Listening to immigrant latino men in rural Oregon: exploring connections between culture and sexual and reproductive health services.

This study explored factors that affect access to and use of sexual and reproductive health services including family planning among immigrant Latino men residing in rural Oregon communities that have experienced a high growth in their Latino population. In-depth interviews were conducted with 49 sexually active men aged 18 to 30 years who recently immigrated to the United States. Findings from content analysis identified multiple overlapping individual-level barriers, including lack of knowledge, perception of personal risk for unintended pregnancy and STIs, and fear of disease. On a service delivery level, structural factors and the importance of confianza when interacting with providers and clinic staff were dominant themes. The majority of these themes were grounded in a cultural context and linked to men's cultural background, beliefs, and experiences. Examining the needs of immigrant Latino men through this cultural lens may be critically important for improving access and use of sexual and reproductive health services.

Immigrant Latino men in rural communities in the Northwest: social environment and HIV/STI risk.

This study explored how migration-related socio-cultural and environmental factors interact to render immigrant Latino men residing in rural Oregon at increased risk for HIV/STI. More specifically, the paper describes the socio-demographic characteristics and sexual risk profile of immigrant Latino men and characterises the physical and socio-cultural contexts in which they reside. In-depth interviews were conducted with 49 men who newly immigrated to the USA and had recently engaged in sexual intercourse with women. Content analysis indicated that job instability and seasonal/industry restrictions resulted in frequent changes in employment and living situations, and one-third of respondents reported having no one to turn to when in need. Over two-fifths had ever had sex with a sex worker, with almost a quarter reporting sex with a sex worker in the past three months. In addition, over half of the men reported that they never, or inconsistently, used condoms. Although respect for wives/girlfriends was valued, loneliness, sexual experimentation and inherent sexual needs were cited as reasons that men have sex outside their primary relationships. Our data support the convergence of risky environments and migration-driven factors in exacerbating STI prevalence and the HIV epidemic among Latino immigrant men residing in the Northwest.

Incentives in smoking cessation: status of the field and implications for research and practice with pregnant smokers.

We review the rationale and empirical evidence for the use of incentive and contingency management strategies for smoking cessation. Plausible theoretical rationales exist for the application of these strategies to smoking cessation, and a great deal of research with illicit drug users in laboratory or controlled treatment settings suggests such strategies can be effective. Contingency management methods have been effective in modifying smoking behavior in volunteers not seeking cessation assistance in highly controlled settings. Incentives have been used primarily as a component of worksite interventions, in community-wide quit-and-win programs, in quasiexperimental and experimental trials, and more recently with low-income pregnant women. Worksite studies have rarely been designed to isolate the impact of incentives. Nevertheless, they appear to be useful in these settings especially in increasing participation and increasing awareness about the deleterious effects of smoking. Quit-and-win programs are used widely in the United States and internationally and appear to attract many participants and produce modest quit rates. The quality of the evaluations of quit-and-win programs varies considerably, and none has employed rigorous control or comparison groups to sufficiently identify the effect of incentives. Recent controlled studies have yielded promising results with pregnant smokers, and larger trials are in progress. We discuss key methodological issues in mounting and evaluating incentive interventions, particularly during pregnancy, and discuss the practical and ethical issues arising from the use of incentives.