24) 15.2% (10) 1.5% (1) 6.1% (4) |
Transnational Experiences
Variable | Descriptive statistics (n = 66) |
---|---|
Birthplace Mexico | 100% (66) |
Age of first migration (n = 77) | M = 21.1 yrs (SD = 6.2), Range 4–39 |
Travel to Mexico Never Rarely Sometimes Often | 72.7% (48) 18.2% (12) 7.6% (5) 1.5% (1) |
Separations any family/close friend separation One or more parents Extended family Close friend(s) Immediate family (spouse and or children) | 97% (64) 77.3% (51) 57.6% (38) 37.9% (25) 7.6% (5) |
Remittances occasionally Regularly No | 56.1% (37) 24.2% (16) 19.7% (13) |
English language proficiency (6 items, summed and averaged, Cronbach’s α = .97) | M = 2.2 (SD = .8), Range 1–4 (26.2% Well-Very Well) |
Spanish language proficiency (6 items, summed and averaged, Cronbach’s α = .94) | M = 3.8 (SD.4),Range 2.7–4.0 (94% Well-Very Well) |
Premigration economic stressors (6 items, summed and averaged, Cronbach’s α = .76; 1 “nunca”—4 “todo el tiempo”) | M = 2.1 (SD = .7), Range 1–4 |
Never | 7.6% (5) |
At least some economic concerns | 92.4% (61) |
Premigration social stigma (4 items, summed and averaged, Cronbach’s α = .89; 1 “nunca”—4 “todo el tiempo”) | M = 1.7 (SD = .9), Range 1–4 |
Never | 34.8% (23) |
At least some social stigma | 65.2% (43) |
Journey trauma (5 items, summed and averaged, Cronbach’s α = .76; 1 “nunca”—4 “todo el tiempo”) Never Exposed to at least one trauma | M = 1.3 (SD = .5), Range 1–3.2 53% (35) 46.7% (31) |
US housing conditions (2 items, summed and averaged, Cronbach’sα = .79; 1 “nunca”—4 “todo el tiempo”) Never Exposed to at least some poor housing | M = 1.6 (SD = .7), Range 1–4 37.9% (25) 62.1% (41) |
Baseline Clinical Characteristics and Barriers to Care
Variable | Descriptive statistics (n = 66) |
---|---|
Age of diagnosis | M = 35.9 yrs (SD = 9.5), Range 0–59.6 |
Months since diagnosis | M = 33.1 months (SD = 61.2), Range 0–273.8 |
Care continuum status Newly diagnosed Not optimally engaged | 68.2% (45) 31.87% (21) |
Country of transmission US At birth in Mexico Close to time of migration prior to entry into US | 95.5% (63) 1.5% (1) 3% (2) |
Suppression rate at study entry | 9.1% (6) |
OIs prior to study entry | 34.8% (23) |
Syphilis at study entry | 25.8% (17) |
Stage 3 at study entry (n = 39) < 3 months from Dx with CD4 < 350 and/or OI) | 82.1% (32/39) |
Acute care referral to intervention | 50% (33) |
Violence | |
I am currently facing violence and, or abuse that threatens my life | −(0) |
I have some fears about my safety (emotional security, sexual, physical) | 16.7% (11) |
I have experienced abuse or domestic violence in the past | 13.6% (9) |
I have never experienced abuse or domestic violence | 69.7% (46) |
CES-D (Total score across 20 items, Cronbach's α = .90; 0 “Menos de un día”−3 “5–7 dias”) (n = 66) | M = 18.1 (SD = 7.3), Range 9–38 47.1% (40) screened positive (scores of 16 or higher) |
PTSD (Total score across 4 items, Cronbach's α = .80; 0 “Nada”, 1 “Algo”, 2 “Mucho”) 1 (n = 65) | M = .86 (SD = 1.25), Range 0–4 15.5% (13) screened positive |
Alcohol substance abuse concerns (Cage; 4 Y/N items) (n = 65) | M = 1.2 (SD = 1.1), Range 0–4 58.8% (50) screened positive (at least 1 or higher score) |
Drug abuse concerns (Cage; 4 items Y/N) (n = 65) | M = .4 (SD = .9), Range 0–4 23.5% (20) screened positive (at least 1 or higher score) |
Barriers to Care (Total score across 24 items, α = .79, 0 “Nada”, 1 “Algo”, 2 “Mucho”, n = 66) | M = 15.7 (SD = 7.9), Range 2–38 Ave 9.9 barriers endorsed (4.4) 1–21 all but 1 endorsed at least 1 barrier |
Item Description | Nada/not at all | Algo/some what | Mucho/a great deal | Endorsed (somewhat to a great deal) |
---|---|---|---|---|
Pensaba que mi diagnóstico era una sentencia de muerte. (I thought my diagnoses was a death sentence.) | 21.2% (14) | 16.7% (11) | 62.1% (41) | 78.8% (52) |
No estaba listo para aceptar mi diagnóstico. (I was not ready to accept my diagnosis.) | 27.3% (18) | 16.7% (11) | 56.1% (37) | 72.8% (48) |
Sentía que podía sufrir discriminación. (I felt I would suffer discrimination.) | 28.8% (19) | 21.2% (14) | 50% (33) | 71.2% (47) |
Pensaba que podría ser juzgado. (I thought that I would be judged.) | 30.3% (20) | 21.2% (14) | 48.5% (32) | 69.7% (46) |
No me sentía enfermo. (I did not feel sick, n = 64) | 39.1% (25) | 17.2% (11) | 43.8% (28) | 60.9% (39) |
No quería que alguien me viera recibiendo atención en una clínica de VIH. (I did not want anyone to see me getting care from an HIV clinic, n = 65) | 44.6% (29) | 24.6% (16) | 30.8% (20) | 55.4% (36) |
No sabía que existía un tratamiento disponible para mí. (I did not know there was treatment available for me.) | 54.5% (36) | 25.8% (17) | 19.7% (13) | 45.5% (30) |
No pensaba que el médico hablaría mi idioma. (I did not think the doctor would speak my language.) | 54.5% (36) | 22.7% (15) | 22.7% (15) | 45.4% (30) |
Tenía miedo del tratamiento. (I was afraid of treatment.) | 54.5% (36) | 22.7% (15) | 22.7% (15) | 45.4% (30) |
El trayecto a la clínica era muy largo. (The travel time to the clinic was too long.) | 56.1% (36) | 25.8% (17) | 18.2% (12) | 43.9% (29) |
No quería tomar mi medicina. (I did not want to take medication, n = 65) | 60.0% (39) | 18.5% (12) | 21.5% (14) | 40.0% (26) |
Pensaba que no podía conseguir atención médica. (I thought I could not obtain medical attention.) | 62.1% (41) | 15.2% (10) | 22.7% (15) | 37.9% (25) |
No sabía a dónde ir. (I did not know where to go.) | 62.1% (41) | 19.7% (13) | 18.2% (12) | 37.9% (25) |
No tenía seguro médico. (I did not have medical insurance.) | 65.2% (43) | 16.7% (11) | 18.2% (12) | 34.9% (23) |
Prefiero utilizar solo la atención de ER o Emergencia y no involucrarme con un proveedor médico regular. (I prefer to utilize care only in the ER and not involve myself with a regular provider.) | 68.2% (45) | 10.6% (7) | 21.2% (14) | 31.8% (21) |
Pensaba que podía tener problemas legales. (I thought I would have legal problems) | 69.7% (46) | 12.1% (18) | 18.2% (12) | 30.3% (20) |
No podía pagar por mi atención médica. (I could not pay for my medical care.) | 71.2% (47) | 13.6% (9) | 15.2% (10) | 28.8% (19) |
Tengo tendencia a no confiar en los proveedores médicos. (I have a tendency to not trust medical providers.) | 71.2% (47) | 16.7% (11) | 12.1% (8) | 28.8% (19) |
Tenía miedo de lo que mi pareja pudiera hacerme si descubría que estaba recibiendo atención. (I was afraid what my partner would do to me if he or she discovered out I was receiving care.) | 71.2% (47) | 7.6% (5) | 21.2% (14) | 28.8% (19) |
No contaba con medio de transporte. (I had no transportation.) | 72.7% (48) | 18.2% (12) | 9.1% (6) | 27.3% (18) |
Nunca antes había visto a un doctor. (I had never before seen a doctor.) | 72.7% (48) | 12.1% (8) | 15.2% (10) | 27.3% (18) |
No podía obtener permiso en el trabajo. (I could not get time off from work.) | 75.8% (50) | 19.7% (13) | 4.5% (3) | 24.2% (16) |
He tenido experiencias negativas con proveedores médicos en el pasado y me resisto a buscar atención. (I have had negative experiences with medical providers in the past and am reluctant to seek care.) | 77.3% (51) | 18.2% (12) | 4.5% (3) | 22.7% (15) |
No contaba con servicio de cuidado infantil. (I had no child care (daycare, n = 48) | 89.6% (43) | 8.3% (4) | 2.1% (1) | 10.4% (5) |