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National HIV Prevention Conference
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[TITLE:] THE CHALLENGES OF PROVIDING HIV PREVENTION MESSAGES ALONG THE MIGRANT WORKER STREAMS: A CASE STUDY
Natl HIV Prev Conf. 2005 Jun 12-15 (abstract no. M1-D1102)
Somerville, GG1; Hernandez, J2; Diaz, S2; Jorge, S1; Wilson, T3; Borman, M4; Rivera, T4; Taveras, S1
1CDC/NCHSTP/DHAP/Capacity Building Branch, Atlanta, GA; 2Farmworker Justice Fund, Inc, Washington, DC; 3Rural Opportunities, Inc, Rochester, NY; 4UMOS, Inc., Milwaukee, WI
ISSUE: Recent studies show increased HIV and STD vulnerability of Mexican Nationals migrating to the U.S. Lack of access to care and language barriers are associated with HIV/STD risk behaviors. One study indicated that the prevalence rate of Mexican workers in Fresno and San Diego counties is three times higher than the rate in the general U.S. and Mexican populations. In another study, HIV prevalence among pregnant women at Tijuana General Hospital in Mexico was found to be more than four times as high as the rate among the general populations in both countries. (Sanchez, et. al, 2004). These data suggests a lack of knowledge about the spread of HIV and the need for targeted HIV prevention approaches for this population.
SETTING: Capacity building assistance (CBA) providers deliver technical assistance to community based organizations (CBOs) and health department staff serving Latino migrant workers in community venues throughout the U.S., and along the U.S.-Mexico border. Many trained promotores (community health workers) are migrant workers themselves and travel along the migrant streams delivering HIV prevention messages according to their traditional culture.
PROJECT: CDC established a national network of Migrant Worker CBA providers to deliver technical consultation and services to strengthen organizational infrastructure; tailored outreach to CBOs and health departments working with Spanish-speaking migrant workers; cultural and linguistic adaptation and tailoring of science-based HIV prevention behavioral interventions. The goals are to increase access and utilization of HIV prevention and care services, including HIV rapid testing, and participation in the community planning process. As a result of CBA, CBO and health department staff learned about the cultural aspects of HIV prevention related to Spanish speaking Latino migrant worker communities, often invisible populations in their jurisdictions.
RESULTS: Between 2001- 2004, 33% of US health departments, including Puerto Rico and Hawaii, and over 1000 CBOs were reached through information transfer, skills building, technical assistance and technology transfer such as the adaptation and tailoring of science-based replication packages. For example, Popular Opinion Leader (POL) was adapted for young migrant men having sex with other men and VOICES/VOCES for use in migrant serving clinics and CBOs. For the first time a bi-national Promotora Conference was held on the Border that focused specifically on HIV prevention and care. A regional forum conducted in collaboration with contingent states reached nontraditional providers such as maternal/child health and mental health providers. Promotoras were trained to deliver the OraQuick HIV test and serve as liaisons for HIV-positive individuals with the US health care system. Each activity was the result of CBA provided by the Migrant CBA Network.
LESSONS LEARNED: Migrant workers are an invisible population in many communities. However significant population growth of the Hispanic population, especially in the southern US, has resulted in increased attention to public health issues related to migrant workers. Migrant workers need to receive consistent HIV prevention messages that are culturally, linguistically and educationally appropriate. National governments should work collaboratively to support training of migrant workers promotores to deliver HIV prevention messages as they migrate.
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050612
M1-D1102
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