La desesperacion: migrant and seasonal farm workers living with HIV/AIDS

The Influence of Online Experiences: The Shaping of Gay Male Identities

Although research has documented that technological advances via online avenues have impacted the way LGBT individuals gain social capital, less is known about how these online experiences influence the coming out processes for gay men. Using a qualitative approach, this study seeks to understand how the online experiences of gay men either enhanced or inhibited the coming out process. Clustered themes revealed four insights: 1. Online experiences catalyzed the coming out process, 2. Early milestones about the realization of homosexuality came largely from online experiences, 3. Pornography was a tool often utilized for sexual knowledge, and 4. Online experiences helped affirm homosexual identity. Generally, data show that online experiences may manifest offline experiences (i.e., meeting up with another individual, talking about their sexual orientation with others), and that technological communication expedites the coming out process.

Sociocultural Determinants of HIV/AIDS Risk and Service Use Among Immigrant Latinos in North Carolina

Latinos in the United States have been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases. Using a community-based participatory research approach to problem identification, the objective of this study is to explore sociocultural determinants of HIV/AIDS risk and service use among immigrant Latino men living with HIV/AIDS in North Carolina. In-depth key-informant interviews with stake-holders ( n = 8) and Latino men living with HIV/AIDS ( n = 10) were conducted. Major themes identified among Latino men living with HIV/AIDS are misconceptions about HIV/AIDS prevention and treatment, intracommunity discrimination against individuals living with HIV, and feared discovery of their undocumented status. Further research is needed to reduce HIV risk and improve access to medical services among Latino men living with HIV/AIDS.

Predictors for Using a HIV Self-Test Among Migrant and Seasonal Farmworkers in North Carolina

Background: Approximately, two million migrant and seasonal farmworkers (MSF) work in the United States annually. Several factors, such as lack of access to healthcare services and health behaviors, contribute to risk of HIV transmission. Relatively few studies have explored MSF knowledge of HIV transmission and testing options. Methods: A 12-question, self-administered survey of farmworkers (n = 178) from 19 migrant camps was conducted. The survey assessed knowledge of factors related to HIV transmission, testing, and intention to use a HIV home-test kit. Results: Participants with knowledge of treatment for HIV (p = 0.03) and that condom use protects against HIV (p = 0.04) were more willing to express intent to use a home test kit than those with less knowledge. Concern among farmworkers that HIV was a very or somewhat serious problem in their community was associated with expressing intent to use a home test kit (OR = 2.3, 95% CI = 0.92–5.5). Respondents with less knowledge were less likely to use a home test kit. Conclusions: MSF were concerned about HIV in their community and would be willing to use to a home test kit. This pilot study provides a basis for additional research related to HIV testing within the MSF community.

HIV and Mexican migrant workers in the United States: a review applying the vulnerable populations conceptual model

Mexican migrant workers residing in the United States are a vulnerable population at high risk for HIV infection. This article critically appraises the published data surrounding HIV prevalence in this vulnerable group, as seen through the lens of the Vulnerable Populations Conceptual Model. This model demonstrates how exposure to risk and resource availability affect health status. The health status of Mexican migrants in the United States is compromised by a number of factors that increase risk of HIV: limited access to health services, multiple sexual partners, low rates of condom use, men having sex with men, and lay injection practices. Migration from Mexico to the United States has increased the prevalence of HIV in rural Mexico, making this an issue of urgent binational concern. This review highlights the implications for further nursing research, practice, and policy.

HEALTH CARE ACCESS AMONG HISPANIC IMMIGRANTS: ¿ALGUIEN ESTÁ ESCUCHANDO? [IS ANYBODY LISTENING?]

This systematic review identified 77 studies to examine patterns and determinants of health care access among Hispanic immigrants (HI) living in the U.S. In spite of major mental and physical care needs, HI and their families are at very high risk of not having access to health care compared with non-immigrant Hispanics and non-Hispanic whites. Noncitizenship status is a major barrier for accessing health care due to program ineligibility and fear of stigma and deportation. Low English proficiency is also an important barrier to health care. Culturally appropriate community outreach programs relying heavily on community health workers, also known as promotoras, have improved health care access and quality. Mexico shares the health care cost for HIs living in bordering states, calling for a binational dialogue. Mixed-methods research is needed to better understand: a) the net influence of acculturation on migrant health; b) the role of informal (e.g., family) vs. formal (e.g. promotoras) social support at facilitating health care access; c) issues related to 'single' male migrant farm workers; d) the "Hispanic mortality paradox"; e) traditional healing and medicine among HI. Comprehensive health and immigration reforms are needed to respect the human right that HIs have to gain access to health care.

Parental liminality: a way of understanding the early experiences of parents who have a very preterm infant

AIM

The aim of this study was to explore the early experiences of parents who have a very preterm infant.

BACKGROUND

Very preterm infants are physiologically ill-prepared for extra-uterine life, but a greater number now survive birth and the postnatal period. The complex needs of the very preterm infant are met in the technological environment of the neonatal intensive care area, separating parents, physically and psychologically from their very preterm infant. Studies exploring the parental experience have identified parental stress; lowly parental status and attachment issues as areas of concern. However, there is little understanding about the early parental experience.

DESIGN

This study used a phenomenological interpretive design.

METHODS

Ethical approval to conduct this study using two study centres was obtained. An interpretive interactionist approach guided this study. Data were collected from three sources: 20 parents of very preterm infants, five senior neonatal nurses and seven neonatal intensive care nurses. Purposive sampling was used for the first and second sources, and data were collected through semi-structured interviews. The third source of data occurred opportunistically through one focus group.

ANALYSIS

Analysis involved constant comparative analysis.

RESULTS

Crisis, uncertainty and powerlessness, properties of liminality framed this early complex parental transition. It is argued that the overarching theme of parental liminality best framed the parental physical, psychological and social experiences.

CONCLUSION

This qualitative interpretive study identified that parents of very preterm infants experienced many crises, uncertainty and powerlessness in their transition to parenthood, making them liminal people.

RELEVANCE TO CLINICAL PRACTICE

Parental liminality provides a means of conceptualising the early experiences of parents of very preterm infants, providing practitioners, at strategic and operational levels, with the means of developing supporting interventions in the early stages of transition for parents of very preterm infants. Such support could mediate parent-infant relationships.

Using theatrical presentations as a means of disseminating knowledge of HIV/AIDS risk factors to migrant farmworkers: an evaluation of the effectiveness of the Infórmate program

Previous research has suggested that Mexican migrant farmworkers are at elevated risk for contracting HIV/AIDS and that they are in need of receiving HIV/AIDS-related education. The present study evaluated the impact of the Infórmate adolescent theater program on HIV/AIDS knowledge and attitudes among farmworker audience members of various ages. Audience members from 7 migrant farmworker camps completed a self-administered questionnaire before and after they observed the Infórmate performance. Paired-samples t-tests and McNemar tests indicated an increase in knowlege in "modes of HIV transmission," "body fluids that can transmit HIV," and items assessing HIV/AIDS "myths." In addition, a greater percentage of farmworkers at posttest reported that they believed that condoms should always be used during sex. The overall findings from this study suggest that theater can be an effective medium for increasing HIV/AIDS-related knowledge among migrant farmworkers. However, it is suggested that, because some farmworkers held false beliefs regarding modes of HIV transmission after viewing the theater program, theater used in combination with other prevention activities may provide for a more comprehensive educational experience.

HIV Health Care Services For Mexican Migrants

This article reviews the literature on HIV/AIDS health care services for Mexican migrants in the United States. Because so little research has been conducted on Mexican migrants per se, we include literature on Latinos/Hispanics in the United States, because some characteristics may be shared. Furthermore, we focus special attention on data from California because it is on the front line of issues regarding health care for Mexican migrants. The types of health care services needed to improve on the quality of care provided to Mexican migrants living with HIV are highlighted, and recommendations are made for future interventions, research, and binational collaborations.

HIV/AIDS knowledge among female migrant farm workers in the midwest

The rate of HIV infection in the migrant farm worker community is 10 times the national average. A survey was conducted of 106 female migrant farm workers in rural Northwest Ohio to assess HIV knowledge. The average participant's age was 28.7 years, 78 spoke Spanish, and 47 had an < or =8th- grade education. Fifty-six women received their information on HIV/AIDS from television. Eighty-seven women identified sexual contact as the major source of HIV transmission and 54 women identified the combination of sex, use of needles, and blood contact as the important routes. Sixty-nine women identified both homosexual and heterosexual intercourse as risk factors. Only 58 women identified perinatal infection as a route of HIV transmission and 59 women knew that treatment was available to prevent perinatal transmission. Although the majority of women had a good general knowledge of HIV transmission, further prevention education on perinatal transmission is needed among this population.

Research agenda for Hispanics in the United States: a nursing perspective

Heterogeneity is perhaps the most salient characteristic that defines Hispanic populations of the United States. Hispanic populations include native-born, migrant, and immigrant peoples with distinctive national origins and regional settlement patterns. This multigenerational migratory and social adjustment process has produced important cultural variations within and among the respective Hispanic ethnic groups. Moreover, the demographic structure of Hispanic populations is also varied and complex. These historical, demographic, and sociocultural features shape the health and disease experience of Hispanics. As expected, respective Hispanic ethnic groups vary in health status and have differing needs for health services. This article provides demographic background, a historical perspective, a synthesis of Hispanic issues identified in major and authoritative government documents, summary on the state-of-the-science for nursing research with Hispanics, and recommendations for future nursing research directions.