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Background People with HIV (PWH) from racial and ethnic minority groups in the United States (US) face a high risk for severe COVID-19 outcomes and have low uptake of the COVID-19 vaccine primary series and booster doses. This study aims to provide insights into barriers and facilitators to vaccination and identify strategies to increase vaccine trust and uptake in these populations. Methods Between November and December 2022, we conducted qualitative interviews with 24 vaccinated and unvaccinated adult PWH who self-identified as Hispanic/Latinx, Black/African American, or Haitian, and were clients of the Miami-Dade County Ryan White HIV/AIDS Program in Florida, US. Data were analyzed using deductive thematic analysis. Results Main barriers to vaccine uptake reported by participants included low or no perception of COVID-19 risk, concerns about safety and efficacy related to HIV status, mistrust of COVID-19 vaccines, general vaccine hesitancy, negative experiences and advice against vaccination within social networks, lack of provider recommendation, and exposure to negative messaging and misinformation about vaccines. Facilitators included perceived risk, awareness of the vaccines’ protective benefits for HIV-immunocompromised individuals and reducing transmission, encouragement and role modeling within social networks, provider recommendation, and exposure to accurate information from reputable sources. Some recommended strategies to increase uptake and trust in vaccines included incorporating vaccination into routine HIV care, leveraging peers with HIV, tailoring vaccine information and messaging, and partnering with trusted individuals for outreach. Conclusion Vaccination efforts for PWH should prioritize addressing specific barriers and concerns related to their HIV status and tailoring strategies to meet their needs.

Efforts in the prevention and treatment of depression among Hispanic immigrant women require studies to identify modifiable factors of depression. Some factors that may merit investigation are gender roles such as egalitarian gender attitudes, marianismo, and self-silencing. This cross-sectional study included 231 Hispanic immigrant women living in Miami-Dade County, Florida. Logistic regression was used to examine associations of covariates, egalitarian gender attitudes, marianismo, and self-silencing in relation to depression. Egalitarian gender attitudes were not associated with depression. For marianismo domains, higher scores on the spiritual pillar scale were associated with lower odds of depression. With regard to self-silencing, higher scores on externalizing self-perception and divided self were associated with higher odds of depression. Findings add to the limited literature on depression among Hispanic immigrants and provides some insight on sociocultural factors that may be considered in depression interventions for Hispanic immigrant women.

HIV testing early in the immigration process can facilitate timely linkage to HIV prevention and treatment services for immigrants. This study aims to determine the prevalence of self-report HIV testing pre- and post-immigration and the associations between pre-immigration HIV sexual risk behaviors, access to healthcare post-immigration, and HIV testing post-immigration among young adult recent Latino immigrants. Cross-sectional data from 504 recent Latino immigrants aged 18 to 34 who immigrated to Miami-Dade County, Florida during the 12 months before assessment were analyzed using robust Poisson regression models. We found that 23.8% of participants reported HIV testing post-immigration and 56.7% reported HIV testing pre-immigration. The prevalence ratio for post-immigration HIV testing was higher for participants that had health insurance (adjusted prevalence ratio [aPR]: 1.70, 95% confidence interval [CI]: 1.21–2.38) and a regular doctor or healthcare provider after immigration (aPR: 1.43, 95% CI 1.03–2.00), and post-immigration HIV testing was higher for participants that had ever been tested for HIV before immigration (aPR: 2.41, 95% CI 1.68–3.45). Also, the prevalence ratio was lower for those who engaged in condomless sex in the three months prior to immigration (aPR: 0.65, 95% 0.47–0.90). These findings suggest that addressing barriers to healthcare and prevention services for young adult recent Latino immigrants is needed to scale-up HIV testing in this population early in the immigration process.

Latinas in farmworker communities are at particularly higher risk for human immunodeficiency virus (HIV) due to the vulnerable circumstances they experience. However, little is known about the factors influencing HIV prevention behaviors in this population. The aim of this study was to examine the associations of self-silencing behaviors and egalitarian attitudes toward women in relation to three HIV prevention behaviors: self-efficacy for HIV prevention, intentions to negotiate safe sex, and HIV-related knowledge. This study is a cross-sectional analysis that used hierarchical multiple regression models to examine these previously mentioned associations, among Latina immigrant farmworkers from Miami-Dade County, Florida (n=232). Findings indicated that self-silencing behaviors were adversely associated with the three HIV preventive behaviors whereas egalitarian attitudes were positively associated. Findings from this study may help to advance the understanding of sociocultural determinants of HIV prevention behaviors among Latina immigrants.

Research examining factors associated with low uptake of HIV testing among Latino emerging adults is scarce. Thus, this study examined the association between familism support and lifetime history of HIV testing among Latino emerging adults, and whether nativity status and gender moderated this association. A cross-sectional online survey of 157 Latino emerging adults aged 18–25 years living in Arizona and Florida was conducted and data were analyzed using robust Poisson regression models. Results indicated that 59.9% of participants reported a lifetime history of HIV testing. Higher familism support was associated with a decreased prevalence of lifetime history of HIV testing (aPR  =  0.81, 95% CI: 0.68– 0.95). Nativity status moderated the association between familism support and lifetime history of HIV testing, with this negative association, only found among immigrants (aPR = 0.46, 95% CI: 0.28–0.74). Gender did not moderate this association. Familism support plays a role in HIV testing behaviors, and thus should be considered when developing programs to increase HIV testing among Latinos.

  Low-income, minority women living with HIV often experience multiple barriers in care that contribute to suboptimal care outcomes. Medical case managers (MCM) and medical providers are key players involved in care coordination and aid women along the HIV care continuum. The objective of this study was to identify current and potential patient-centered practices that facilitate adherence to medication and retention in care, from the perspective of racially and ethnically diverse women living with HIV. We implemented a qualitative study using semi-structured interviews with 75 African American, Hispanic/Latina, and Haitian women who were enrolled in the Ryan White HIV/AIDS Program in South Florida in 2019. We organized domains of exploration using a patient-centered care framework to identify practices in which providers acknowledged, respected, and responded to clients’ preferences, needs, and values. Interviews were analyzed using consensual thematic analysis approach. Findings reflect women valued MCMs who were proactive and directive in care, provided motivation, and aided with navigation of shame, fear, and stigma. Women valued medical providers who upheld simple educational communication. Moreover, women reported that providers who reviewed medical results with clients, incorporated questions about families, and inquired about multiple physical and clinical needs beyond HIV created opportunities for women to feel respected, valued, and in turn, enhanced their involvement in their care. Findings identify specific interpersonal practices that can enhance the ability to better meet the needs of diverse groups of women, specifically those from racial/ethnic minority groups who face multiple sociocultural barriers while in care.

Latina immigrants living in farmworker communities are a population in need of HIV risk reduction interventions due to their high risk for HIV and their limited access to health care and prevention services. The present study is the first to evaluate the efficacy of SEPA intervention on a cohort of 234 pre-established Latina immigrants living in farmworker communities in South Florida. SEPA is a CDC evidenced-based and Latinx culturally tailored HIV risk reduction intervention. Data were collected through structured interviews at baseline and 6-months post intervention and were analyzed using generalized linear mixed modeling. Results showed that SEPA was effective on increasing condom use during vaginal and anal sex with male partners, self-efficacy for condom use, intentions to negotiate safe sex and HIV-related knowledge from baseline to 6-months post intervention. These findings contribute to the evidence supporting the efficacy of SEPA by confirming previous results and demonstrating the efficacy of this intervention for Latinas of diverse backgrounds.

Objective This study examined associations of family cohesion and acculturation gap conflicts with depressive symptoms, as well as the moderation effect of family cohesion on the association between acculturation gap conflicts and depressive symptoms among Latinx emerging adults. Background In addition to normative developmental stressors (e.g., making long‐term career decisions), many Latinx emerging adults face additional sociocultural stressors (acculturative stress, ethnic discrimination) that put them at risk of experiencing adverse psychological outcomes. However, acculturation gap conflicts have not been examined much in this population. Method Data from a cross‐sectional survey were collected from 200 participants from Arizona (n = 99) and Florida (n = 101). Hierarchical multiple regression and moderation analyses were conducted to examine the association between acculturation gap conflicts and depressive symptoms and the moderating effects of family cohesion of that respective association. Results Higher family cohesion was associated with lower depressive symptoms. Conversely, higher acculturation gap conflicts were associated with higher depressive symptoms. Moderation analyses indicated that family cohesion moderated the association between acculturation gap conflicts and depressive symptoms. Conclusion This study adds to the limited literature on acculturation gap conflicts among Latinx emerging adults and advances our understanding of the role of family cohesion as a modifiable moderator. Implications It is critical to identify culturally relevant and modifiable determinants that can have beneficial or adverse associations with the mental health of Latinx emerging adults. Findings from this study have the potential to inform intervention for mental health targeting Latinx emerging adults.

Latino emerging adults account for a significant proportion of incident HIV cases among emerging adults aged 18-24 in the United States, but have a lower prevalence of HIV testing compared to other racial/ethnic emerging adult groups. Yet, factors that influence HIV testing behaviors among Latino emerging adults are poorly understood. This dissertation examined sociocultural and psychological factors of HIV testing behaviors among a sample of 157 sexually active Latino emerging adults aged 18 to 25. Cross-sectional data from the Project on Health among Emerging Adult Latinos (Project HEAL) were used. Robust Poisson regressions were used to estimate adjusted prevalence ratios (aPRs) and hierarchical logistic regressions were used to estimate adjusted odds ratios (aORs) for HIV testing behaviors.Findings indicated that 59.9% of participants reported lifetime history of HIV testing. Of those engaging in sexual risk behaviors, 62.8% reported lifetime history of HIV testing. Familism support was significantly associated with lifetime history of HIV testing (aPR= .81, 95% confidence interval [CI]: .68-.95). Nativity status but not gender moderated the association between familism support and lifetime history of HIV testing. Also, self-efficacy for HIV testing was significantly associated with lifetime history of HIV testing (aOR=3.49, 95% CI: 1.78-6.83), and this association was moderated by distress tolerance and sexual risk behaviors. Lastly, cognitive reappraisal was significantly associated with HIV testing intentions (aOR=1.44, 95%CI=1.04-1.99), and this association was moderated by gender.Collectively, our findings highlight the significance of sociocultural and psychological factors that are associated with HIV testing behaviors and may have the potential to inform evidence-based prevention programs that promote HIV testing among Latino emerging adults. Future research should examine the direction of these potential casual associations to better inform HIV testing efforts.