HIV Risk Knowledge among Hispanic Adults in a U.S. – Mexico Border Community: Opportunities for Sexual Health Promotion and Education

Background and Purpose: Hispanics experience a disproportionate burden of chronic disease, including HIV/AIDS. Community-level data regarding HIV risk and transmission are vital to effectively respond to health disparities in unique, high-risk populations. This study described HIV risk behavior knowledge among Hispanics in El Paso, Texas, in order to contribute to culturally and linguistically appropriate services for clinical and community settings in this U.S.-Mexico border community. Specifically, this project highlights misconceptions and gaps in HIV risk knowledge in two Mexican-American adult samples: (1) 103 men recruited primarily through agencies providing HIV-related medical and social services, and (2) 98 women recruited primarily through events hosted at a local community center. Methods: Data were gathered through structured interviews with participants as part of a larger study of HIV risk factors. Results: Less than 20% of men and 5% of women answered all 12 knowledge items correctly. Conclusion: This study builds on previous research identifying gaps in HIV knowledge by prioritizing two different at-risk populations in a U.S.- Mexico border community, where sociodemographic factors such as poverty, stigma, and limited access to healthcare services may contribute to increased HIV risk

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Development and evaluation of a personalized normative feedback intervention for Hispanic youth at high risk of smoking

Despite reductions in overall smoking rates, data show that adolescents continue to smoke at higher rates than adults and that adolescents living in the Texas–Mexico border area are more likely than their counterparts living elsewhere in Texas to smoke. While adult smoking in the Paso del Norte Region has decreased significantly over the past decade, area youth smoking rates exceed both state and national averages. Recent estimates report cigarette smoking among El Paso youth in the past month to be slightly more than 28% as compared with 21% among Texas youth participating in the 2009 statewide Youth Risk Behavior Survey and 19% among U.S. youth in the same survey. Sociodemographic factors such as income, low community educational attainment, ethnicity, and social context have been shown to contribute to smoking initiation and prevalence among adolescents. In addition to prioritizing groups that may be at high risk of smoking, the CDC\u27s Best Practices for Tobacco Control Programs (2007) suggests several strategies to help eliminate tobacco-related health disparities nationwide. These include identifying populations with disparities related to smoking, partnering to enhance intervention reach and resources, and developing and implementing culturally relevant approaches to smoking prevention and cessation. Accordingly, the purpose of this research project was to develop and evaluate an innovative intervention for youth who may be at high risk of smoking because of sociodemographic factors. Specifically, the research examined whether existing behavioral technology that has been used successfully to reduce alcohol consumption in youth and adults, Personalized Normative Feedback (PNF), can be adapted to similarly affect smoking behavior. PNF refers to a brief intervention process that includes assessment of individual use patterns and direct comparisons of such behaviors to normative data. In the current project, PNF techniques were featured in a brief intervention program that prioritized smoking and non-smoking youth who may be at high risk for continued or future smoking. The primary hypotheses were that participants receiving the PNF intervention would report decreased susceptibility to smoking, lowered estimates of descriptive norms favoring smoking (social norms), and increased negative attitudes towards smoking relative to baseline and in comparison with participants exposed to a nutrition program similar in format and duration but that did not address smoking in any way. Results indicated that although intervention participants reported decreased susceptibility and lowered social norms relative to controls, these changes were not statistically reliable. Regarding changes in attitudes, participants in both groups reported increases in negative attitudes towards smoking which were statistically reliable, and were highest among youth who reported current smoking. Significant differences in smoking prevalence, norms, attitudes, and susceptibility were found by study site and by smoking status, suggesting the need for tailored prevention intervention approaches at the community level. Implications for future research and prevention intervention programs are discussed, as are limitations and strengths of the use of PNF to reduce smoking susceptibility among youth who may be at high risk of smoking because of contextual and sociodemographic factors

A Comparison of Sexual Relationships Among Hispanic Men by Sexual Orientation: Implications for HIV/STI Prevention

Hispanic men experience high rates of HIV infection and other sexually transmitted infections (STIs) when compared to non-Hispanic whites. Many factors contribute to HIV/STI risk among Hispanic men. Some researchers have suggested that primary relationships may be a source of HIV/STIs because some men engage in sexual relationships outside of the primary relationship. However, little is known about this among Hispanic men, and less is known about how sexual relationships differ by sexual orientation. The purpose of this study was twofold: (1) to determine if Hispanic men engage in sexual relationships outside of primary relationships; and (2) to compare sex outside of primary relationships by sexual orientation. Data for this study were obtained from a larger study that investigated health risks of Hispanic men residing in the U.S.–Mexico border community. Participants were recruited from agencies that provided services to Hispanic men. Participants completed a structured interview that included questions about primary relationships and sex outside of primary relationships. The sample consisted of 103 Hispanic men (50 heterosexual, 43 gay, and 10 bisexual Hispanic men), but two participants refused to answer relationship questions, resulting in a sample of 101 Hispanic men. About one-third of the participants (n = 29) reported sex outside of the primary relationship, but no differences were found between the gay/bisexual and heterosexual men, X 2 (2, N = 101) = 9.91, p = .128. More gay/bisexual men reported sex with the primary partner and another person at the same time than heterosexual men, X 2 (2, N = 101) = 13.32, p = .010. More gay/bisexual men reported open relationships when compared to heterosexual men, X 2 (2, N = 101) = 17.23, p = .008, and more gay/bisexual men reported sex outside the primary relationship without the primary partner’s knowledge, X 2 (2, N = 101) = 15.09. p = .020. However, more heterosexual men reported that condoms were not used for sex outside the primary relationship when compared to gay/bisexual men, X 2 (2, N = 101) = 14.01, p = .029. Sex outside of primary relationships presents some implications for HIV/STI prevention among Hispanic men. Because gay/bisexual men experience higher rates of HIV/STI, more attention needs to be focused on all forms of relationships to prevent acquisition of HIV/STIs. Among heterosexual Hispanic men more attention needs to be given to reinforcement of safer sex practices both outside the primary relationship, and within the primary relationship if high risk sex is occurring outside the primary relationship. More research is needed on the reasons for sex outside the primary relationship among Hispanic men, as well as research to promote safer sex practices when sex occurs outside of the primary relationship

Culture and sexuality-related communication as sociocultural precursors of HPV vaccination among mother-daughter dyads of Mexican descent

© 2020 The Authors U.S. Latinas are the second most affected ethnic group by cervical cancer morbidity and mortality. Cervical cancer is caused by high risk Human Papillomavirus (HPV) strains and HPV vaccines are an effective form of primary prevention. Parents are the primary decision makers of vaccination uptake as vaccination is recommended for children between the ages of 11–12. The purpose of our study is to investigate the influence of sociocultural factors particularly salient to U.S. Latinos and their role in facilitating or hindering communication about sexuality and vaccination uptake. We conducted a mixed methods sequential study with Latina mother-daughter dyads of Mexican descent (50% who had vaccinated). Our study was informed by the Information-Motivation-Behavioral Skills (IMB) model of preventive behavior. We assessed the influence of communication about sexuality on uptake and the influence of relationship factors such as familism, mother-daughter connectedness, and children\u27s autonomy and cultural factors such as acculturation and ethnic identity on sexuality-related communication. Our results indicated that mothers who engaged in conversations about birth control methods with their daughters had 5.69 times the odds of having vaccinated their daughters. Our qualitative data indicated that mothers who had vaccinated communicated about sexuality emphasizing that sexuality is a normal part of life, perceived that their child is likely to be sexually active one day, and viewed themselves as a primary source of sexuality-related information compared to mothers who had not vaccinated. Findings highlighted potential sociocultural approaches to motivate open communication about sexuality and adoption of sexual health preventative measures for children

Depression and Co-Occurring Health Determinants of Hispanic Men With HIV Infection in the U.S.-Mexico Border Region: A Pilot Study

HIV infection among Hispanic men is a public health concern. Certain factors have been identified that may contribute to the high rates of HIV infection among Hispanic men such as migration, acculturation, poverty, and depression. These men are at risk for additional co-occurring health issues. Given limited research, few studies have focused specifically on Hispanic men with HIV infection residing in a U.S.-Mexico border community. This pilot study surveyed participants (n = 39) to better understand co-occurrence of health determinants, especially depression among Hispanic men with HIV infections. The study's findings indicate that clinicians need to be aware that certain factors may influence depression among people with Hispanic men with HIV infection. Clinicians also need awareness of the impact of depression on adherence to HIV care and treatment among Hispanic men with HIV infection. More research is needed to explore the relationship of HIV-related stigma, HIV disclosure, social support, and depression among Hispanic men with HIV infections

Health Risk and Protective Factors Among Hispanic Women Living in the U.S.-Mexico Border Region

As the Hispanic population continues to flourish in areas such the U.S.-Mexico border region, more attention needs to be focused on health factors among Hispanics. The purpose of this study was (1) to determine what specific health protective and health risk factors exist among Mexican/Mexican American women residing along the U.S.-Mexico border and (2) to determine the relationship between the protective and risk factors among these women. A sample of Mexican/Mexican American women (N = 98) participated in a structured interview that collected data on familism, Hispanic stress, depression, violence, and sexual risk and demographic variables. Religious factors had the largest influence on the health risk behaviors of alcohol intoxication and drug intoxication (p < .05), while familism influenced only condom use (p = .002) and a lifetime history of intimate partner violence (p = .039). Health care access also influenced the health risks of alcohol intoxication (p = .013), drug intoxication (p = .012), and condom use (p = .019). The study's results provide implications for clinical care and directions for future research

Increasing Our Advocacy Capacity Through HIV Community Mobilization: Perspectives From Emerging and Mid-Career Professionals

© 2016, © 2016 Society for Public Health Education. In this commentary, six public health practitioners and researchers discuss how their participation in the El Paso HIV Community Mobilization effort has contributed to their professional development and increased their collective capacity to advocate for practice and policy improvements that contribute to health equity in general and within the context of HIV prevention. Like previous commentaries in this department that have highlighted the value of the Certified Health Education Specialist credential (http://www.nchec.org/health-education-credentialing) and the importance of gaining experience in policy advocacy, this article is relevant for public health professionals in diverse work settings. The authors hope that their experience will encourage others to participate in community mobilization efforts, and they welcome communication and collaboration with anyone interested in learning more about the HIV Community Mobilization efforts discussed in this commentary

Professional Development through Planning for and/or Participating in and Accreditation/Approval Review

The quality of delivery of health education services is connected to landmark events in the history of health education. Quality assurance is one type of professional development in which practicing health education specialists engage. This article presents the steps of an accreditation/approval process, brief overviews of the major accreditation/approval systems, and the opportunities within the accreditation/approval process for professional development