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Randomized Controlled Trial
. 2019 Apr;23(4):835-846.
doi: 10.1007/s10461-019-02413-y.

High HIV/STI Test Acceptance Through a Behavioral Health Encounter in Latino Immigrants with Substance Use and Mental Health Problems

Julie H Levison  1   2 , Margarita Alegría  3   4   5 , Ye Wang  5 , Sheri L Markle  5 , Larmiar Fuentes  5 , Dianna L Mejia  6 , Andrew Tarbox  6 , Lucía Albarracín García  7 , Lucía Cellerino  8 , Nabila El-Bassel  9
Affiliations
Randomized Controlled Trial

High HIV/STI Test Acceptance Through a Behavioral Health Encounter in Latino Immigrants with Substance Use and Mental Health Problems

Julie H Levison et al. AIDS Behav. 2019 Apr.

Abstract
in English, Spanish

Latino immigrants with substance use and mental health problems are at risk for undiagnosed HIV and sexually transmitted infections (STIs). Participants in a randomized control trial were recruited in Boston, USA and Madrid and Barcelona, Spain. Eligibility criteria were Latino self-identification, age 18-70, elevated substance use and mental health symptoms, and not currently in substance or mental health care. A multinomial logistic regression examined predictors of HIV/STI testing decline and lost to follow-up (LTFU) prior to testing compared with acceptance. Of 341 participants, 74% accepted testing, 4% declined, and 22% were LTFU. The odds of LTFU were higher in those with high concern for HIV and those whose main partner had done HIV testing. Age ≥ 35 years, females, higher education, and higher report of discrimination lowered the odds of LTFU. Delivery of HIV/STI testing through community agencies and outreach could overcome barriers to HIV/STI diagnosis in this population of Latinos.Clinical Trial Number: NCT02038855.

Los inmigrantes de origen Latino con problemas de uso de substancias y salud mental presentan un mayor riesgo de no ser diagnosticados de VIH e infecciones de transmisión sexual (ITS). Los participantes de este ensayo aleatorio controlado fueron reclutados en Boston, Estados Unidos y en Madrid y Barcelona, España. Los criterios de inclusión incluían autoidentificarse Latino, edad entre 18 y 70 años, síntomas elevadas de uso de substancias y salud mental, y no estar recibiendo ningún tratamiento para los síntomas de uso de substancias o salud mental. Una regresión logística multinomial examinó los predictores de disminución de test de VIH/ITS y pérdida de seguimiento (PDS) antes de ofrecer el test de VIH/ITS comparándolo con los que aceptaron realizar el test y mantenerse en tratamiento. De 341 participantes, 74% aceptaron realizarse las pruebas, 4% las rechazaron, y 22% fueron PDS. La probabilidad de PDS fue mayor en aquellos con alta preocupación por el VIH y en aquellos cuya pareja principal se había hecho la prueba del VIH. Edad de ≥35 años, mujeres, educación superior, y referir niveles altos de discriminación percibida son factores relacionados con la reducción de la probabilidad de PDS. La realización de test de HIV/ITS a través de agencias comunitarias y divulgación en la comunidad se plantean como una opción para superar las barreras de diagnóstico de VIH/ITS en esta población de Latinos.

Keywords: HIV; Latinos; Mental health; Sexually transmitted infections; Substance use; Testing.

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Conflict of interest statement

Conflicts of Interest: All authors have declared that no competing interests exist.

References

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