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Rodriguez E, Boga DJ, Shrader CH, Arroyo-Flores J, Rosas Y, Kanamori M. PROGRESO-II: Developing Culturally Tailored Materials for a Social Network-Based Intervention to Promote HIV Pre-Exposure Prophylaxis Initiation Among Latina Seasonal Farmworkers. AIDS Patient Care STDS 2024; 38:134-143. [PMID: 38471094 PMCID: PMC10951438 DOI: 10.1089/apc.2023.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Latina Seasonal Farmworkers (LSFW) in South Florida are a community affected by human immunodeficiency virus (HIV) due to cultural barriers, stigma, and lack of awareness of pre-exposure prophylaxis (PrEP). Building on the PROGRESO study, this study sought to: (1) develop and pre-test scientifically supported and culturally tailored PrEP materials for PROGRESO and (2) assess the acceptability of these PrEP materials by LSFW who use alcohol and/or drugs. PrEP messages were selected based on a literature review, feedback from experts working on PrEP programs, and recommendations from a four-member scientific expert panel through a two-level Delphi method. A culturally tailored PrEP presentation was developed and presented to sixteen LSFW, who engaged in four focus groups. Materials were modified based on participants' suggestions. Thematic analysis was used to assess the acceptability and usability of these materials in the LSFW community. Participants responded positively to the PrEP messages and understood their importance for Latinx communities. Participants felt empowered and comfortable enough with the information to distribute the messages to partners, children, and friends with the aid of a physical pamphlet or flyer. A strong cultural context of familialismo and confianza was present in comments made by our participants. This study has the potential to increase LSFW's PrEP awareness and initiation. Future studies may implement a hybrid-interview approach, allowing individuals to self-select into a virtual or in-person focus group. Such flexibility may increase participation and discussion by allowing participants to attend in a format they are most comfortable with, as noted by participants in this study.
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Affiliation(s)
- Edda Rodriguez
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Devina J. Boga
- Department of Psychology, College of Arts and Sciences, University of Miami, Miami, Florida, USA
| | - Cho Hee Shrader
- College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | | | - Yesenia Rosas
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Mariano Kanamori
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
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Algarin AB, Shrader CH, Hackworth BT, Ibanez GE. Condom use likelihood within the context of PrEP and TasP among men who have sex with men in Florida: a short report. AIDS Care 2022; 34:294-300. [PMID: 33565330 PMCID: PMC8353001 DOI: 10.1080/09540121.2021.1883515] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Despite the development of targeted interventions for men who have sex with men, this population continues to comprise the majority of new HIV diagnoses. Though condoms are highly efficacious, some sexually active MSM use sero-sorting as a method of HIV prevention. This study aimed to characterize: (1) differences between partner sero-status and condom use likelihood, and (2) demographic, behavioral, and knowledge-related factors influencing condom use likelihood with varying sero-status partners. Using convenience sampling, 150 sexual and gender minority men completed a survey on PrEP and sexual behaviors. The majority of participants identified as racial/ethnic minorities (51.7%), having 4 years of college or more (52.0%), and being HIV-negative (not on PrEP) (68.8%). Our sample reported the lowest average condom use likelihood with a partner on PrEP (2.93 ± 1.39) and the highest average likelihood with an HIV-positive partner (unknown VL) (4.57 ± 0.98). Age, race/ethnicity, education, HIV-status, and HIV and PrEP knowledge were significantly associated with differences in condom use likelihood. Our findings elucidate the complexity of sero-sorting scenarios and decision-making processes in the context of biomedical HIV prevention. These results may provide insight for future condom use and sero-sorting interventions in the context of biomedical HIV prevention.
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Affiliation(s)
- Angel B. Algarin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0507, USA
| | - Cho Hee Shrader
- Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, CRB 1006, Miami, FL 33136, USA
| | | | - Gladys E. Ibanez
- Department of Epidemiology, Florida International University, 11200 SW 8th St. AHC5-505, Miami, FL 33199, USA
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Kanamori MJ, Williams ML, Fujimoto K, Shrader CH, Schneider J, de La Rosa M. A Social Network Analysis of Cooperation and Support in an HIV Service Delivery Network for Young Latino MSM in Miami. J Homosex 2021; 68:887-900. [PMID: 31553688 PMCID: PMC7093249 DOI: 10.1080/00918369.2019.1667160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Purpose: The study aimed to identify HIV prevention, testing, and care services prioritizing young Latino men who have sex with men (MSM) in an HIV service delivery network in Miami-Dade County, Florida, by visually describing structural features and processes of collaboration within and between health and social venues.Methods: The study used cross-sectional data from 40 social and healthcare venues providing goods and services to young Latino MSM. Each venue provided information surrounding HIV-related services provided and collaborations with other venues. Network visualization analyses were performed using UCINET6 and NetDraw2.160.Results: The most commonly used services offered by health and social venues were free condoms and HIV education materials. Collaborations both within and between health and social venues components of the network existed. Not all health and social venues provided services to young Latino MSM.Conclusion: Health venues can reach and incorporate hard to reach populations, such as non-English speaking and undocumented young Latino MSM, to provide HIV-related services using service delivery venue social networks.
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Affiliation(s)
- Mariano J Kanamori
- Department of Public Health Sciences, Division of Prevention Science and Community Health, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Mark L Williams
- Department of Health Policy and Management, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Kayo Fujimoto
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cho Hee Shrader
- Department of Public Health Sciences, Division of Prevention Science and Community Health, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - John Schneider
- University of Chicago Medicine and Biological Sciences Department, University of Chicago Medicine, Chicago, Illinois, USA
| | - Mario de La Rosa
- School of Social Work, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
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Algarin AB, Hee Shrader C, Hackworth BT, Varas-Diaz N, Fennie KP, Sheehan DM, Ibañez GE. Development and Validation of the Community PrEP-Related Stigma Scale (Community-PSS). AIDS Educ Prev 2021; 33:120-128. [PMID: 33821676 PMCID: PMC8054770 DOI: 10.1521/aeap.2021.33.2.120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite increasing availability of pre-exposure prophylaxis (PrEP), HIV prevention efforts have stalled. It is important to study potential barriers to HIV prevention methods, such as pre-exposure prophylaxis stigma. This study aims to develop and validate the Community PrEP-related Stigma Scale (Community-PSS) to address gaps in the literature. Participants were 108 sexual and gender minority men recruited through virtual and community-posted advertisements in Florida. The authors assessed reliability using Cronbach's alpha analysis, determined scale components using principal component analysis, and assessed construct validity based on five a priori hypotheses. The scale had high internal consistency (α = 0.86) and four components (stigma of actions outside of sex, stigma of sexual actions, extreme stigma perceptions, and positive community perception). The Community-PSS was valid, supporting four out of five hypotheses and in the expected directions. The Community-PSS was a valid and reliable tool in the sample and correlates with a previously validated PrEP stigma scale, HIV knowledge, PrEP knowledge, and likelihood of condom use with a partner on PrEP.
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Affiliation(s)
- Angel B Algarin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, California
| | - Cho Hee Shrader
- Department of Public Health Sciences, University of Miami, Miami, Florida
| | | | - Nelson Varas-Diaz
- Department of Global & Sociocultural Studies, Florida International University, Miami, Florida
| | | | - Diana M Sheehan
- Department of Epidemiology, Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), and the FIU Research Center in Minority Institutions (FIU-RCMI), Florida International University, Miami, Florida
| | - Gladys E Ibañez
- Department of Epidemiology, Florida International University, Miami, Florida
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Kanamori M, Shrader CH, De La Rosa M. A Timely Concern: Would Immigration Policies and Enforcement Actions Influence Higher Alcohol Dependence among Latina Seasonal Farmworkers? J Agromedicine 2021; 26:266-272. [PMID: 32238054 PMCID: PMC7530090 DOI: 10.1080/1059924x.2020.1744494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: We report the potential negative health consequences of immigration policies and enforcement actions, such as the increase of at-risk drinking, in the US Latino seasonal farmworker (LSFW) community.Method: Logistic regression analysis was performed using data from 213 female LSFWs over age 18 years.Results: The prevalence of at-risk drinking varied across participants' age groups: 18% for ages 21-29, 14% ages 30-39, 12% ages 40-49, and 32% ages 50 and older. Half of the participants reported being worried/tense, because they had difficulties finding legal services for their immigration status, and 65% reported that they have been questioned about their legal status. Of participants, 55% reported feeling worried/tense, because they were treated badly due to their lack of English; 42% because they have felt unaccepted by others due to their Latino culture; and 44% because they have been discriminated against. Legal and discrimination concerns were associated with at-risk drinking.Discussion: Enactment of new immigration policies and enforcement of existing immigration policies should consider negative public health implications. Novel approaches should be explored to more effectively reach and engage LSFW at-risk of problematic alcohol use or in need of substance use treatment.
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Affiliation(s)
- Mariano Kanamori
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Cho Hee Shrader
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mario De La Rosa
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Vos SR, Shrader CH, Alvarez VC, Meca A, Unger JB, Brown EC, Zeledon I, Soto D, Schwartz SJ. Cultural Stress in the Age of Mass Xenophobia: Perspectives from Latin/o Adolescents. Int J Intercult Relat 2021; 80:217-230. [PMID: 33456095 PMCID: PMC7806182 DOI: 10.1016/j.ijintrel.2020.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
During the last four years, xenophobic rhetoric directed toward Latino immigrants in U.S. media outlets and political forums has greatly increased. Using a general inductive approach, this qualitative study examined the forms of cultural stress, with a focus on discrimination and xenophobia, experienced by Latino adolescents in urban U.S. settings in 2018 and 2019. Six focus groups were conducted in Miami and Los Angeles (three groups per city) with first- and second-generation tenth-grade Latino students (n = 34). The following four themes emerged from the data: perceived discrimination from other Latino subgroups (in-group discrimination), perceived discrimination from non-Latino groups (out-group discrimination), internalization of stressors and discrimination experienced by participants' parents, and the current U.S. political rhetoric surrounding immigration. Understanding cultural stress among Latino adolescents provides valuable insight for future interventions to offset negative health outcomes associated with cultural stress.
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Algarin AB, Shrader CH, Bhatt C, Hackworth BT, Cook RL, Ibañez GE. The Pre-exposure Prophylaxis (PrEP) Continuum of Care and Correlates to Initiation Among HIV-Negative Men Recruited at Miami Gay Pride 2018. J Urban Health 2019; 96:835-844. [PMID: 31165357 PMCID: PMC6904709 DOI: 10.1007/s11524-019-00362-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
While the national HIV infection rate is decreasing, the highest rates of infections continue among men who have sex with men (MSM), particularly minority MSM. It is important to understand attitudes, knowledge, and behaviors surrounding HIV prevention methods, such as pre-exposure prophylaxis (PrEP). In the present study, we created a snapshot of the PrEP continuum of care and identified participant demographic and sources of PrEP awareness factors that were associated with PrEP initiation. Data were collected using anonymous paper-based surveys employing a venue intercept procedure. A total of 188 HIV-negative men completed the survey at Miami Gay Pride 2018. Participants answered questions regarding demographics, PrEP use, and sources of PrEP awareness. The sample was majority Hispanic (55.4%), gay (83.0%), and single (57.7%). The constructed PrEP continuum revealed that a low proportion of those identified as PrEP naïve (n = 143) for HIV infection had PrEP interest (49/143). Moreover, among those who initiated PrEP (n = 45), a high proportion were retained in a PrEP program (37/45), with approximately half achieving medication adherence (25/45). Age group, PrEP knowledge, and source of PrEP awareness were all significantly associated with PrEP initiation. In areas with high HIV infection rates, studies like these offer crucial insight on how public health practitioners should proceed in the goal of decreasing HIV transmission rates. More research is needed to increase PrEP uptake and adherence.
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Affiliation(s)
- Angel B Algarin
- Department of Epidemiology; Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street AHC5, Miami, FL, 33199, USA.
| | - Cho Hee Shrader
- Department of Public Health Sciences, University of Miami, Miami, FL, USA
| | - Chintan Bhatt
- Department of Health Promotion and Disease Prevention; Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | | | - Robert L Cook
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Gladys E Ibañez
- Department of Epidemiology; Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
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