El Paso HRSASPNS USMexico Border Health Initiative

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El Paso HRSA/SPNSUS/Mexico Border Health
Initiative
Centro de Salud Familiar La Fe CARE
Center Community Advocacy, Resources, and
Education
University of Texas at El Paso
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Client Demographics

• Gender 85 male
• Ethnicity
• Hispanic 89
• Non-Hispanic 11
• Sexual Orientation
• Gay/lesbian 57
• Heterosexual 30
• Bisexual 9

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Client Demographics

• Median annual household income
• 9,000
• Average time since HIV diagnosis
• 7.1 years
• Average age
• 40 years

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Language Use

• Over 50 of clients communicate with CARE Center
  staff in Spanish
• 21 of clients are monolingual, speaking solely
  Spanish compared with 2 who are monolingual
  English speakers
• 67 report being able to read very well in
  Spanish

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Education
Years
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Employment

• 22 are working full time
• 45.5 were not employed in the past year
• Of those not working, 48 were unemployed due to
  health reasons
• 76.5 of those who are currently unemployed are
  not looking for work
• 22.6 are concerned about losing their current
  benefits if they begin work
• 13 have no income

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Transcultural Nature of CARE Center Clients

• In addition to communicating in both Spanish and
  English, many clients travel frequently between
  Mexico and the U.S.
• The average client crosses the border 47 times
  per year (range 0 to 500 crossings)
• The average client lives in or visits Mexico for
  1.7 months each year (range 0 to 12 months)
• 53 of clients were born in Mexico
• 48 were raised solely in Mexico before the age
  of 16 years

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Self-Reported Presenting Issues
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Self-Reported Substance Use
Frequency
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Depressive Symptomatology
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Most Frequent Axis IV Psychosocial Stressors

• Insufficient Social Support 49
• Severe Poverty 20
• Interpersonal Conflict 10
• Recent Job Loss 7
• Recent Health Status Changes 6
• Illness of Significant Other 6
• Underemployment 5

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• Implications of Working With Border-Hispanic
  Populations
• Legal/bureaucratic impediments in preventing
  treating disease
• which does not observe borders
• Poverty low education levels cause ignorance
  about anatomy
• importance of adherence to medical
  regimens
• Myths about mental health issues and/or treatment
• Shame-based secrecy re homosexuality and HIV/AIDS

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• Cultural injunctions against assertiveness in
  women
• Cultural fear of authority figures
• Fluid border and mobility of clients
• Patients at lowest level of Maslows Hierarchy