Impact of a Bilingual/Bicultural Care Team on HIV-Related Health Outcomes

Enriquez, Maithe; Farnan, Rose; Cheng, A.H.; Almeida, Amalia; Valle, Daniel del; Pulido-Parra, Maria; Flores, Gabriela

doi:10.1016/j.jana.2008.04.004

Cited by 25 publications

(17 citation statements)

References 5 publications

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“…Culturally appropriate care with bilingual and bicultural staff has been shown to improve adherence significantly, as discussed previously [14]. In our experience, urban foreign-born Latinos, largely from Mexico and Central America, demonstrate excellent adherence when offered care in clinics with appropriate Spanish language resources and adherence aids.…”

Section: Adherencesupporting

confidence: 64%

“…Spanish-speaking HIV-positive Latinos in particular have been found to have more problems paying for medical care and difficulty communicating with physicians than English-speaking Latinos [13]. Small studies in Latino communities have demonstrated that culturally and linguistically appropriate care significantly increase CD4 counts and decrease viral loads, largely through improved adherence [14]. Therefore, whenever possible, Spanish-speaking providers should be available in clinics serving Latino populations, but if not possible, translation services are a necessity.…”

Section: Implications For the Clinicianmentioning

confidence: 99%

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Unique Aspects of the Care of HIV-Positive Latino Patients Living in the United States

2010

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Latinos are disproportionately affected by HIV, with a higher risk of infection and a delayed presentation to care as compared to non-Hispanic whites. Over the last decade many Latinos, especially foreign-born migrants, have settled in regions of the country with historically low Latino representation. Therefore, clinicians who care for HIV-infected patients are likely to encounter Latino patients, regardless of their practice location. Providing optimal care to this population may be especially challenging for clinicians practicing in areas of newer Latino expansion, where culturally appropriate services may be sparse. In this article, we argue that an understanding of the HIV epidemic among Latinos requires an appreciation of the diversity and heterogeneity of the Latino population in the United States. We also review unique clinical aspects of HIV care among Latinos, including manifestation of co-infections with pathogens endemic in Latin America but rare in the United States.

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Section: Adherencesupporting

confidence: 64%

Section: Implications For the Clinicianmentioning

confidence: 99%

Unique Aspects of the Care of HIV-Positive Latino Patients Living in the United States

2010

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“…When we assessed the HIV continuum of care among participants enrolled in the four A2C programs included in this analysis, we found that 54% were virally suppressed at follow-up which compares favorably to other programs [21, 22]. When we analyzed the continuum of care by whether or not a participant prioritized a basic need at enrollment, we did not find differences in engagement in HIV care among participants who reported an urgent basic need at enrollment and those that did not.…”

Section: Discussionmentioning

confidence: 97%

A Mixed-Methods Exploration of the Needs of People Living with HIV (PLWH) Enrolled in Access to Care, a National HIV Linkage, Retention and Re-Engagement in Medical Care Program

et al. 2017

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Competing needs pose barriers to engagement in HIV medical care. Mixed methods were used to explore and describe the needs of participants enrolled in Access to Care, a national HIV linkage, retention and re-engagement in care (LRC) program that served people living with HIV who knew their status but were not engaged in care. When asked to prioritize their most urgent needs, participants reported housing or shelter (31%), HIV medical services (24%), and employment (8%). When we assessed the HIV continuum of care by needs status, we found no significant differences in linkage, retention, or viral suppression between participants with and without basic needs. Qualitative interviews with program staff contextualized the barriers to HIV medical care faced by participants and explored the strategies used by LRC programs to address participant needs. Study findings will be of use to future programs and have implications for HIV policy, in particular the implementation of the National HIV/AIDS Strategy (2015–2020).

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“…In addition, it was customary for ad hoc interpreters to provide enhanced ancillary services for patients requiring interpretation, such as appointment reminder calls, expedited prescription assistance, and referral visit coordination. There is research to support the association between linguistically appropriate education materials and improved health outcomes (Enriquez et al, 2008), but additional research in this area is needed to inform future retention improvement interventions among adults with HIV infection who struggle with linguistic barriers. AIDS Care 1301…”

Section: Discussionmentioning

confidence: 99%

Measurement of retention in care among adults infected with HIV in an urban clinic

2011

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Adults infected with HIV live longer when they receive regular medical care, yet many adults are not retained in care. Providers measure retention in order to evaluate interventions to improve retention and quality of HIV care. However, multiple measures for retention exist. This study compares two methods of operationalizing retention and evaluates the contribution of individual characteristics on the likelihood of retention. A chart review was performed for a random sample of 212 active clients of an urban HIV primary care clinic. Data on clinic utilization, sex, age, race, mental illness, substance use, AIDS diagnosis, language, and housing were collected for each participant. Clinic utilization data were used to classify participants for retention status and to score them by frequency of visits. Binary logistic regression analysis was compared with ordinal logistic regression analysis, using distinct retention measures as outcome variables. In the binary model, those with a history of substance use were about half as likely to be retained (OR 0.52, 95% CI 0.29-0.94) and those with an AIDS diagnosis were more than twice as likely to be retained (OR 2.18, 95% CI 1.17-4.09). These characteristics were significant predictors in the ordinal model, with the additional finding that those reporting English as a primary language were less likely to have higher retention scores (OR 0.40, 95% CI 0.19-0.84). An ordinal score for retention can identify unexpected predictors, but a dichotomous measure of retention may be easier to use and interpret for providers involved in retention-related quality improvement activities.

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Impact of a Bilingual/Bicultural Care Team on HIV-Related Health Outcomes

Cited by 25 publications

References 5 publications

Unique Aspects of the Care of HIV-Positive Latino Patients Living in the United States

Unique Aspects of the Care of HIV-Positive Latino Patients Living in the United States

A Mixed-Methods Exploration of the Needs of People Living with HIV (PLWH) Enrolled in Access to Care, a National HIV Linkage, Retention and Re-Engagement in Medical Care Program

Measurement of retention in care among adults infected with HIV in an urban clinic

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