학술논문

Proyecto Compadre: Using Implementation Science to Tailor Peer Navigation for Latino Men in the US–Mexico Border Region
Document Type
article
Source
JAIDS Journal of Acquired Immune Deficiency Syndromes. 90(S1)
Subject
Health Services and Systems
Public Health
Health Sciences
Pediatric
HIV/AIDS
Pediatric AIDS
Infectious Diseases
Clinical Research
Prevention
Behavioral and Social Science
Mental Health
Health Services
Good Health and Well Being
HIV Infections
Hispanic or Latino
Homosexuality
Male
Humans
Implementation Science
Male
Mexico
Sexual and Gender Minorities
HIV testing
peer navigation
PrEP
implementation science
Latino MSM
EPIS framework
Clinical Sciences
Public Health and Health Services
Virology
Clinical sciences
Epidemiology
Public health
Language
Abstract
BackgroundLatino men who have sex with men (MSM) in San Diego have poor HIV testing and prevention outcomes compared with non-Latino White men. Peer navigation (PN) is a promising evidence-based intervention to reduce disparities but needs tailoring for Latino MSM.SettingsHealth centers near the US-Mexico border.MethodsUsing the Exploration, Preparation, Implementation, Sustainment Framework, we conducted mixed-methods implementation science study. In phase I, we conducted interviews with Latino men (n = 15), focus groups with staff (n = 7), and surveys with all to understand the Exploration, Preparation, Implementation, Sustainment factors associated with HIV testing and care linkage. In phase II, we conducted 31 web-based surveys with Latino men and staff to rank intervention and implementation strategies from phase I. Quantitative data were analyzed descriptively, integrated with qualitative data, and reviewed by our community-academic partnership to develop an implementation model.ResultsLatino men (N = 15) were 94% Spanish speaking, 67% gay identified, 27% US born, and their suggestions were to have navigators use peer referral to address barriers such as stigma; use the Latino social network to expand reach, leverage social media for peer-led intervention, and disseminate HIV information. Staff (N = 26) were 77% Spanish speaking, 35% gay-identified, 96% trained in cultural competency, and suggested including culturally appropriate HIV educational materials in Spanish, status and identity neutral programs, administrative/supervisorial/training structure for PNs, and PN compensation and team integration. Overall, results emphasized a need for a formalized PN model centered on referrals and using existing Latino community social networks.ConclusionsFindings can be packaged for future implementation of PN programs for Latino MSM.