Skip to main content
Springer Nature Link
Log in

A Critical Review and Commentary on the Challenges in Engaging HIV-Infected Latinos in the Continuum of HIV Care

  • Substantive Review
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Antiretroviral therapy for treatment of HIV infection has become increasingly effective. Persistent poor HIV outcomes in racial and ethnic minority populations in the US call for a closer examination into why Latinos are at significant risk for acquiring and dying from HIV. To improve clinical outcomes and achieve an AIDS-free generation, HIV research must address disparities in HIV outcomes in Latinos, the largest ethnic/racial minority population in the US. Immigrant status as well as cultural factors influence HIV care utilization and are essential to highlight for effective intervention development in Latinos. A better understanding of these individual and contextual factors is critical to developing tailored approaches to engaging Latinos in HIV care. Based on a comprehensive literature review, we offer a framework for understanding what is needed from clinical practice and research to improve engagement in HIV care for US-based Latinos. These findings may have implications for other minority populations.

Resumen

Mientras la eficacia del tratamiento antirretroviral del VIH aumenta, resultados pobres en minoridades raciales y étnicas en los EEUU requieren una examinación sobre por qué los Latinos tienen un riesgo significativo de adquirir y morir del VIH. Para mejorar resultados clínicos y alcanzar una generación libre del SIDA, investigaciones deben abordar las disparidades en resultados de Latinos con VIH, la minoría étnica/racial más grande de los EEUU. Ser inmigrante más factores culturales influyen en el cuidado de VIH, haciendo imperativo resaltarlos para desarrollar intervenciones eficaces para Latinos. Un mejor entendimiento de factores contextuales e individuales es crítico para crear métodos de engranaje para Latinos en el cuidado de VIH. Basado en una revisión bibliográfica comprensiva, ofrecemos un marco para entender lo requerido de práctica clínica e investigaciones para mejorar la participación en cuidado del VIH de Latinos en los EEUU, lo cual puede implicarse para otras minoridades.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Canada)

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. UNAIDS. Press Release September 25, 2014 Countries ready to fast track response to end the AIDS epidemic by 2030. http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2014/September/20140925_pr_fast_track. Accessed 23 April 2018.

  2. Pew Research Center. Facts on U.S. Latinos, 2016. http://www.pewhispanic.org/2017/09/18/facts-on-u-s-latinos-current-data/. Accessed 23 April 2018.

  3. Prosser AT, Tang T, Hall HI. HIV in persons born outside the United States, 2007–2010. JAMA. 2012;308(6):601–7.

    Article  PubMed  Google Scholar 

  4. Gray KM, Valverde EE, Tang T, Siddiqi AE, Hall HI. Diagnoses and prevalence of HIV infection among Hispanics or Latinos—United States, 2008-2013. MMWR Morb Mortal Wkly Rep. 2015;64(39):1097–103.

    Article  PubMed  Google Scholar 

  5. Sheehan DM, Trepka MJ, Dillon FR. Latinos in the United States on the HIV/AIDS care continuum by birth country/region: a systematic review of the literature. Int J STD AIDS. 2015;26(1):1–12.

    Article  PubMed  Google Scholar 

  6. Espinoza L, Hall HI, Hu X. Diagnoses of HIV infection among Hispanics/Latinos in 40 states and Puerto Rico, 2006–2009. J Acquir Immune Defic Syndr. 2012;60(2):205–13.

    Article  PubMed  Google Scholar 

  7. Espinoza L, Hall HI, Selik RM, Hu XH. Characteristics of HIV infection among Hispanics, United States 2003–2006. JAIDS. 2008;49(1):94–101.

    PubMed  Google Scholar 

  8. Chen NE, Gallant JE, Page KR. A systematic review of HIV/AIDS survival and delayed diagnosis among Hispanics in the United States. J Immigr Minor Health. 2011;14(1):65–81.

    Article  Google Scholar 

  9. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Centers for Disease Control. Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings, 2006. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm. Accessed 23 April 2018.

  10. Dennis AM, Wheeler JB, Valera E, et al. HIV risk behaviors and sociodemographic features of HIV-infected Latinos residing in a new Latino settlement area in the Southeastern United States. AIDS Care. 2013;25(10):1298–307.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Trepka MJ, Fennie KP, Sheehan DM, Lutfi K, Maddox L, Lieb S. Late HIV diagnosis: differences by rural/urban residence, Florida, 2007–2011. AIDS Patient Care STDS. 2014;28(4):188–97.

    Article  PubMed  PubMed Central  Google Scholar 

  12. El-Sadr WM, Gamble TR, Cohen MS. Linkage from HIV testing to care: a positive test often leads nowhere. Sex Transm Dis. 2013;40(1):26–7.

    Article  PubMed  Google Scholar 

  13. Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2014. HIV Surveillance Supplemental Report 2016;21(No. 4). https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-21-4.pdf. Accessed 23 April 2018.

  14. Beer L, Bradley H, Mattson CL, et al. Trends in racial and ethnic disparities in antiretroviral therapy prescription and viral suppression in the United States, 2009-2013. J Acquir Immune Defic Syndr. 2016;73(4):446–53.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. English PB, Kharrazi M, Guendelman S. Pregnancy outcomes and risk factors in Mexican Americans: the effect of language use and mother’s birthplace. Ethn Dis. 1997;7(3):229–40.

    PubMed  CAS  Google Scholar 

  16. Vaca FE, Anderson CL, Hayes-Bautista DE. The Latino adolescent male mortality peak revisited: attribution of homicide and motor vehicle crash death. Inj Prev. 2011;17(2):102–7.

    Article  PubMed  Google Scholar 

  17. Centers for Disease Control and Prevention. HIV Surveillance Report, 2014, vol. 26. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-us.pdf. Accessed 23 April 2018.

  18. Eldred L, Malitz F. Introduction to the supplemental issue on the HRSA SPNS outreach initiative. AIDS Patient Care STDs. 2007;21:S1–2.

    Article  Google Scholar 

  19. HRSA Ryan White and Global HIV/AIDS Programs. SPNS initiative: targeted HIV outreach and intervention models for underserved HIV-positive populations not in care 2001–2006. https://hab.hrsa.gov/about-ryan-white-hivaids-program/spns-outreach-underserved-populations. Accessed 23 April 2018.

  20. Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Understanding the HIV Care Continuum. 2016. http://www.cdc.gov/hiv/pdf/library/factsheets/cdc-hiv-care-continuum.pdf. Accessed 23 April 2018.

  21. Eldred L, Malitz F. Introduction. AIDS Patient Care STDs. 2007;21:S1–2.

    Article  Google Scholar 

  22. Mugavero MJ, Norton WE, Saag MS. Health care system and policy factors influencing engagement in HIV medical care: piecing together the fragments of a fractured health care delivery system. Clin Infect Dis. 2011;52(Suppl 2):S238–46.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Amico KR. A situated-information motivation behavioral skills model of care initiation and maintenance (sIMB-CIM): an IMB model based approach to understanding and intervening in engagement in care for chronic medical conditions. J Health Psychol. 2011;16:1071–81.

    Article  Google Scholar 

  24. Christopoulos KA, Das M, Colfax GN. Linkage and retention in HIV care among men who have sex with men in the United States. Clin Infect Dis. 2011;52(Suppl 2):S214–22.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Mugavero MJ, Amico KR, Horn T, Thompson MA. The state of engagement in HIV care in the United States: from cascade to continuum to control. Clin Infect Dis. 2013;57(8):1164–71.

    Article  PubMed  Google Scholar 

  26. Cohn D, Patten E, Hugo Lopez, M. Puerto Rican population declines on Island, Grows on US Mainland. August 11, 2014. Pew Research Center. http://www.pewhispanic.org/2014/08/11/puerto-rican-population-declines-on-island-grows-on-u-s-mainland/. Accessed 23 April 2018.

  27. Alvarez L. A great migration from Puerto Rico is set to transform Orlando. New York Times. November 17, 2017. U.S. Section. https://www.nytimes.com/2017/11/17/us/puerto-ricans-orlando.html?_r=0. Accessed 23 April 2018. New York Times, US

  28. Gelberg L, Andersen RM, Leake BD. The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people. Health Serv Res. 2000;34(6):1273–302.

    PubMed  PubMed Central  CAS  Google Scholar 

  29. Yang PQ, Hwang SH. Explaining immigrant health service utilization: a theoretical framework. SAGE Open. 2016;6(2):1–15.

    Article  Google Scholar 

  30. Lopez-Quintero C, Shtarkshall R, Neumark YD. Barriers to HIV-testing among Hispanics in the United States: analysis of the National Health Interview Survey, 2000. AIDS Patient Care STDS. 2005;19(10):672–83.

    Article  PubMed  Google Scholar 

  31. Ma M, Malcolm LR. Cultural influences on HIV testing among Latino youth. Cult Health Sex. 2016;18(4):470–80.

    Article  PubMed  Google Scholar 

  32. Levy V, Page-Shafer K, Evans J, et al. HIV-related risk behavior among Hispanic immigrant men in a population-based household survey in low-income neighborhoods of northern California. Sex Transm Dis. 2005;32(8):487–90.

    Article  PubMed  Google Scholar 

  33. Villarruel AM, Jemmott JB 3rd, Jemmott LS, Ronis DL. Predictors of sexual intercourse and condom use intentions among Spanish-dominant Latino youth: a test of the planned behavior theory. Nurs Res. 2004;53(3):172–81.

    Article  PubMed  Google Scholar 

  34. Cianelli R, Villegas N, Lawson S, et al. Unique factors that place older Hispanic women at risk for HIV: intimate partner violence, machismo, and marianismo. J Assoc Nurses AIDS Care. 2013;24(4):341–54.

    Article  PubMed  Google Scholar 

  35. Zambrana RE, Cornelius LJ, Boykin SS, Lopez DS. Latinas and HIV/AIDS risk factors: implications for harm reduction strategies. Am J Public Health. 2004;94(7):1152–8.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Villar-Loubet OM, Vamos S, Jones DL, Lopez E, Weiss SM. A cultural perspective on sexual health: HIV positive and negative monolingual Hispanic women in South Florida. Hisp Health Care Int. 2011;9(2):82–90.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Parra EO, Doran TI, Ivy LM, Aranda JM, Hernandez C. Concerns of pregnant women about bing tested for HIV: a study in a predominately Mexican-American population. AIDS Patient Care STDS. 2001;15(2):83–93.

    Article  PubMed  CAS  Google Scholar 

  38. Joseph HA, Belcher L, O’Donnell L, Fernandez MI, Spikes PS, Flores SA. HIV testing among sexually active Hispanic/Latino MSM in Miami-Dade County and New York City: opportunities for increasing acceptance and frequency of testing. Health Promot Pract. 2014;15(6):867–80.

    Article  PubMed  Google Scholar 

  39. Diaz RM, Ayala G. Love, passion and rebellion: ideologies of HIV risk among Latino gay men in the USA. Cult Health Sex. 1999;1(3):277–93.

    Article  Google Scholar 

  40. Jarama SL, Kennamer JD, Poppen PJ, Hendricks M, Bradford J. Psychosocial, behavioral, and cultural predictors of sexual risk for HIV infection among Latino men who have sex with men. AIDS Behav. 2005;9(4):513–23.

    Article  PubMed  Google Scholar 

  41. Zeglin RJ. Assessing the role of masculinity in the transmission of HIV: a systematic review to inform HIV risk reduction counseling interventions for men who have sex with men. Arch Sex Behav. 2015;44(7):1979–90.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Fleming PJ, DiClemente RJ, Barrington C. Masculinity and HIV: dimensions of masculine norms that contribute to men’s HIV-related sexual behaviors. AIDS Behav. 2016;20(4):788–98.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Zea MC, Reisen CA, del Rio-Gonzalez AM, Bianchi FT, Ramirez-Valles J, Poppen PJ. HIV prevalence and awareness of positive serostatus among men who have sex with men and transgender women in Bogota, Colombia. Am J Public Health. 2015;105(8):1588–95.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Garcia LI, Lechuga J, Zea MC. Testing comprehensive models of disclosure of sexual orientation in HIV-positive Latino men who have sex with men (MSM). AIDS Care. 2012;24(9):1087–91.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Berry JW. Acculturation and adaptation: health consequences of culture contact among circumpolar peoples. Arctic Med Res. 1990;49(3):142–50.

    PubMed  CAS  Google Scholar 

  46. Lescano CM, Brown LK, Raffaelli M, Lima LA. Cultural factors and family-based HIV prevention intervention for Latino youth. J Pediatr Psychol. 2009;34(10):1041–52.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Fernandez MI, Bowen GS, Perrino T, et al. Promoting HIV testing among never-tested Hispanic men: a doctor’s recommendation may suffice. AIDS Behav. 2003;7(3):253–62.

    Article  PubMed  Google Scholar 

  48. Ham DC, Huang Y, Gvetadze R, Peters PJ, Hoover KW. Health Care Use and HIV Testing of males aged 15–39 years in physicians’ offices—United States, 2009–2012. MMWR Morb Mortal Wkly Rep. 2016;65:619–22. https://doi.org/10.15585/mmwr.mm6524a3.

    Article  PubMed  Google Scholar 

  49. Murray K, Oraka E. Racial and ethnic disparities in future testing intentions for HIV: United States, 2007–2010: results from the National Health Interview Survey. AIDS Behav. 2014;18(7):1247–55.

    Article  PubMed  Google Scholar 

  50. Mills CW, Sabharwal CJ, Udeagu CC, et al. Barriers to HIV testing among HIV/AIDS concurrently diagnosed persons in New York City. Sex Transm Dis. 2011;38(8):715–21.

    PubMed  Google Scholar 

  51. Arya M, Patuwo B, Lalani N, et al. Are primary care providers offering HIV testing to patients in a predominantly Hispanic community health center? An exploratory study. AIDS Patient Care STDS. 2012;26(5):256–8.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Johnson CV, Mimiaga MJ, Reisner SL, VanDerwarker R, Mayer KH. Barriers and facilitators to routine HIV testing: perceptions from Massachusetts Community Health Center personnel. AIDS Patient Care STDS. 2011;25(11):647–55.

    Article  PubMed  Google Scholar 

  53. U.S. Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Capacity Building Branch. Implementing HIV testing in nonclinical settings a guide for HIV testing providers. March 2, 2016. https://www.cdc.gov/hiv/pdf/testing/cdc_hiv_implementing_hiv_testing_in_nonclinical_settings.pdf. Accessed 18 May 2018.

  54. Pew Research Center. Hispanics and health care in the United States-Access, information, and knowledge. http://www.pewhispanic.org/2008/08/13/hispanics-and-health-care-in-the-united-states-access-information-and-knowledge/. Accessed 23 April 2018.

  55. Cohen RA, Martinez ME. Health insurance coverage: early release of estimates from the National Health Interview Survey, January–March 2015: Centers for Disease Control and Prevention; August, 2015; 2015.

  56. Zammitti EP, Cohen RA, Martinez ME. Health insurance coverage: early release of estimates from the National Health Interview Survey, January–June 2016. National Center for Health Statistics. November 2016. http://www.cdc.gov/nchs/nhis/releases.htm. Accessed 23 April 2018.

  57. Kaiser Family Foundation. State Medicaid Coverage of Routine HIV Screening. February 25, 2014. http://kff.org/hivaids/fact-sheet/state-medicaid-coverage-of-routine-hiv-screening/. Accessed 23 April 2018.

  58. Ohl ME, Perencevich E. Frequency of human immunodeficiency virus (HIV) testing in urban vs. rural areas of the United States: results from a nationally-representative sample. BMC Public Health. 2011;11:681.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Dolwick Grieb SM, Desir F, Flores-Miller A, Page K. Qualitative assessment of HIV prevention challenges and opportunities among Latino immigrant men in a new receiving city. J Immigr Minor Health. 2015;17(1):118–24.

    Article  PubMed  Google Scholar 

  60. Kaiser Family Foundation. Current status of medicaid expansion decisions, July 7, 2016. http://kff.org/health-reform/slide/current-status-of-the-medicaid-expansion-decision/. Accessed 23 April 2018.

  61. Guerrero EG, Marsh JC, Khachikian T, Amaro H, Vega WA. Disparities in Latino substance use, service use, and treatment: implications for culturally and evidence-based interventions under health care reform. Drug Alcohol Depend. 2013;133(3):805–13.

    Article  PubMed  Google Scholar 

  62. Alegria M, Carson NJ, Goncalves M, Keefe K. Disparities in treatment for substance use disorders and co-occurring disorders for ethnic/racial minority youth. J Am Acad Child Adolesc Psychiatry. 2011;50(1):22–31.

    Article  PubMed  Google Scholar 

  63. Pollack HA, D’Aunno T. HIV testing and counseling in the nation’s outpatient substance abuse treatment system, 1995–2005. J Subst Abuse Treat. 2010;38(4):307–16.

    Article  PubMed  Google Scholar 

  64. Guerrero EG, Cederbaum JA. Adoption and utilization of sexually transmitted infections testing in outpatient substance abuse treatment facilities serving high risk populations in the U.S. Int J Drug Policy. 2011;22(1):41–8.

    Article  PubMed  Google Scholar 

  65. Maruschak LM, Berzofsky M, Unangst J. Medical Problems of State and Federal Prisoners and Jail Inmates, 2011–12. US Department of Justice and Bureau of Justic Statistics. February 2015, Revised October 4, 2016.

  66. Dumont DM, Gjelsvik A, Chen N, Rich JD. Hispanics, incarceration, and TB/HIV screening: a missed opportunity for prevention. J Immigr Minor Health. 2013;15(4):711–7.

    Article  PubMed  Google Scholar 

  67. Rosen DL, Golin CE, Grodensky CA, et al. Opt-out HIV testing in prison: informed and voluntary? AIDS Care. 2015;27(5):545–54.

    Article  PubMed  Google Scholar 

  68. US immigration and customs enforcement. ICE/DRO detention standard: medical care, February 2013. http://www.ice.gov/doclib/dro/detention-standards/doc/medical_care.doc. Accessed 23 April 2018.

  69. National Commission on Correctional Health Care. Position Statement: administrative management of HIV in correctional institutions, 2014. http://www.ncchc.org/administrative-management-of-hiv-in-correctional-institutions. Accessed 23 April 2018.

  70. Lehman JS, Carr MH, Nichol AJ, et al. Prevalence and public health implications of state laws that criminalize potential HIV exposure in the United States. AIDS Behav. 2014;18(6):997–1006.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Massachusetts Department of Public Health. Bureau of Infectious Disease. United States Travel Ban Lifted for People Living with HIV. February 2010. http://www.mass.gov/eohhs/docs/dph/aids/hiv-travel-ban-repeal.pdf. Accessed 23 April 2018.

  72. Fabi R, Saloner B. Covering undocumented immigrants—state innovation in California. N Engl J Med. 2016;375:1913–5.

    Article  PubMed  Google Scholar 

  73. Bhatia R, Hartman C, Kallen MA, Graham J, Giordano TP. Persons newly diagnosed with HIV infection are at high risk for depression and poor linkage to care: results from the Steps Study. AIDS Behav. 2011;15(6):1161–70.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Rajabiun S, Rumptz MH, Felizzola J, et al. The impact of acculturation on Latinos’ perceived barriers to HIV primary care. Ethn Dis. 2008;18(4):403–8.

    PubMed  PubMed Central  Google Scholar 

  75. Mason HR, Marks G, Simoni JM, Ruiz MS, Richardson JL. Culturally sanctioned secrets? Latino men’s nondisclosure of HIV infection to family, friends, and lovers. Health Psychol. 1995;14(1):6–12.

    Article  PubMed  CAS  Google Scholar 

  76. Keesee MS, Natale AP, Curiel HF. HIV positive Hispanic/Latinos who delay HIV care: analysis of multilevel care engagement barriers. Soc Work Health Care. 2012;51(5):457–78.

    Article  PubMed  Google Scholar 

  77. Philbin MM, Tanner AE, DuVal A, et al. Factors affecting linkage to care and engagement in care for newly diagnosed HIV-positive adolescents within fifteen adolescent medicine clinics in the United States. AIDS Behav. 2014;18(8):1501–10.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Kelly JD, Hartman C, Graham J, Kallen MA, Giordano TP. Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study. J Assoc Nurses AIDS Care. 2014;25(5):405–13.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Gardner LI, Metsch LR, Anderson-Mahoney P, et al. Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care. AIDS. 2005;19(4):423–31.

    Article  PubMed  Google Scholar 

  80. Gardner LI, Marks G, Craw J, et al. Demographic, psychological, and behavioral modifiers of the Antiretroviral Treatment Access Study (ARTAS) intervention. AIDS Patient Care STDS. 2009;23(9):735–42.

    Article  PubMed  Google Scholar 

  81. Flores G. Culture and the patient-physician relationship: achieving cultural competency in health care. J Pediatr. 2000;136(1):14–23.

    Article  PubMed  CAS  Google Scholar 

  82. Morales LS, Cunningham WE, Galvan FH, Andersen RM, Nakazono TT, Shapiro MF. Sociodemographic differences in access to care among Hispanic patients who are HIV infected in the United States. Am J Public Health. 2004;94(7):1119–21.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Cabral HJ, Tobias C, Rajabiun S, et al. Outreach program contacts: do they increase the likelihood of engagement and retention in HIV primary care for hard-to-reach patients? AIDS Patient Care STDS. 2007;21(Suppl 1):S59–67.

    Article  PubMed  Google Scholar 

  84. Bradford JB, Coleman S, Cunningham W. HIV system navigation: an emerging model to improve HIV care access. AIDS Patient Care STDS. 2007;21(Suppl 1):S49–58.

    Article  PubMed  Google Scholar 

  85. Koester KA, Morewitz M, Pearson C, et al. Patient navigation facilitates medical and social services engagement among HIV-infected individuals leaving jail and returning to the community. AIDS Patient Care STDS. 2014;28(2):82–90.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Murphy DA, Roberts KJ, Hoffman D, Molina A, Lu MC. Barriers and successful strategies to antiretroviral adherence among HIV-infected monolingual Spanish-speaking patients. AIDS Care. 2003;15(2):217–30.

    Article  PubMed  CAS  Google Scholar 

  87. Katz IT, Ryu AE, Onuegbu AG, et al. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis. J Int AIDS Soc. 2013;16(3 Suppl 2):18640.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Bogart LM, Wagner GJ, Galvan FH, Klein DJ. Longitudinal relationships between antiretroviral treatment adherence and discrimination due to HIV-serostatus, race, and sexual orientation among African-American men with HIV. Ann Behav Med. 2010;40(2):184–90.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Galvan FH, Bogart LM, Wagner GJ, Klein DJ, Chen YT. Conceptualisations of masculinity and self-reported medication adherence among HIV-positive Latino men in Los Angeles, California, USA. Cult. Health Sex. 2014;16(6):697–709.

    Article  PubMed  PubMed Central  Google Scholar 

  90. Sauceda JA, Johnson MO, Saberi P. Nonadherence as 4-day antiretroviral therapy interruptions: do depression and race/ethnicity matter as much in the modern antiretroviral therapy era? AIDS Behav. 2016;20(11):2624–8.

    Article  PubMed  PubMed Central  Google Scholar 

  91. Quandt SA, Arcury TA, Early J, Tapia J, Davis JD. Household food security among migrant and seasonal latino farmworkers in North Carolina. Public Health Rep. 2004;119(6):568–76.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Cunningham PJ, Hibbard J, Gibbons CB. Raising low ‘patient activation’ rates among Hispanic immigrants may equal expanded coverage in reducing access disparities. Health Aff (Millwood). 2011;30(10):1888–94.

    Article  PubMed  Google Scholar 

  93. Marshall R, Beach MC, Saha S, et al. Patient activation and improved outcomes in HIV-infected patients. J Gen Intern Med. 2013;28(5):668–74.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Ortega AN, Rodriguez HP, Vargas Bustamante A. Policy dilemmas in Latino health care and implementation of the Affordable Care Act. Annu Rev Public Health. 2015;18(36):525–44.

    Article  Google Scholar 

  95. Alegria M, Sribney W, Perez D, Laderman M, Keefe K. The role of patient activation on patient-provider communication and quality of care for US and foreign born Latino patients. J Gen Intern Med. 2009;24(Suppl 3):534–41.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Fiscella K, Boyd M, Brown J, et al. Activation of persons living with HIV for treatment, the great study. BMC Public Health. 2015;15:1056.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Fleishman JA, Yehia BR, Moore RD, Gebo KA, Agwu AL. Disparities in receipt of antiretroviral therapy among HIV-infected adults (2002-2008). Med Care. 2012;50(5):419–27.

    Article  PubMed  PubMed Central  Google Scholar 

  98. Moreno CL. The relationship between culture, gender, structural factors, abuse, trauma, and HIV/AIDS for Latinas. Qual Health Res. 2007;17(3):340–52.

    Article  PubMed  Google Scholar 

  99. Thrasher AD, Earp JA, Golin CE, Zimmer CR. Discrimination, distrust, and racial/ethnic disparities in antiretroviral therapy adherence among a national sample of HIV-infected patients. J Acquir Immune Defic Syndr. 2008;49(1):84–93.

    Article  PubMed  Google Scholar 

  100. Graham JL, Shahani L, Grimes RM, Hartman C, Giordano TP. The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care. AIDS Patient Care STDS. 2015;29(12):661–7.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Lillie-Blanton M, Stone VE, Snow Jones A, et al. Association of race, substance abuse, and health insurance coverage with use of highly active antiretroviral therapy among HIV-infected women, 2005. Am J Public Health. 2010;100(8):1493–9.

    Article  PubMed  PubMed Central  Google Scholar 

  102. National ADAP Monitoring Project: 2016 Annual Report, National Alliance of State and Territorial AIDS Directors (NASTAD), February 2016. https://www.nastad.org/sites/default/files/2016-National-ADAP-Monitoring-Project-Annual-Report.pdf. Accessed 23 April 2018.

  103. Kaiser Family Foundation. ADAP Financial Eligibility as a Percent of the Federal Poverty Level. http://www.kff.org/hivaids/state-indicator/adap-financial-eligibility-as-a-percent-of-the-federal-poverty-level/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D/. Accessed 23 April 2018.

  104. Kaiser Family Foundation. AIDS Drug Assistance Programs (ADAPs). August 16, 2017. https://www.kff.org/hivaids/fact-sheet/aids-drug-assistance-programs/. Accessed 23 April 2018.

  105. Grossman CI, Purcell DW, Rotheram-Borus MJ, Veniegas R. Opportunities for HIV combination prevention to reduce racial and ethnic health disparities. Am Psychol. 2013;68(4):237–46.

    Article  PubMed  PubMed Central  Google Scholar 

  106. Sheehan DM, Fennie KP, Mauck DE, Maddox LM, Lieb S, Trepka MJ. Retention in HIV care and viral suppression: individual- and neighborhood-level predictors of racial/ethnic differences, Florida, 2015. AIDS Patient Care STDS. 2017;31(4):167–75.

    Article  PubMed  PubMed Central  Google Scholar 

  107. Levison JH, Bogart LM, Khan IF, Mejia D, Amaro H, Alegría M, Safren S. “Where it falls apart”: barriers to retention in HIV care in Latino immigrants and migrants. AIDS patient care and STDs. 2017;31(9):394–405.

    Article  PubMed  PubMed Central  Google Scholar 

  108. Wohl AR, Galvan FH, Myers HF, et al. Do social support, stress, disclosure and stigma influence retention in HIV care for Latino and African American men who have sex with men and women? AIDS Behav. 2011;15(6):1098–110.

    Article  PubMed  Google Scholar 

  109. Abreu M, Hynes HP. The Latino Health Insurance Program: a pilot intervention for enrolling Latino families in health insurance programs, East Boston, Massachusetts, 2006–2007. Prev Chronic Dis. 2009;6(4):A129.

    PubMed  PubMed Central  Google Scholar 

  110. Dang BN, Westbrook RA, Hartman CM, Giordano TP. Retaining HIV patients in care: the role of initial patient care experiences. AIDS Behav. 2016;20(10):2477–87.

    Article  PubMed  PubMed Central  Google Scholar 

  111. Bustamante AV, Chen J. Physicians cite hurdles ranging from lack of coverage to poor communication in providing high-Quality care to Latinos. Health Aff. 2011;30(10):1921–9.

    Article  Google Scholar 

  112. Beach MC, Saha S, Korthuis PT, et al. Differences in patient-provider communication for Hispanic compared to non-Hispanic white patients in HIV care. J Gen Intern Med. 2010;25(7):682–7.

    Article  PubMed  PubMed Central  Google Scholar 

  113. Hargreaves M, Hidalgo J, Byrd V, Bagchi A, Kim J. Strategies for engaging and retaining Latinos in HIV Care. Mathematic Policy Research, Inc. August 2010; 2. P. 1–4.

  114. Sommers BD, Parmet WE. Health care for immigrants—implications of Obama’s executive action. N Engl J Med. 2015;372(13):1187–9.

    Article  PubMed  Google Scholar 

  115. Venkataramani AS, Tsai AC. Dreams deferred—the public health consequences of rescinding DACA. N Engl J Med. 2017;377(18):1707–9.

    Article  PubMed  Google Scholar 

  116. Sommers BD, Tomasi MR, Swartz K, Epstein AM. Reasons for the wide variation in Medicaid participation rates among states hold lessons for coverage expansion in 2014. Health Aff (Millwood). 2012;31(5):909–19.

    Article  PubMed  Google Scholar 

  117. Watson T. Inside the refrigerator: immigration enforcement and chilling effects in Medicaid participation. Cambridge: National Bureau of Economic Research; 2010.

    Book  Google Scholar 

  118. Das M, Chu PL, Santos GM, et al. Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco. PLoS ONE. 2010;5(6):e11068.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  119. Singer M, Bulled N, Ostrach B, Mendenhall E. Syndemics and the biosocial conception of health. Lancet. 2017;389(10072):941–50.

    Article  PubMed  Google Scholar 

  120. Sullivan KA, Messer LC, Quinlivan EB. Substance abuse, violence, and HIV/AIDS (SAVA) syndemic effects on viral suppression among HIV positive women of color. AIDS Patient Care STDS. 2015;29(Suppl 1):S42–8.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Espino SR, Fletcher J, Gonzalez M, Precht A, Xavier J, Matoff-Stepp S. Violence screening and viral load suppression among HIV-positive women of color. AIDS Patient Care STDS. 2015;29(Suppl 1):S36–41.

    Article  PubMed  PubMed Central  Google Scholar 

  122. Taylor BS, Reyes E, Levine EA, et al. Patterns of geographic mobility predict barriers to engagement in HIV care and antiretroviral treatment adherence. AIDS Patient Care STDS. 2014;28(6):284–95.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Myers JE, Taylor BS, Rojas Fermin RA, et al. Transmitted drug resistance among antiretroviral-naive patients with established HIV type 1 infection in Santo Domingo, Dominican Republic and review of the Latin American and Caribbean literature. AIDS Res Hum Retrovir. 2012;28(7):667–74.

    Article  PubMed  CAS  Google Scholar 

  124. Calsyn RJ, Klinkenberg WD, Morse GA, Miller J, Cruthis R, Health Outcomes and Cost Study Group. Recruitment, engagement, and retention of people living with HIV and co-occurring mental health and substance use disorders. Aids Care. 2004;16:56–70.

    Article  Google Scholar 

  125. Guerrero EG, Aarons GA, Grella CE, Garner BR, Cook B, Vega WA. Program capacity to eliminate outcome disparities in addiction health services. Adm Policy Ment Health. 2016;43(1):23–35.

    Article  PubMed  PubMed Central  Google Scholar 

  126. Ludema C, Cole SR, Eron JJ Jr, et al. Impact of health insurance, ADAP, and income on HIV viral suppression among US women in the women's interagency HIV study, 2006–2009. J Acquir Immune Defic Syndr. 2016;73(3):307–12.

    Article  PubMed  PubMed Central  Google Scholar 

  127. US Department of health and human services, Health resources and services administration, HIV/AIDS bureau, special projects of national significance. Introducing the Latino initiative: affirming cultural diversity through culturally competent care. August 10, 2013. https://hab.hrsa.gov/sites/default/files/hab/About/Parts/latinoinitiative.pdf. Accessed 23 April 23 2018.

  128. Sena AC, Hammer JP, Wilson K, Zeveloff A, Gamble J. Feasibility and acceptability of door-to-door rapid HIV testing among latino immigrants and their HIV risk factors in North Carolina. AIDS Patient Care STDS. 2010;24(3):165–73.

    Article  PubMed  PubMed Central  Google Scholar 

  129. Nunn A, Brinkley-Rubinstein L, Rose J, et al. Latent class analysis of acceptability and willingness to pay for self-HIV testing in a United States urban neighbourhood with high rates of HIV infection. J Int AIDS Soc. 2017;20(1):1–9.

    Article  Google Scholar 

  130. Krakowiak D, Kinuthia J, Osoti AO, et al. Home-based HIV testing among pregnant couples increases partner testing and identification of serodiscordant partnerships. J Acquir Immune Defic Syndr. 2016;72(Suppl 2):S167–73.

    Article  PubMed  PubMed Central  Google Scholar 

  131. Ware NC, Wyatt MA, Asiimwe S, et al. How home HIV testing and counselling with follow-up support achieves high testing coverage and linkage to treatment and prevention: a qualitative analysis from Uganda. J Int AIDS Soc. 2016;19(1):20929.

    Article  PubMed  PubMed Central  Google Scholar 

  132. Rhodes SD, Hergenrather KC, Bloom FR, Leichliter JS, Montano J. Outcomes from a community-based, participatory lay health adviser HIV/STD prevention intervention for recently arrived immigrant Latino men in rural North Carolina. AIDS Educ Prev. 2009;21(5 Suppl):103–8.

    Article  PubMed  PubMed Central  Google Scholar 

  133. Bauermeister JA, Pingel ES, Jadwin-Cakmak L, et al. Acceptability and preliminary efficacy of a tailored online HIV/STI testing intervention for young men who have sex with men: the Get Connected! program. AIDS Behav. 2015;19(10):1860–74.

    Article  PubMed  PubMed Central  Google Scholar 

  134. Rhodes SD, McCoy TP, Tanner AE, et al. Using social media to increase HIV testing among gay and bisexual men, other men who have sex with men, and transgender persons: outcomes from a randomized community trial. Clin Infect Dis. 2016;62(11):1450–3.

    Article  PubMed  PubMed Central  Google Scholar 

  135. Young SD, Cumberland WG, Nianogo R, Menacho LA, Galea JT, Coates T. The HOPE social media intervention for global HIV prevention in Peru: a cluster randomised controlled trial. Lancet. 2015;2(1):e27–32.

    Article  PubMed  Google Scholar 

  136. Mead EL, Doorenbos AZ, Javid SH, et al. Shared decision-making for cancer care among racial and ethnic minorities: a systematic review. Am J Public Health. 2013;103(12):e15–29.

    Article  PubMed  PubMed Central  Google Scholar 

  137. Earnshaw VA, Bogart LM, Dovidio JF, Williams DR. Stigma and racial/ethnic HIV disparities: moving toward resilience. Am Psychol. 2013;68(4):225–36.

    Article  PubMed  PubMed Central  Google Scholar 

  138. Carrasco MA, Barrington C, Kennedy C, Perez M, Donastorg Y, Kerrigan D. ‘We talk, we do not have shame’: addressing stigma by reconstructing identity through enhancing social cohesion among female sex workers living with HIV in the Dominican Republic. Cult Health Sex. 2017;19(5):543–56.

    Article  PubMed  Google Scholar 

  139. Derose KP, Bogart LM, Kanouse DE, et al. An intervention to reduce HIV-related stigma in partnership with African American and Latino churches. AIDS Educ Prev. 2014;26(1):28–42.

    Article  PubMed  PubMed Central  Google Scholar 

  140. Frye V, Paige MQ, Gordon S, et al. Developing a community-level anti-HIV/AIDS stigma and homophobia intervention in new York city: the project CHHANGE model. Eval Program Plann. 2017;63:45–53.

    Article  PubMed  Google Scholar 

  141. Mouw T, Chavez S, Edelblute H, Verdery A. bi-national social networks and assimilation: a test of the importance of transnationalism. Soc Probl. 2014;61(3):329–59.

    Article  PubMed  PubMed Central  Google Scholar 

  142. Georgetti Gomez L, Hightow-Weidman L, Vergara-Rodriquez P, Wiersema J. Transnational practices and engagement in care: lessons from the SPNS Latino access initiative, 6332. 2016 National Ryan White Conference on HIV Care and Treatment. http://latinoetac.ucsf.edu/sites/latinoetac.ucsf.edu/files/Transnationalism%20and%20Engagement%20in%20Care.pdf. Accessed 7 Dec 2017.

  143. Ventanillas de Salud. http://www.migrantclinician.org/services/ventanillas-de-salud.html. Accessed 23 April 2018.

  144. Servin AE, Munoz FA, Zuniga ML. Healthcare provider perspectives on barriers to HIV-care access and utilisation among Latinos living with HIV in the US-Mexico border. Cult. Health Sex. 2014;16(5):587–99.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors appreciate the efforts of Ms. Iman Kahn for editorial assistance in review of the manuscript.

Funding

The work was supported by the National Institutes Health (K23 MH100978, R01 DA034952), Harvard Catalyst/Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award 8UL1TR000170-05), Harvard University Center for AIDS Research (P30-AI060354), and financial contributions from Harvard University and its affiliated academic health care centers. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard Medical School and its affiliated academic health care centers, or the National Institutes of Health.

Author information

Authors and Affiliations

  1. Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Julie H. Levison, Julia K. Levinson & Margarita Alegría

  2. Division of General Internal Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA, 02114, USA

    Julie H. Levison & Julia K. Levinson

  3. Harvard Medical School, Boston, MA, USA

    Julie H. Levison & Margarita Alegría

Authors
  1. Julie H. Levison
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Julia K. Levinson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Margarita Alegría
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Julie H. Levison.

Ethics declarations

Conflict of interest

All authors have declared that no competing interests exist.

Informed Consent

No human participants participated in this study.

Research Involving Human Participants and/or Animal

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Levison, J.H., Levinson, J.K. & Alegría, M. A Critical Review and Commentary on the Challenges in Engaging HIV-Infected Latinos in the Continuum of HIV Care. AIDS Behav 22, 2500–2512 (2018). https://doi.org/10.1007/s10461-018-2187-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-018-2187-1

Keywords

Search

Navigation