A 20002005 SPNS HIVAIDS PROJECT: A PROFILE OF 1200 PERSONS LIVING WITH HIVAIDS ALONG THE USMEXICO BO

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A 2000-2005 SPNS HIV/AIDS PROJECT A PROFILE OF
1200 PERSONS LIVING WITH HIV/AIDS ALONG THE
US/MEXICO BORDER

• Herman Curiel,María Luisa Zúñiga, Rosana
  Scolari, Alisa M. Olshefsky Yolanda Cantu
• U.S.- Mexico Border Health Association 64rth
  Annual Conference, Monterrey, Nuevo Leon, Mexico,
  May 2, 2006

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Acknowledgements

• U.S. Department of Health and Human Services
  (HRSA), HIV/AIDS Bureau, Special Projects of
  National Significance (SPNS), Grant 5 H97 HA
  00180 03.
• University of Oklahoma, Center for Applied Social
  Research

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Acknowledgements
The U.S.-Mexico Border study partners
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Session objectives

• Purpose of HIV/AIDS Bureau, HRSA
• Ryan White Care Act background
• Ryan White Care Act objectives
• Describe goals of five year initiative
• Describe results five year U.S.-Mexico border
  SPNS study (2000-2004

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HIV/AIDS Bureau, HRSA

• Administers Ryan White Comprehensive AIDS
  Resources Emergency Act ( CARE)
• Mission Improve availability quality of
  HIV/AIDS Care

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Ryan White CARE ACT

• Enacted 1990 improve quality availability
  HIV care to low income individuals families
• Largest HIV specific care program
• Cares for over 533,000 individuals annually

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Ryan White CARE ACT

• Title l Eligible Metropolitan areas (EMAs)
• Title ll States (AIDS drug assistance)
• Title lll Early intervention programs
• Title lV Women, children families
• Part F AIDS Education Training Centers,
• HIV/AIDS Dental Reimbursement,
• SPNS

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Special Projects of National Significance (SPNS)
Goals

• Development of innovative HIV care models with
  potential for local or national recognition
• Require an evaluation component
• Ensure health care access
• Disseminate findings

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Current SPNS Initiatives

• Prevention with positives 2003-2007
• American Indian/Alaska Native 2002-2007
• Peer support for Caribbean's in U.S. 2003-2007
• Integrating Buprenorphine with HIV care 2004-2009
• Targeted HIV outreach intervention 2001-2006
• Young MSM of Color 2004-2009

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Goals of 2000-2005 SPNS HIV/AIDS Border Project

• increase early detection of HIV positives
• identify cross-cutting service care strategies
• increase access to comprehensive HIV/AIDS care
• identify perceived barriers to care
• enhance capacity of community migrant health
  care centers to provide care for persons living
  with HIV/AIDS
• evaluate care outcomes
• disseminate findings

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Focus Select findings

• demographic characteristics
• 1200 volunteer participants
• collective five site participants
• Years 2001-2005

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Methodology

• quantitative study
• interviewer administered questionnaire
• twenty-four close ended questions
• Spanish or English versions
• anonymous record
• available at http www.ou.edu/border

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Results Race/Ethnicity Sexual Orientation
(N1200)

• 970 (81) Mexican origin/Hispanic
• 194 (16) White non-Hispanic
• 29 (2) African American non-Hispanic
• 7 (-1) American Indian/Alaska Native, Asian,
  Pacific Islander or Other
• 712 (60) sexual orientation gay, lesbian or
  bisexual

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Results by Gender, Age Ethnicity N 1200
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Exposure Modes By Gender Ethnicity (N 1200)
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HIV/AIDS Current Status Years with disease
Prior to SPNS (N1200)
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Marital Employment Status (N1200)
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Income source by ethnicity (N1200)
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Miles Traveled to Program Site
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Border Crossings Use of Traditional
Medications (N1200)
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Summary of findings

• Majority (81) Hispanic or Mexican origin
• Majority, males, age 30-39 (42)
• Most participants single (56)
• MSM primary source exposure (69)
• IDU small percentage, males (7) females (11)
• Primary exposure for Hispanic females (84)
  heterosexual
• Majority report HIV positive or unknown (72),
  27 AIDS diagnosis
• Majority unemployed (60)

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Summary findings Continued

• Most Hispanic participants travel short distances
  for care
• Thirty percent report 37 or more annual crossing
  to Mexico
• Majority (84) do not report using alternative
  medications such as herbs etc.

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Limitations

• Limitations of descriptive research
• Sample limited to SPNS project volunteer
  participants
• Limitations of non-random sample
• Limitation of instruments
• Limitations of program outcome research
• Missing information

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Limitations continued

• Language translations
• Some questions were not clear
• Findings are only attributable to sample of 1200
  participants
• Non-Hispanic participants included where sites
  had difficulty identifying Hispanic participants

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Recommendations

• Researchers working with Hispanic populations
  need to be sensitive to culture language
  issues
• Further research to correct problems identified
  in this study
• Include interviewer training that addresses
  potential ethnic or sexual orientation bias

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For more information

• For more detailed description of findings, see
  upcoming special issue, Vol 5, 2 of Journal of
  HIV/AIDS and Social Services
• For more information on U.S.-Mexico Border
  Initiative, visit http//hab.hrsa.gov/special/bord
  er_index.htm and http//www.ou.edu/border/

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Primary Reference Source

• Marguerite S. Keesee, Kimberly A. Shinault,
  Hélène Carabin,Ahmad Saleem G. Ahmad, Kermyt G.
  Anderson, Timothy R. Brittingham, Lynda M.
  Williams, Nancy K. Sonleitner, Adan Cajina, Robyn
  Schulhof, Herman Curiel, Morris W. Foster.
  (2006). Socio-demographic characteristics of
  HIV/AIDS individuals living receiving care
  along the U.S.-Mexico border through five SPNS
  demonstration projects. Journal of HIV/AIDS
  Social Services. 5, 2.

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Special thanks gracias a ustedes y conference
committee

• U.S. Mexico Health Association
• Herman Curiel, Mari Zuniga, Rosana Scolari, Alisa
  M. Olshefsky y Yolanda Cantu