From Theory to Application: A Description of Transnationalism in Culturally-Appropriate HIV Interventions of Outreach, Access, and Retention Among Latino/a Populations

Abstract

Interventions aiming to improve access to and retention in HIV care are optimized when they are tailored to clients’ needs. This paper describes an initiative of interventions implemented by ten demonstration sites using a transnational framework to tailor services for Mexicans and Puerto Ricans living with HIV. Transnationalism describes how immigrants (and their children) exist in their “receiving” place (e.g., continental U.S.) while simultaneously maintaining connections to their country or place of origin (e.g., Mexico). We describe interventions in terms of the strategies used, the theory informing design and the tailoring, and the integration of transnationalism. We argue how applying the transnational framework may improve the quality and effectiveness of services in response to the initiative’s overall goal, which is to produce innovative, robust, evidence-informed strategies that go beyond traditional tailoring approaches for HIV interventions with Latino/as populations.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. 1.

    McCree DB, Beer L, Prather C, Gant Z, Harris N, Sutton M, Sionean C, Dunbar E, Smith J, Wortley P. An approach to achieving the health equity goals of the National HIV/AIDS Strategy for the United States among racial/ethnic minority communities. Public Health Rep. 2016;131:526–30.

    Article  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Sheehan DM, Mauck DE, Fennie KP, Cyrus EA, Maddox LM, Lieb S, Trepka MJ. Black–White and country of birth disparities in retention in HIV care and viral suppression among Latinos with HIV in Florida, 2015. Int J Environ Res Public Health. 2017;14:120.

    Article  PubMed Central  Google Scholar 

  3. 3.

    Qiang X, Lazar R, Bernard MA, McNamee P, Daskalakis DC, Torian LV, Braunstein SL. New York City achieves the UNAIDS 90-90-90 targets for HIV-infected Whites but not Latinos/Hispanics and Blacks. J Acquir Immune Defic Syndr. 2016;73:e59–e62.

    Article  Google Scholar 

  4. 4.

    Brummer S, Reyes I, Martin ML, Walker LU, Heron SL. Racial/ethnic health care disparities and inequities: historical perspectives. In: Martin ML, Heron SL, Moreno-Walton L, Jones AW, editors. Diversity and inclusion in quality patient care. Cham: Springer International Publishing; 2016. pp. 11–21.

    Google Scholar 

  5. 5.

    CDC. HIV Surveillance Report. 2014; vol. 26. Accessed August 2017 from: http://www.cdc.gov/hiv/library/reports/surveillance/. Published November 2015.

  6. 6.

    CDC. HIV among Hispanics/Latinos. 2017. Accessed August 2017 from: https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/cdc-hiv-latinos-508.pdf.

  7. 7.

    United States. National HIV/AIDS Strategy for the United States: updated to 2020. Washington, D.C.: White House Office of National AIDS Policy.

  8. 8.

    HIV Continuum of Care, U.S., 2014; Overall and by age race, ethnicity. transmission route, and sex. NCHHSTP Newsroom – 2017 Press Releases. July, 27, 2017. Access August, 2017. https://www.cdc.gov/nchhstp/newsroom/2017/HIV-Continuum-of-Care.html.

  9. 9.

    Herbst JH, Kay LS, Passin WF, Lyles CM, Crepaz N, Marin BV. A systematic review and meta-analysis of behavioral interventions to reduce HIV risk behaviors of Hispanics in the United States and Puerto Rico. AIDS Behav. 2007;11(1):25–47.

    Article  PubMed  Google Scholar 

  10. 10.

    Motel S, Patten E. Hispanic origin profiles. Pew Hispanic center. Accessed October, 2016 from: http://www.pewhispanic.org/2012/06/27/country-of-origin-profiles/. Published June, 2012.

  11. 11.

    Taylor P, Lopez MH, Martínez JH, Velasco G. When labels don’t fit: Hispanics and their views of identity. Pew Hispanic center. Accessed October, 2016 from: http://www.pewhispanic.org/2012/04/04/when-labels-dont-fit-hispanics-and-their-views-of-identity/. Published April, 2012.

  12. 12.

    Marín G, Marín BV. Research with Hispanic populations. Newbury Park: Sage.

  13. 13.

    Añez LM, Paris M, Bedregal LE, Davidson L, Grilo CM. Application of cultural constructs in the care of first generation Latino clients in a community mental health setting. J Psychiatr Pract. 2005;11:221–30.

    Article  PubMed  Google Scholar 

  14. 14.

    Caban A, Walker EA. A systematic review of research on cultural relevant issues for Hispanics with diabetes. Diabetes Educ. 2006;32:584–95.

    Article  PubMed  Google Scholar 

  15. 15.

    Marín BV. HIV prevention in the Hispanic community: sex, culture, and empowerment. J Transcult Nurs. 2003;14:186–92.

    Article  PubMed  Google Scholar 

  16. 16.

    Mikawa JK, Morones PA, Gomez A, Case HL, Olsen D, Gonzales-Huss MJ. Cultural practices of Hispanics: Implications for the prevention of AIDS. Hisp J Behav Sci. 1992;14:421–33.

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Abraído-Lanza AF, Viladrich A, Flórez KR, Céspedes A, Aguirre AN, De La Cruz AA. Commentary: fatalismo reconsidered: a cautionary note for health-related research and practice with Latino populations. Ethn Disparities. 2007;17(1):153–8.

    Google Scholar 

  18. 18.

    Keese MS, Natale AP, Curiel HF. HIV positive Hispanic/Latinos who delay HIV care: analysis of multilevel care engagement barriers. Soc Work Health Care. 2012;51:457–78.

    Article  Google Scholar 

  19. 19.

    Gonzales JS, Hendriksen ES, Collins EM, Durán RE, Safren SE. Latinos and HIV/AIDS: examining factors related to disparity and identifying opportunities for psychosocial intervention research. AIDS Behav. 2009;13:582–602.

    Article  Google Scholar 

  20. 20.

    Gómez CA, Marín BV. Gender, culture, and power: barriers to HIV-prevention strategies for women. J Sex Res. 1996;33:355–62.

    Article  Google Scholar 

  21. 21.

    Neff JA, Hoppe SK. Race/ethnicity, acculturation, and psychological distress: fatalism and religiosity as cultural resources. J Community Psychol. 1993;21:3–20.

    Article  Google Scholar 

  22. 22.

    Earnshaw VA, Bogart LM, Dovidio JF, Williams DR. Stigma and racial/ethnic HIV disparities: moving toward resilience. Am Psychol. 2013;68:225–36.

    Article  PubMed  PubMed Central  Google Scholar 

  23. 23.

    Hunt LM, Schneider S, Comer B. Should “acculturation” be a variable in health research? A critical review of research on US Hispanics. Soc Sci Med. 2004;59:973–86.

    Article  PubMed  Google Scholar 

  24. 24.

    Carrillo H. Sexual culture, structure, and change: a transnational framework for studies of Latino/a migration and HIV. In: Organista KC, editor. HIV prevention with latinos: theory, research, and practice. New York: Oxford; 2012. pp. 41–61.

    Google Scholar 

  25. 25.

    Villarruel AM, Jemmot LS, Jemmott JB III. Designing a culturally based intervention to reduce HIV sexual risk for Latino adolescents. J Assoc Nurses AIDS Care. 2005;16:23–31.

    Article  PubMed  Google Scholar 

  26. 26.

    Rhodes SD, McCoy TP, Vissman AT, DiClemente RJ, Duck S, Hergenrather KC, Long Foley K, Alonzo J, Bloom FR, Eng E. A randomized controlled trial of a culturally congruent intervention to increase condom use and HIV testing among heterosexually active immigrant Latino men. AIDS Behav. 2011;15:1764–75.

    Article  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Grieb SD, Flores-Miller A, Page K. ¡Sólo Se Vive Una Vez! (You Only Live Once): a pilot evaluation of individually tailored video modules aiming to increase HIV testing among foreign-born Latino men. J Acquir Immune Defic Syndr. 2017;74:S104–S112.

    Article  PubMed Central  Google Scholar 

  28. 28.

    Organista KC, Carillo H, Ayala G. HIV prevention with Mexican migrants: review, critique and recommendations. J Acquir Immune Defic Syndr. 2004;37:S227–S239.

    Article  PubMed  Google Scholar 

  29. 29.

    Schiller NG, Basch L, Blanc-Szanton C. Towards a definition of transnationalism: introductory remarks and research questions. Ann N Y Acad Sci. 1992;645:ix-xiv.

    PubMed  Google Scholar 

  30. 30.

    Smith R. Mexican New York: transnational lives of new immigrants. Berkeley: University of California Press; 2006.

    Google Scholar 

  31. 31.

    Vertovec S. Transnationalism and identity. J Ethn Migr Stud. 2001;27:573–82.

    Article  Google Scholar 

  32. 32.

    Concannon K, Lomelí FA, Priewe M. Imagined transnationalism: U.S. Latino/a literature, culture, and identity. New York: Palgrave MacMillian; 2009.

    Google Scholar 

  33. 33.

    Levitt P, Jaworsky N. Transnationalism migration studies: past developments and future trends. Annu Rev Sociol. 2007;33:129–56.

    Article  Google Scholar 

  34. 34.

    Levitt P. The transnational villagers. Berkeley: University of California Press; 2001.

    Google Scholar 

  35. 35.

    Waldinger R: Between here and there: How attached are Latino immigrants to their native country? Pew Hispanic center. Accessed October, 2016 from: http://www.pewhispanic.org/2007/10/25/between-here-and-there-how-attached-are-latino-immigrants-to-their-native-country/. Published October, 2007.

  36. 36.

    Vertovec S. Cheap calls: the social glue of migrant transnationalism. Glob Netw. 2004;4:219–24.

    Article  Google Scholar 

  37. 37.

    Remittances to Latin America grow, but Mexico bucks the trend faced with the US slowdown. The World Bank—Who We Are – News. Published October 8, 2013. From http://www.worldbank.org/en/news/feature/2013/10/04/remesas-latinoamerica-crecimiento-mexico-caida.

  38. 38.

    Vega WA, Rodriguez MA, Gruskin E. Health disparities in the Latino population. Epidemiol Rev. 2009;31:99–112.

    Article  PubMed  PubMed Central  Google Scholar 

  39. 39.

    Levitt P. Social remittances: migration driven local-level forms of cultural diffusion. Int Migr Rev. 1998;32:926–48.

    Article  CAS  PubMed  Google Scholar 

  40. 40.

    Alcántara C, Chen C, Alegría M. Transnational ties and past-year major depressive episodes among Latino immigrants. Cultur Divers Ethnic Minor Psychol. 2015;21:486–95.

    Article  PubMed  Google Scholar 

  41. 41.

    Murphy EJ, Mahalingam R. Transnational ties and mental health of Caribbean immigrants. J Immigr Minor Health. 2004;6(4):167–78.

    Article  Google Scholar 

  42. 42.

    Deren S, Kang S, Colón HM, Andia JF, Robles RR, Oliver-Velez D, Finlinson A. Migration and HIV risk behaviors: Puerto rican drug injectors in New York City and Puerto Rico. Am J Public Health. 2003;93:812–6.

    Article  PubMed  PubMed Central  Google Scholar 

  43. 43.

    Kessing KL, Norredam M, Kvernrod A, Mygind A, Kristiansen M. Contexualising migrants’ health behavior—a qualitative study of transnational ties and their implications for participation in mammography screening. BMC Public Health. 2013;13:431.

    Article  Google Scholar 

  44. 44.

    Zhou YR, Coleman WD, Huang Y, Sinding C, Wei W, Gahagan J, Micollier E, Su HH. Exploring the intersections of transnationalism, sexuality, and HIV risk. Cult Health Sex. 2017;645–52.

  45. 45.

    Villa-Torres L, González-Vázquez T, Fleming PJ, González- González EL, Infante-Xibille C, Chavez R, Barrington C. Transnationalism and health: a systematic review on the use of transnationalism in the study of health practices and behaviors of migrants. Soc Sci Med. 2017;183:70–9.

    Article  PubMed  Google Scholar 

  46. 46.

    Health Resources and Service Administration (HRSA). Performance measure Portfolio – core measures. Accessed November, 2017 from: https://hab.hrsa.gov/clinical-quality-management/performance-measure-portfolio.

  47. 47.

    Wilson BDM, Miller RL. Examining strategies for culturally grounded HIV prevention: a review. AIDS Educ Prev. 2003;15:184–202.

    Article  PubMed  Google Scholar 

  48. 48.

    Marín G. AIDS prevention among Hispanics: needs, risk behaviors, and cultural values. Public Health Rep. 1989;104:411–5.

    PubMed  PubMed Central  Google Scholar 

  49. 49.

    McKleroy VS, Galbraith JS, Cummings B, et al. Adapting evidence–based behavioral interventions for new settings and target populations. AIDS Educ Prev. 2006;18:59–73.

    Article  PubMed  Google Scholar 

  50. 50.

    Bowen DJ, Kreuter M, Spring B. How we design feasibility studies. AM J Prevent Med. 2009;36:452–7.

    Article  Google Scholar 

  51. 51.

    Rivera JO, Ortiz M, Gonzalez-Stuart A, Hughes H. Bi-national evaluation of herbal product use on the United States/Mexico border. J Herb Pharmacother. 2007;7:91–103.

    Article  PubMed  Google Scholar 

  52. 52.

    Gelberg L, Andersen RM, Leake BD. The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people. Health Serv Res. 2000;34:1273–302.

    CAS  PubMed  PubMed Central  Google Scholar 

  53. 53.

    Griner D, Smith TB. Culturally adapted mental health interventions: a meta-analytic review. Psychother: Theory Res Pract Train. 2006;34:531–48.

    Article  Google Scholar 

  54. 54.

    Crepaz N, Tang T, Marks G, et al. Durable viral suppression and transmission risk potential among persons with diagnosed HIV infection: United States, 2012–2013. Clin Infect Dis. 2016;63:967–83.

    Article  Google Scholar 

  55. 55.

    Salgado de Synder VN, de Jesus Diaz-Perez M, Maldonado M, Bautista EM. Pathways to mental health services among inhabitants of a Mexican village. Health Soc Work. 1998;23:250–61.

    Google Scholar 

  56. 56.

    Koehn PH, Swick HM. Medical education for a changing world: moving beyond cultural competence into transnational competence. Acad Med. 2006;81:548–56.

    Article  PubMed  Google Scholar 

  57. 57.

    Sears KP. Improving cultural competence education: the utility of an intersectional framework. Med Educ. 2012;46:545–51.

    Article  Google Scholar 

  58. 58.

    Koehn PH. Health-care outcomes in ethno-culturally discordant medical encounters: the role of physician transnational competence in consultation with asylum seekers. J Immigr Minor Health. 2006;8:137–47.

    Article  PubMed  Google Scholar 

  59. 59.

    Gardner L, Metsch LR, Anderson-Mahoney P, et al. Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care. AIDS. 2005;19:423–31.

    Article  PubMed  Google Scholar 

  60. 60.

    Rodriguez-Diaz CE. Maria in Puerto Rico: natural disasters in a colonial archipelago. Am J Public Health. 2018;1:30–2.

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Contributions

Author contributions to the study and the manuscript following the criteria set forth by International Committee of Medical Journal Editors: JAS and RAB shared first-author responsibilities. Both contributed to the design of four of the interventions that are described in this multisite initiative as research liaisons (i.e., provided technical assistance in the acquisition of data and application of theory). Additionally, both directed the content and writing of all manuscript sections. JX was the project officer of the funding agency that proposed the concept behind this multisite initiative (along with the 8th author), and contributed to the writing of the introduction. AM was also a research liaison that contributed to the design of two of the site’s interventions that are described in this study, and contributed to the writing of the introduction and discussion sections. LGG was the project coordinator for this multisite initiative and organized the acquisition of all data collected, as well as contributing to the writing of sections describing the demonstration sites in this manuscript. She provided substantial intellectual contributions through her writing and revisions to the co-authors. SZ-H was also a research liaison that contributed to the design of two of the site’s interventions that are described in this study, and contributed to the writing of sections that described the application of theory to each intervention. CERD was a consultant on this project and contributed the design of the interventions that focused on recruitment and retention of participants Puerto Rican participants. He made substantial intellectual contributions to the overall manuscript through revisions and edits. AC is the Branch Chief of the funding agency that originally proposed the concept behind this multisite initiative (along with the third author). He contributing to the writing of the introduction and discussion sections of the manuscript. JM is the principal investigator of the grant that supported this manuscript and director of the UCSF Evaluation and Technical Assistance Center, which supervised all research liaisons that are listed as co-authors on this manuscript. As senior author, she made substantial intellectual contributions through writing, editing and providing feedback on each section of the manuscript.

Corresponding author

Correspondence to John A. Sauceda.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Appendix

Appendix

figurea
figureb

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Sauceda, J.A., Brooks, R.A., Xavier, J. et al. From Theory to Application: A Description of Transnationalism in Culturally-Appropriate HIV Interventions of Outreach, Access, and Retention Among Latino/a Populations. J Immigrant Minority Health 21, 332–345 (2019). https://doi.org/10.1007/s10903-018-0753-2

Download citation

Keywords

  • HIV
  • Latino
  • Transnationalism
  • Health disparities
  • Implementation science
  • Health service