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1.
J Immigr Minor Health ; 21(5): 1070-1076, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30141023

RESUMO

Female sex workers (FSW) constitute a highly vulnerable population challenged by numerous co-existing, or syndemic, risk factors. FSW also display resilience to these, and some evidence suggests that resilience may be associated with protective factors that improve health outcomes. We conducted in-depth interviews with indirect sex workers (n = 11) and their clients (n = 18). Interviews were coded utilizing an iterative, modified constant comparison method to identify emergent themes. We identified five syndemic risk factors (difficulty finding work due to undocumented status, shame and mental health hardship, lack of social support, alcohol use, and violence) and five resilient factors (rationalizing sex work, identifying as a "decent" woman, fulfilling immigrant goals, reducing alcohol consumption, and creating rules to reduce risk of violence and HIV/STIs). Understanding the syndemic risk factors and resiliency developed by FSW is important to develop tailored, strength-based interventions for HIV/STIs and other risks.


Assuntos
Emigrantes e Imigrantes , Profissionais do Sexo , Sindemia , Adulto , Infecções por HIV/epidemiologia , Hispânico ou Latino/psicologia , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa , Apoio Social , Sexo sem Proteção
2.
Lancet HIV ; 5(10): e597-e604, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29997050

RESUMO

In our work as clinicians, researchers, and immigrant rights advocates, we have noted increased anxiety about the possibility of deportation and disruptions in care among immigrants with HIV. Before the 2016 US elections, patients rarely asked about HIV treatment in their home countries. However, since the increase in anti-immigrant rhetoric and arrests by US Immigration and Customs Enforcement, patients have voiced concerns about the availability of HIV treatment in their home countries much more frequently. Although antiretroviral therapy is available throughout Latin America, access depends on economic, social, and political circumstances. Maintaining uninterrupted continuity of care among immigrants held in detention or deported to their home countries is challenging. In this Viewpoint, we identify periods of particular vulnerability for immigrants during deportation proceedings, from initial detention to deposition in their country of origin. We discuss the effect of enhanced immigration enforcement on the health and wellbeing of HIV-infected immigrants, and on public health. Finally, we also discuss recommendations for clinicians, immigration authorities, and public health institutions in the USA and in receiving countries.


Assuntos
Emigrantes e Imigrantes , Emigração e Imigração/legislação & jurisprudência , Infecções por HIV/terapia , Acessibilidade aos Serviços de Saúde , Continuidade da Assistência ao Paciente , Emigrantes e Imigrantes/legislação & jurisprudência , Feminino , Direitos Humanos , Humanos , América Latina/etnologia , Masculino , Saúde Pública , Estados Unidos
3.
AIDS Educ Prev ; 29(5): 389-400, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29068715

RESUMO

Sexual and gender minority Hispanics/Latinxs (henceforth: Latinxs) continue to be disproportionately impacted by HIV/AIDS in the U.S. Pre-exposure prophylaxis (PrEP) is a biomedical prevention approach which holds significant promise for at risk and vulnerable populations. We discuss barriers and facilitators to uptake of PrEP among sexual and gender minority Latinxs living in the U.S. through an ecosocial lens that takes into account structural, community, and individual contexts. The impact of immigration status on PrEP uptake emerges as a major and recurrent theme that must be understood and addressed by HIV prevention programs aiming to promote an inclusive strategy for sexual and gender minority Latinxs living in the U.S.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Infecções por HIV/psicologia , Hispânico ou Latino , Grupos Minoritários/psicologia , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Baltimore , Emigração e Imigração , Feminino , Identidade de Gênero , Infecções por HIV/etnologia , Hispânico ou Latino/psicologia , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Fatores Sexuais , Comportamento Sexual , Minorias Sexuais e de Gênero/psicologia , Pessoas Transgênero , Populações Vulneráveis
4.
Prog Community Health Partnersh ; 11(1): 13-22, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28603146

RESUMO

BACKGROUND: In 2007 the journal Progress in Community Health Partnerships was launched to advance the field of community-engaged research and the journal's editors engaged in a Delphi process to identify priorities for the journal and field. Ten years later, the increased adoption of community-engaged research continues to improve public health. OBJECTIVES: The purpose of this manuscrip t is to i dentify community-engaged research priorities for the next 10 years. METHODS: The study engaged leaders in community-engaged research using a two-round Delphi process, whereby leaders in the field were asked to identify and then rank order topics in community-engaged research that needed to be prioritized for the next decade. RESULTS: In stage 1, 41 respondents generated 441 priorities across 8 categories (e.g., theory, epidemiology, intervention science) that were collapsed into 90 priority topics, ranging from 8 to 15 per category. In stage 2, 73 respondents ranked five prioritized items for each category. The prioritized items are provided, with the following themes present across all categories: 1) improvements to equity among partners, 2) partnership sustainability, and 3) increased efforts to translate community-engaged research into policy change. CONCLUSIONS: We compare the findings from this Delphi process with the priorities identified in 2007 to reflect on how the field has progressed. It is our hope that community and academic stakeholders will be able to use these priorities as a guide to their community-engaged research in the coming years.


Assuntos
Serviços de Saúde Comunitária/tendências , Redes Comunitárias , Pesquisa Participativa Baseada na Comunidade , Relações Comunidade-Instituição , Publicações Periódicas como Assunto , Comportamento Cooperativo , Técnica Delphi , Difusão de Inovações , Previsões , Pesquisa sobre Serviços de Saúde , Humanos , Objetivos Organizacionais
5.
Ann Rheum Dis ; 76(4): 673-680, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27613807

RESUMO

OBJECTIVE: To identify a core set of domains (outcomes) to be measured in psoriatic arthritis (PsA) clinical trials that represent both patients' and physicians' priorities. METHODS: We conducted (1) a systematic literature review (SLR) of domains assessed in PsA; (2) international focus groups to identify domains important to people with PsA; (3) two international surveys with patients and physicians to prioritise domains; (4) an international face-to-face meeting with patients and physicians using the nominal group technique method to agree on the most important domains; and (5) presentation and votes at the Outcome Measures in Rheumatology (OMERACT) conference in May 2016. All phases were performed in collaboration with patient research partners. RESULTS: We identified 39 unique domains through the SLR (24 domains) and international focus groups (34 domains). 50 patients and 75 physicians rated domain importance. During the March 2016 consensus meeting, 12 patients and 12 physicians agreed on 10 candidate domains. Then, 49 patients and 71 physicians rated these domains' importance. Five were important to >70% of both groups: musculoskeletal disease activity, skin disease activity, structural damage, pain and physical function. Fatigue and participation were important to >70% of patients. Patient global and systemic inflammation were important to >70% of physicians. The updated PsA core domain set endorsed by 90% of OMERACT 2016 participants includes musculoskeletal disease activity, skin disease activity, pain, patient global, physical function, health-related quality of life, fatigue and systemic inflammation. CONCLUSIONS: The updated PsA core domain set incorporates patients' and physicians' priorities and evolving PsA research. Next steps include identifying outcome measures that adequately assess these domains.


Assuntos
Artrite Psoriásica/complicações , Artrite Psoriásica/tratamento farmacológico , Atitude do Pessoal de Saúde , Medidas de Resultados Relatados pelo Paciente , Médicos , Adolescente , Adulto , Idoso , Artrite Psoriásica/fisiopatologia , Ensaios Clínicos como Assunto , Consenso , Fadiga/etiologia , Feminino , Grupos Focais , Nível de Saúde , Humanos , Inflamação/etiologia , Internacionalidade , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Qualidade de Vida , Literatura de Revisão como Assunto , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
6.
Prog Community Health Partnersh ; 10(3): 365-372, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28230544

RESUMO

BACKGROUND: Latinos, particularly immigrant men, are more likely to present late to care for human immunodeficiency virus (HIV) infection. OBJECTIVES: This manuscript describes the development of ¡Sólo Se Vive Una Vez! (¡Vive!) (You Only Live Once), a multilevel (individual and community) intervention aimed at increasing HIV testing. METHODS: A partnership was established between the Baltimore Latino outreach team, a community coalition, designers, and academics. Intervention priorities were identified through a nominal group technique process. Design students then developed intervention material through an iterative process including feedback from the partners and 75 Latino immigrant men who participated in focus group discussions. RESULTS: ¡Vive! is composed of nine motion graphic modules that can be individually tailored and delivered through a tablet or cell phone, and a complementary social marketing campaign to address HIV stigma in the community. CONCLUSIONS: An iterative process with ongoing feedback resulted in intervention components that were engaging and appealing, and reflected the community's experience.


Assuntos
Relações Comunidade-Instituição , Emigrantes e Imigrantes , Infecções por HIV/diagnóstico , Hispânico ou Latino , Adulto , Baltimore , Pesquisa Participativa Baseada na Comunidade , Grupos Focais , Infecções por HIV/etnologia , Humanos , Masculino , Desenvolvimento de Programas , Avaliação de Programas e Projetos de Saúde
7.
Prog Community Health Partnersh ; 9(2): 275-82, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26412768

RESUMO

BACKGROUND: Qualitative research is appearing with increasing frequency in the public health and medical literature. Qualitative research in combination with a community-based participatory research (CBPR) approach can be powerful. However little guidance is available on how to present qualitative research within a CBPR framework for peer-review publications. OBJECTIVES: This article provides a brief overview of how qualitative research can advance CBPR partnerships and outlines practical guidelines for writing for publication about qualitative research within a CBPR framework to (1) guide partners with little experience publishing in peer-reviewed journals and/or (2) facilitate effective preparation of manuscripts grounded in qualitative research for peer-reviewed journals. We provide information regarding the specific benefits of qualitative inquiry in CBPR, tips for organizing the manuscript, questions to consider in preparing the manuscript, common mistakes in the presentation of qualitative research, and examples of peer-reviewed manuscripts presenting qualitative research conducted within a CBPR framework. CONCLUSIONS: Qualitative research approaches have tremendous potential to integrate community and researcher perspectives to inform community health research findings. Effective dissemination of CBPR informed qualitative research findings is crucial to advancing health disparities research.


Assuntos
Pesquisa Participativa Baseada na Comunidade/organização & administração , Disseminação de Informação/métodos , Revisão da Pesquisa por Pares , Pesquisa Qualitativa , Relações Comunidade-Instituição , Comportamento Cooperativo , Humanos , Projetos de Pesquisa , Universidades/organização & administração
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