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1.
J Immigr Minor Health ; 24(4): 918-927, 2022 Aug.
Article in English | MEDLINE | ID: mdl-34935087

ABSTRACT

Survivors of domestic violence (DV) and of violence perpetrated by organized gangs (GV) face barriers to legal protection under U.S. asylum law. We abstracted data from 132 affidavits based on forensic medical evaluations of asylum seekers granted legal protection in the U.S. on the basis of DV and/or GV. We described claimants' trauma exposures and resilience factors and used multiple logistic regression to quantify associations with Diagnostic and Statistical Manual-5 (DSM-5) diagnoses and improvement in mental health. People seeking asylum based on DV and/or GV have endured multiple types of trauma with significant impacts on their mental health. New experiences of trauma following migration to the U.S. were common and associated with DSM-5 diagnoses. Conversely, resilience factors were associated with improved mental health. Policies that aim to reduce ongoing trauma in the U.S. and to bolster resilience factors may promote asylee mental health and well-being.


Subject(s)
Domestic Violence , Refugees , Humans , Mental Health , Outcome Assessment, Health Care , Refugees/psychology , Survivors
2.
J Immigr Minor Health ; 23(1): 179-183, 2021 Feb.
Article in English | MEDLINE | ID: mdl-33085030

ABSTRACT

In response to the rapidly rising number of asylum applications, student-run asylum clinics (SRACs) designed to provide pro bono forensic medical evaluations have emerged at medical schools across the United States. Distinct from traditional student-run clinics in the services they provide and in their operational models, SRACs face a unique set of challenges. This study aims to identify the common challenges in building SRACs and to collect insights to inform a structured approach to collaborative problem-solving. This study gathered data from online surveys and semi-structured phone interviews with representative medical student SRAC leaders. 14 clinics participated in the 2017 online survey, 15 clinics in the 2018 online survey, and eight clinics in the 2018-2019 phone interviews. We identified common challenges in five areas: volunteer recruitment, clinic operations, case demand, institutional support, and leadership. SRACs stand to benefit from ongoing extramural collaborations to overcome shared challenges.


Subject(s)
Refugees , Students, Medical , Ambulatory Care Facilities , Humans , Schools, Medical , Surveys and Questionnaires , United States
4.
Glob Public Health ; 14(9): 1221-1240, 2019 09.
Article in English | MEDLINE | ID: mdl-30829113

ABSTRACT

Syndemics theory has been applied to the structurally shaped, biologically facilitated co-occurrence of HIV/AIDS with Neglected Tropical Diseases (NTDs) and with sexually transmitted infections (STIs). The biological and social pathways of interaction between all three ailments have not yet been analysed together. The effects of these diseases are often exacerbated by structural factors including access to care and socioeconomic status. We explore the interrelated biological pathways and structural factors that have further heightened the risk for HIV/AIDS, NTDs, and STIs. Furthermore, we argue women in rural areas are at an increased risk for all three diseases due to biological and social factors including increased distance to quality care and lower reproductive autonomy. This paper integrates the established syndemics of HIV/NTDs and HIV/STIs within the historical and modern contexts of colonisation and neo-colonisation in Nigeria. We explore the effects of colonisation on women's health by evaluating the influence of foreign aid policies, structural programmes, and shifting gender norms. Applying a syndemic approach, juxtaposed by historical contextualisation, offers important implications for the prevention and treatment of HIV/AIDS, STIs, and NTDs. Our analysis suggests a perspective through which to view health of regions with a history of colonisation.


Subject(s)
Eugenics , HIV Infections/epidemiology , International Cooperation , Neglected Diseases/epidemiology , Sexually Transmitted Diseases/epidemiology , Syndemic , Women's Health , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Adult , Female , HIV Infections/prevention & control , Health Services Accessibility , Humans , Neglected Diseases/prevention & control , Nigeria/epidemiology , Prevalence , Reproductive Health , Rural Population , Sexually Transmitted Diseases/prevention & control
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