Sólo Se Vive Una Vez: The Implementation and Reach of an HIV Screening Campaign for Latinx Immigrants.

Latinxs in the United States are disproportionately affected by HIV and present with more advanced disease than their non-Latinx peers, due to numerous barriers to care including HIV stigma. We describe the adaptation, implementation, and reach of Sólo Se Vive Una Vez (You Only Live Once), Baltimore's first social marketing campaign promoting HIV screening among Spanish-speaking Latinxs. The 6-month campaign promoted free HIV testing by addressing HIV stigma. The campaign included a website, a social marketing campaign, community outreach events, and advertisements via radio, billboards, local partners, and buses. During the campaign, there were 9,784 unique website users, and ads were served to over 84,592 people on social media platforms. Among Latinx HIV testers at the Baltimore City Health Department, 31.6% reported having seen or heard of Sólo Se Vive Una Vez and 25.3% of Latinx HIV testers reported that the campaign influenced them to get tested.

Exploring the Sexually Transmitted Infection Testing Experiences of Young People through Creative Visual Mapping.

BACKGROUND: Innovative solution-focused research with youth is needed to improve sexually transmitted infection (STI) testing among adolescents and young adults (AYA). We sought to identify moments that matter to AYA during the STI testing experience. METHODS: Five social design graduate students and five youth advisory council (YAC) members independently received STI testing and created journey maps documenting their experience. Social design students assisted YAC members in their map creation during group workshops and one-on-one worktime. Participants completed interviews about their experience using their maps to facilitate responses. We used thematic content analysis to synthesize textual interview data. RESULTS: Participants experienced stress and discomfort throughout the testing process, with three main sources of stress identified: finding a clinic, completing registration forms, and general lack of clarity during the clinical experience. Friendly interactions with providers and staff improved the experience, however. Finally, the physical environment of the clinic space could positively or negatively impact the overall experience. CONCLUSIONS: Journey mapping may be an important tool for identifying solutions to improve STI testing among AYA.

Youth Voices on the Sexually Transmitted Infection Risk Environment: Community Violence, Chronic Trauma, and Sexual Health Outcomes.

BACKGROUND: Sexually transmitted infections (STIs) disproportionately affect young people in the United States. Although social determinants have been identified as important in shaping STI prevalence and STI disparities, the voice of young people and key stakeholders representing young people is lacking to prioritize interventions aiming to improve these. OBJECTIVE: The objective of this study was to use a community-based participatory research (CBPR) framework to explore how young people and community key stakeholders representing young people understand the context of STI risk experienced in their community, and gather information about their prioritization of social determinants of STIs and STI inequities in Baltimore City, Maryland. METHODS: We conducted key informant interviews (n = 27) with young people ages 15 to 24 years and key stake-holders in neighborhoods with high rates of STIs. Interview transcripts were analyzed through a constant comparison approach. RESULTS: Participants overwhelmingly identified trauma as the key challenge among young people in their communities and largely focused on the role of community violence as a source of chronic trauma. Participants described two pathways through which this trauma contributes to young people's risk of STI acquisition and transmission: (1) competing short-term priorities in a struggle for daily survival, and (2) sex as an available resource for stress relief, self-medication, and escapism. CONCLUSIONS: These findings demonstrate a need to understand social determinants through youth voice and engage young people and key stakeholders in prioritizing and addressing STI disparities. Findings also support the urgent need for structural interventions for STI prevention.

¡Sólo Se Vive Una Vez! (You Only Live Once): A Pilot Evaluation of Individually Tailored Video Modules Aiming to Increase HIV Testing Among Foreign-Born Latino Men.

BACKGROUND: Although Latinos living in the United States are disproportionately affected by HIV, the development, implementation, and evaluation of HIV prevention, testing, and linkage to care interventions lag behind efforts occurring in other communities. To address sociocultural barriers to testing, we developed a multilevel intervention. This study is a pilot evaluation of the individual-level component of the intervention-animated video modules that address specific barriers to HIV testing common among foreign-born Latino men. METHODS: We conducted a survey assessing HIV risk and barriers to testing with a convenience sample of 104 foreign-born Latino men in Baltimore, MD, who had not tested for HIV within the past year. Intention to test in the next 3 months was measured before and after viewing an intervention module selected based on survey responses. RESULTS: Fifty-two (50.0%) participants had never tested for HIV. Of the participants who had previously tested for HIV, the mean time since their last test was 3.48 years (SD = 3.55). Participants' intention to test for HIV significantly increased after watching the module (t = -8.28, P < 0.001). Increased intention to test was not associated with any socio-demographic characteristics (ie, age, country of origin) or reported sexual behaviors (ie, number of sex partners in the past year). DISCUSSION: These results suggest that our culturally sensitive, individually tailored intervention can be an additional tool to encourage HIV testing among previously untested foreign-born Latino men, one of the demographic groups at highest risk for delayed HIV diagnosis in the United States.

HIV-Related Stigma Among Spanish-speaking Latinos in an Emerging Immigrant Receiving City.

HIV-related stigma has been associated with a reluctance to test for HIV among Latinos. This study assessed community HIV-related stigma within an emerging Latino immigrant receiving city. We conducted a brief survey among a convenience sample of 312 Spanish-speaking Latinos in Baltimore, Maryland. HIV-related stigma was assessed through six items. Associations between stigma items, socio-demographic characteristics, and HIV testing history were considered. Gender, education, and religiosity were significantly associated with stigmatizing HIV-related beliefs. For example, men were 3.4 times more likely to hold more than three stigmatizing beliefs than women, and were also twice as likely as women to report feeling hesitant to test for HIV for fear of people's reaction if the test is positive. These findings can help inform future stigma interventions in this community. In particular, we were able to distinguish between drivers of stigma such as fear and moralistic attitudes, highlighting specific actionable items.

Qualitative assessment of HIV prevention challenges and opportunities among Latino immigrant men in a new receiving city.

Changing demographics in new receiving communities contributes to a lag time between the arrival of new immigrants and the development of appropriate services. This scarcity of services can exacerbate existing disparities in health conditions such as HIV, which disproportionately affects Latinos. Focus groups were conducted in Baltimore with 59 Latino men who had immigrated to the U.S. within the past 10 years to explore the challenges and opportunities to accessing HIV testing and preventative services. Transcripts were analyzed through a modified thematic constant comparison approach. Four thematic categories emerged: information about HIV, HIV fear and stigma, barriers to accessing healthcare, and opportunities for intervention approaches. Information and communication technology provides an opportunity to improve access to HIV testing and prevention services. Individualized interventions, though, must be disseminated in collaboration with community-, structural-, and policy-level interventions that address HIV risk, HIV/AIDS stigma, and healthcare access among Latino immigrants.

Smoking, environmental tobacco smoke, and risk of renal cell cancer: a population-based case-control study.

BACKGROUND: Kidney and renal pelvis cancers account for 4% of all new cancer cases in the United States, among which 85% are renal cell carcinomas (RCC). While cigarette smoking is an established risk factor for RCC, little is known about the contribution of environmental tobacco smoke (ETS) to RCC incidence. This study assesses the role of smoking and ETS on RCC incidence using a population-based case-control design in Florida and Georgia. METHODS: Incident cases (n = 335) were identified from hospital records and the Florida cancer registry, and population controls (n = 337) frequency-matched by age (+/- 5 years), gender, and race were identified through random-digit dialing. In-person interviews assessed smoking history and lifetime exposure to ETS at home, work, and public spaces. Home ETS was measured in both years and hours of exposure. Odds ratios and 95% confidence intervals were calculated using logistic regression, controlled for age, gender, race, and BMI. RESULTS: Cases were more likely to have smoked 20 or more pack-years, compared with never-smokers (OR: 1.35, 95% CI: 0.93 - 1.95). A protective effect was found for smoking cessation, beginning with 11-20 years of cessation (OR: 0.39, 95% CI: 0.18-0.85) and ending with 51 or more years of cessation (OR: 0.11, 95% CI: 0.03-0.39) in comparison with those having quit for 1-10 years. Among never-smokers, cases were more likely to report home ETS exposure of greater than 20 years, compared with those never exposed to home ETS (OR: 2.18; 95% CI: 1.14-4.18). Home ETS associations were comparable when measured in lifetime hours of exposure, with cases more likely to report 30,000 or more hours of home ETS exposure (OR: 2.37; 95% CI: 1.20-4.69). Highest quartiles of combined home/work ETS exposure among never-smokers, especially with public ETS exposure, increased RCC risk by 2 to 4 times. CONCLUSION: These findings confirm known associations between smoking and RCC and establish a potential etiologic role for ETS, particularly in the home. Differences in methods of retrospective measurement of lifetime smoking and ETS exposure may contribute to discrepancies in measures of associations across studies, and should be addressed in future research.