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Populations
of minority races and ethnicities continue to be disproportionately
affected by the HIV epidemic. To reduce the incidence of HIV, CDC
released Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings
in 2006. These new recommendations advise routine HIV screening for
adults, adolescents, and pregnant women in health care settings in the
United States.
In 2003, CDC announced Advancing HIV Prevention.
This initiative comprises 4 strategies: making HIV testing a routine part of
medical care, implementing new models for diagnosing HIV infections outside
medical settings, preventing new infections by working with HIV-infected persons
and their partners, and further decreasing perinatal HIV transmission.
It is important to evaluate the effectiveness of HIV prevention interventions
for the US Hispanic/Latino population. Research shows that HIV prevention
efforts can reduce risk behaviors and increase protective behaviors among
Hispanics/Latinos at risk for HIV infection. One systematic review found that
HIV prevention interventions for Hispanics/Latinos increased the use of condoms
and reduced the number of acts of unprotected sex, the number of sex partners,
the frequency of injection drug use, and the acquisition of STD infections [33].
CDC is engaged in a wide range of activities to decrease the incidence of
HIV/AIDS in Hispanics/Latinos. For example, CDC
- Conducts epidemiologic and behavioral research focused on
Hispanics/Latinos, including
- Brothers y Hermanos, a study of African American and Hispanic/Latino MSM
conducted in Los Angeles, New York, and Philadelphia that aims to identify
and understand risk-promoting and risk-reducing sexual behaviors
- Women’s Study, a study of African American and Hispanic/Latina women in
the southeastern United States that examines relationship, cultural,
psychosocial, and behavioral factors associated with HIV infection
- Supports, through the Minority AIDS Initiative,
efforts to reduce the health disparities experienced in the communities of
minority races and ethnicities at high risk for HIV infection. These funds
are used to address the high-priority HIV prevention needs of such
communities, including funding community-based organizations (CBOs) to
provide services to Hispanics/Latinos.
- Provides effective, scientifically based interventions to organizations
serving Hispanic/Latino populations. The following are examples of
interventions that have been validated for English-speaking populations and
that have been translated or adapted for Hispanic/Latinos.
- VOICES /VOCES (Video Opportunities for Innovative Condom Education & Safer Sex/Video Oportunidades acerca de Condom Educación y Sexo Seguro), a group-level, single-session video-based intervention designed to increase condom use among heterosexual African American and Hispanic/Latino men and women who visit STD clinics.
- Safety Counts, an HIV prevention intervention that includes sructured and unstructured educational activities for out-of-treatment drug users (those who inject and those who ingest by smoking, snorting, inhaling). The intervention is delivered in group and individual settings to reduce high-risk drug use and sexual behaviors.
- Community Peers Reaching Out and Modeling Intervention Strategies (PROMISE), an intervention in which peer advocates (including men who do not identify themselves as gay) help people reduce or eliminate risk factors for HIV infection.
- Partnerships for Health, a brief, medical provider – delivered counseling program for individual men and women living with HIV/AIDS.
- Has translated the following effective interventions for use with
Hispanic/Latino populations:
- Healthy Relationships, a 5-session, small-group intervention that helps people living with HIV/AIDS to develop self-efficacy and skills in disclosing HIV serostatus and negotiating safer sexual behaviors
- Many Men, Many Voices (3MV), a group STD/HIV prevention intervention for gay men of color and men who have sex with other men but do not identify themselves as gay or bisexual
- POL (Popular Opinion Leader), which identifies, enlists, and trains key opinion leaders to encourage safer sexual norms and behaviors within their social networks (adapted for young migrant Hispanic/Latino MSM [34])
- Street Smart, an 8-session HIV/AIDS and STD prevention program for small groups of runaway and homeless youth
- Together Learning Choices (TLC), which focuses on young people (aged 13 – 29) living with HIV/AIDS and is delivered through small-group sessions
- Is adapting other effective behavioral interventions for at-risk Hispanic/Latino populations
- Is packaging additional effective behavioral interventions for Hispanics/Latinos (available for use soon):
- Connect, a 5-session HIV/STD prevention intervention delivered to heterosexual couples or women alone that emphasizes the importance of communication, negotiating safer sex, and problem-solving skills
- ¡Cuídate! a 6-session intervention that presents sexual abstinence and condom use as culturally accepted ways for Latino youth to reduce their risk for STDs, including HIV
- PICUSS (Projecto de Intervención, Cuídado y Utilización de Servicios de Salud), a 6-session intervention in which motivational interviewing strategies are used to engage Latino injection drug users in behavior change
- Is working to strengthen and sustain the capabilities of the HIV prevention workforce to conduct effective and efficient HIV prevention services throughout the United States and US-dependent areas by building the capacity of programs that serve Hispanics/Latinos through partnerships with national, regional, and nongovernmental organizations. These capacity-building activities include 12 federally funded programs in health departments and CBOs that provide culturally appropriate capacity-building assistance.
- In 2006, CDC provided 56 awards to CBOs in the United States and Puerto Rico that focus primarily on Hispanics/Latinos. CDC also provides funding through state, territorial, and local health departments to organizations serving this population. The following are examples of CDC-funded programs focused on Hispanics/Latinos:
- A program in New York that provides multifaceted, integrated prevention
and education programs such as Prevention Education; Wellness Program and
Support Services; and Research, Policy and Development. The Prevention
Education Program promotes increased awareness and knowledge of HIV/AIDS in
Latino communities; addresses the attitudes, beliefs, and behaviors that
place Latinos at risk for HIV infection; and provides individual and couples
risk-reduction counseling. The Wellness Program and Support Services program
seeks to ensure that Latinos affected by HIV/AIDS receive the maximum
benefit from available resources and services and provides emotional support
and empowerment to persons affected by the disease. The Research, Policy and
Development program d ocuments the health-related needs of Latinos in order
to advocate for and guide the development of public health programs and
policies that are responsive to the needs of Latino communities in New York
City and nationwide.
- A program in Puerto Rico that provides
community Education;
community Development,
community health initiatives; individual and family development; and the
National Center for Training, Support, and Technical Assistance. The
community development program includes transitional housing for HIV/AIDS
clients and the development of housing for persons with low-to-moderate
income. The community health initiative provides HIV/AIDS case management,
HIV/AIDS health education and risk-reduction workshops, HIV/AIDS client
support groups, HIV counseling and testing, HIV/AIDS community outreach, and
emergency rental, utility, and food assistance, and HIV treatment education,
and Individual and Family Development
services. The National Center for Training, Support, and Technical Assistance
provides services for capacity building, training, and technical assistance
in the areas of organizational/infrastructure development, program and
curriculum development, and the implementation of HIV prevention
interventions.
- A program in Illinois that seeks to provide culturally competent and
language-appropriate services to the Latino community. The program offers
training, HIV capacity building and technical assistance, and effective
outreach techniques to service providers and administrators, health
departments, planning committees, CBOs, and faith-based organizations. This
program sensitizes providers to the special needs and social conditions that
affect the health of the Latino community.
In addition, CDC provides training for researchers of minority
races/ethnicities through a program called Research Fellowships in HIV
Prevention in Communities of Color. Recognizing the importance of conducting
culturally competent research and programs, CDC established the Minority
HIV/AIDS Research Initiative (MARI) in 2002 to create partnerships between CDC
epidemiologists and researchers who are members of minority races and
ethnicities and who work in communities of color. MARI funds epidemiologic and
preventive studies of HIV in communities of color and encourages the career
development of young investigators. CDC invests $2 million per year in the
program and since 2003 has funded 13 junior investigators at 12 sites across the
country [35].
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