Desired Characteristics of HIV Testing and Counseling among Diverse Survivors of Intimate Partner Violence Receiving Social Services.

Despite recent calls to integrate HIV testing into social services addressing intimate partner violence (IPV), few studies have reported on survivors' perspectives regarding the desired characteristics of this integration. The purpose of this study was to describe desired characteristics of HIV and sexually transmitted infection (STI) testing services from a survivor's perspective. A qualitative descriptive approach was taken to describe the perspectives of IPV survivors who may or may not have accessed this service. Four focus groups were conducted with a diverse sample of English and Spanish speakers (N = 25) who sought services through a family justice center and associated shelters. Focus groups were recorded, transcribed, and analyzed using conventional content analysis. Three themes were identified, including (1) peace of mind; (2) interacting stigmas and traumas; and (3) making testing easy, comfortable, and tailored. The findings of this study have the potential to influence survivor-centered practices and policies regarding the integration of culturally informed HIV/STI and IPV services.

The contribution of stress, cultural factors, and sexual identity on the substance abuse, violence, HIV, and depression syndemic among Hispanic men.

OBJECTIVES: The purpose of this study was to confirm the substance abuse, violence, HIV, and depression syndemic among Hispanic men, and to test whether stress and sociocultural factors, including acculturation, family support, and sexual orientation, predict this syndemic. METHOD: A cross-sectional survey was administered to 164 Hispanic men using standardized measures for Hispanic Stress (Cervantes, Padilla, & Salgado de Snyder, 1991), substance abuse (Kelly et al., 1994), violence (Peragallo et al., 2005), risk for HIV (González-Guarda, Peragallo, Urrutia, Vasquez, & Mitrani, 2008), and depression (Center for Epidemiologic Studies Scale, CES-D; Radloff, 1977). RESULTS: Results from Structural Equation Modeling (SEM) supported the syndemic factor among Hispanic men. While family/cultural stress and homosexual identity were risk factors for the syndemic factor, family support was protective. CONCLUSIONS: More longitudinal research is needed to identify influences on the syndemic factor among diverse Hispanic communities. Interventions that address stress and enhance family supports may show promise in addressing and preventing syndemics among Hispanic men. (PsycINFO Database Record

Examining the Preliminary Efficacy of a Dating Violence Prevention Program for Hispanic Adolescents.

The purpose of this study is to evaluate the preliminary efficacy of a dating violence (DV) prevention program for Cuban American adolescents (JOVEN/YOUTH: Juntos Opuestos a la Violence Entre Novios/Together Against Dating Violence). A randomized-controlled experimental design with a delayed condition was used to evaluate the effects on DV victimization and perpetration (N = 82). Self-administrated assessments were completed at baseline, 1 week, 3 months, and 12 months after the intervention to assess for psychological victimization and perpetration and physical and sexual victimization and perpetration. Effect sizes were estimated, and generalized estimating equations were generated to test intervention effects over time and potential gender interactions. The intervention had medium to strong effects on DV victimization and perpetration for male participants but not for females. However, intervention effects were not statistically significant over time. More research is needed to enhance intervention effects of JOVEN on DV outcomes and to evaluate these effects among a larger and more diverse sample.

Substance abuse, violence, HIV, and depression: an underlying syndemic factor among Latinas.

BACKGROUND: Evidence from the literature suggests that substance abuse, violence, HIV risk, depressive symptoms, and underlying socioeconomic conditions are tied intrinsically to health disparities among Latinas. Although these health and social conditions appear to comprise a syndemic, an underlying phenomenon disproportionately accounting for the burden of disease among marginalized groups, these hypothesized relationships have not been formally tested. OBJECTIVES: The aim of this study was to assess (a) if substance abuse, violence, HIV risk, and depressive symptoms comprised a syndemic and (b) if this syndemic was related to socioeconomic disadvantage among Latinas. METHODS: Baseline assessment data from a randomized controlled community trial testing the efficacy of an HIV risk reduction program for adult Latinas (n = 548) were used to measure demographic variables, substance abuse, violence, risk for HIV, and depressive symptoms. Structural equation modeling was used to test a single underlying syndemic factor model and any relation to socioeconomic disadvantage. RESULTS: The results of this study support the idea that HIV risk, substance abuse, violence, and depressive symptoms comprise a syndemic, χ(27) = 53.26, p < .01 (relative χ = 1.97, comparative fit index = .91, root mean square error of approximation = .04). In addition, in limited accord with theory, this factor was related to 2 measures of socioeconomic disadvantage, percentage of years in the United States (b = 7.55, SE = 1.53, p < .001) and education (b = -1.98, SE = .87, p < .05). DISCUSSION: The results of this study could be used to guide public health programs and policies targeting behavioral health disparity conditions among Latinos and other vulnerable populations. Further study of the influence of gender-role expectations and community-level socioeconomic indicators may provide additional insight into this syndemic.

Factors Associated With HIV Testing in Youth in the United States: An Integrative Review.

We used an integrative review to synthesize existing literature on the factors associated with HIV testing by youth ages 13 to 24 years in the United States. PubMed, CINAHL, PsycINFO, and Google Scholar were systematically searched and 44 original research studies met our criteria. A directed qualitative content analysis was conducted to integrate findings according to the personal, relationship, community, and society levels of the social-ecological model. Female gender, African American race, age, and physical illness were some of the factors more consistently associated with HIV testing. Modifiable factors such as fear, drug use, poor condom use, partner communication, and multiple sexual partners were also noted as influencing HIV testing in youth. Our integrative review revealed gaps in the literature that need further exploration, particularly in the area of community and society influences on HIV testing for youth. Implications for research, practice, and policy are discussed.

Transnational Motherhood: Health of Hispanic Mothers in the United States Who Are Separated From Children.

Immigration often results in the separation of families, and in particular transnational parenting, which is the separation of mothers from children. Transnational mothers may have greater risks for poor mental health and behavioral conditions such as substance abuse, violence, sexual risk, and depression. This study was a secondary analysis of self-reported data from 425 Hispanic mothers (328 with no separations, 60 separated from an adult child, and 37 separated from a minor child) enrolled in a randomized trial of a sexual health group intervention in South Florida (USA). Separations were related to mother's age, years in the United States, family income, number of people living on income, acculturation to the United States, occupational/economic stress, immigration stress, and lifetime exposure to abuse. A follow-up analysis described the types of childhood or adulthood abuse experienced by mothers with separations. These findings provide new information for nurses about the experience of immigrant mothers.

[Intimate Partner Violence Among Hispanic Women: Implications for Research and Practice]. / Violencia de Pareja en Mujeres Hispanas: Implicaciones para la Investigación y la Práctica.

Research on intimate partner violence indicates that Hispanic women are disproportionately affected by the occurrence and consequences of this public health problem. The objective of this article is to review the state of the art regarding the epidemiology, consequences and risk factors for IPV among Hispanic women, as well as discuss the implications these have for research and practice. Research has demonstrated a strong association between socioeconomic factors, drug and alcohol abuse, mental health, acculturation, immigration, risky sexual behaviors, history of abuse and IPV among community samples of Hispanics. As research elucidates the etiology of IPV among Hispanic women, nurses and other health professionals should develop, implement and evaluate culturally appropriate strategies for the primary and secondary prevention of IPV.

A Community Forum to Assess the Needs and Preferences for Domestic Violence Prevention Targeting Hispanics.

Hispanics are disproportionately affected by the occurrence and consequences of domestic violence when compared to their non-Hispanic counterparts. The Partnership for Domestic Violence used a community-based participatory research approach to assess the needs and preferences for preventing domestic violence (DV) among Hispanics in Miami-Dade County. Researchers conducted a community forum in which data collected from focus groups were presented to approximately 100 community members to gather their feedback regarding the development of DV prevention programs tailored for Hispanics. Participants were in high agreement that a program targeting youth is the highest priority and that specific cultural variables should be incorporated to make the program most effective. Recommendations for DV prevention targeting Hispanics and the use of community forums as a method of research are provided.

Hispanic women's experiences with substance abuse, intimate partner violence, and risk for HIV.

UNLABELLED: Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. THE PURPOSE: Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo ) in interventions targeting Hispanics.

La mancha negra: substance abuse, violence, and sexual risks among Hispanic males.

Hispanics are disproportionately affected by substance abuse, intimate partner violence, and HIV. Although the relationship between these conditions has been documented in the literature, few studies have explored the intersection of these health problems and their culture-related risk factors in an integrative manner. The purpose of this study is to explore the experiences that Hispanic heterosexual males in South Florida have with substance abuse, violence, and risky sexual behaviors. Three focus groups with a total of 25 Hispanic adult men are completed and analyzed using grounded theory. Three core categories emerge from the data. These include la cuna de problemas sociales (the cradle of social problems), ramas de una sola mata (branches from one same tree), and la mancha negra (the black stain). This study suggests that substance abuse, violence, and risky sexual behaviors are linked conditions with common cultural and socioenvironmental risk factors and consequences.

Drugs, Women and Violence in the Americas: U.S. Quantitative Results of a Multi-Centric Pilot Project (Phase 2).

OBJECTIVES: To explore the collective and individual experiences that Latin American females in the U.S. have with substance abuse, violence and risky sexual behaviors. METHODS: This study was conducted in two phases from July 2006 to June 2007 in south Florida. This paper covers Phase 2. In Phase 2, questionnaires were provided to women to test whether there is a relationship between demographics, acculturation, depression, self-esteem and substance use/abuse; whether there is a relationship between demographics, acculturation, depression, self-esteem and violence exposure and victimization; whether there is a relationship between demographics, acculturation, depression, self-esteem, HIV knowledge and STD and HIV/AIDS risks among respondents; and whether there is a relationship between substance abuse, violence victimization and HIV/AIDS risks among respondents. RESULTS: Participants reported high rates of alcohol and drug abuse among their current or most recent partners. This is a major concern because partner alcohol use and drug use was related to partner physical, sexual and psychological abuse. Only two factors were associated with lifetime drug use: income and acculturation. Over half of the participants reported being victims of at least one form of abuse during childhood and adulthood. A substantial component of abuse reported during adulthood was perpetrated by a currently or recent intimate partner. CONCLUSIONS: The results from this study suggest that substance abuse, violence and HIV should be addressed in an integrative and comprehensive manner. Recommendations for the development of policies, programs and services addressing substance abuse, violence and risk for HIV among Latinos are provided.

Drugs, Women and Violence in the Americas: U.S. Results of a Multi-Centric Pilot Project (Phase 1).

OBJECTIVES: To explore the collective and individual experiences that Latin American females in the U. S. have with substance abuse, violence and risky sexual behaviors. METHODS: This study was conducted in two phases that were carried out from July 2006 to June 2007 in south Florida. This paper covers Phase 1. In Phase 1, focus groups were conducted among 93 women in English, Spanish and Portuguese. Through content analyses of the focus group transcriptions, major themes were identified. RESULTS: Participants identified substance abuse, violence and risky sexual behaviors as closely related problems of great concern in Latina women in the U.S. Three important themes emerged from the focus groups. These included "Living in the US and the Devaluing of Latino Culture," the "Vicious Cycle of Abuse" and "Breaking the Silence". CONCLUSIONS: The results from this study suggest that substance abuse, violence and HIV should be addressed in an integrative and comprehensive manner. Recommendations for the development of policies, programs and services addressing substance abuse, violence and risk for HIV among Latinos are provided.

Violencia de pareja en mujeres hispanas: implicancias para la investigación y la práctica / Intimate partner violence among Hispanic women: implications for research and practice

Las investigaciones sobre la violencia entre parejas sugieren que las mujeres hispanas están siendo afectadas desproporcionadamente por la ocurrencia y consecuencias de este problema de salud pública. El objetivo del presente artículo es dar a conocer el estado del arte en relación a la epidemiología, consecuencias y factores de riesgo para violencia de pareja (VP) entre mujeres hispanas, discutiendo las implicancias para la investigación y la práctica. Las investigaciones han demostrado una fuerte asociación del estatus socioeconómico, abuso de las drogas y el alcohol, la salud mental, aculturación, inmigración, comportamientos sexuales riesgosos e historia de abuso con la violencia entre parejas. Sin embargo, más estudios se deben llevar a cabo para identifi car otros factores de riesgos y de protección a poblaciones hispanas no clínicas. Mientras que el conocimiento sobre la etiología de la VP entre mujeres hispanas se expanda, enfermeras y otros profesionales de la salud deben desarrollar, implementar y evaluar estrategias culturalmente adecuadas para la prevención primaria y secundaria de la violencia entre pareja.

Research on intimate partner violence indicates that Hispanic women are disproportionately affected by the occurrence and consequences of this public health problem. The objective of this article is to review the state of the art regarding the epidemiology, consequences and risk factors for Partner violence IPV among Hispanic women, as well as discuss the implications these have for research and practice. Research has demonstrated a strong association between socioeconomic factors, drug and alcohol abuse, mental health, acculturation, immigration, risky sexual behaviors, history of abuse and IPV among community samples of Hispanics. As research elucidates the etiology of IPV among Hispanic women, Nurses and other health professionals should develop, implement and evaluate culturally appropriate strategies for the primary and secondary prevention of IPV.

Drugs, women and violence in the Americas: U.S. quantitative results of a multi-centric pilot project (phase 2) / Drogas, mujeres y violencia en el continente americano: resultados de un proyecto piloto multicéntrico en Estados Unidos (fase 2)

Objetivo: Explorar las experiencias colectivas e individuales que mujeres latinomaericanas tienen en los Estados Unidos en cuanto al abuso de sustancias, violencia y conductas sexuales de riesgo. Métodos: El estudio se realizó en dos fases entre julio de 2006 y junio de 2007, en el sur de Florida. En la Fase 2, se dieron cuestionarios a las mujeres para comprobar si existe una relación entre: características demográficas, grado de aculturación, depresión, autoestima, uso/abuso de sustancias, exposición a la violencia y conocimiento de los riesgos del VIH y el sida. Resultados: Los participantes reportaron altos índices de abuso de alcohol y drogas. Sólo dos factores se asociaron con el uso de drogas de por vida: ingresos económicos y aculturación. Más de la mitad de los participantes informaron haber sido víctimas de al menos una forma de abuso (físico, sexual y/o psicológico) durante la infancia y la adultez. Un componente importante de los abusos reportados durante la edad adulta es que fueron perpetrados por un compañero íntimo. Conclusiones: Los resultados de este estudio sugieren que el abuso de sustancias, la violencia y el VIH deben abordarse de manera integradora y global...

Objectives: To explore the collective and individual experiences that Latin American females in the U.S. have with substance abuse, violence and risky sexual behaviors. Methods: This study was conducted in two phases from July 2006 to June 2007 in south Florida. This paper covers Phase 2. In Phase 2, questionnaires were provided to women to test whether there is a relationship between demographics, acculturation, depression, self-esteem and substance use/abuse; whether there is a relationship between demographics, acculturation, depression, self-esteem and violence exposure and victimization; whether there is a relationship between demographics, acculturation, depression, self-esteem, HIV knowledge and STD and HIV/AIDS risks among respondents; and whether there is a relationship between substance abuse, violence victimization and HIV/AIDS risks among respondents. Results: Participants reported high rates of alcohol and drug abuse among their current or most recent partners. This is a major concern because partner alcohol use and drug use was related to partner physical, sexual and psychological abuse. Only two factors were associated with lifetime drug use: income and acculturation. Over half of the participants reported being victims of at least one form of abuse during childhood and adulthood. A substantial component of abuse reported during adulthood was perpetrated by a currently or recent intimate partner. Conclusions: The results from this study suggest that substance abuse, violence and HIV should be addressed in an integrative and comprehensive manner. Recommendations for the development of policies, programs and services addressing substance abuse, violence and risk for HIV among Latinos are provided...

Drugs, women and violence in the Americas: U.S. results of a multi-centric pilot project (phase 1) / Drogas, mujeres y violencia en el continente americano: resultados de un proyecto piloto multicéntrico en Estados Unidos (fase 1)

Objetivo: explorar las experiencias colectivas e individuales que mujeres latinoamericanas experimentan en los Estados Unidos en relación con el abuso de sustancias, violencia y conductas sexuales de riesgo. Métodos: el estudio se realizó en dos fases que se llevaron a cabo entre julio de 2006 y junio de 2007 en el sur del estado de la Florida (Estados Unidos). Este documento recoge la Fase 1, en la cual se llevaron a cabo grupos focales entre 93 mujeres, en inglés, español y portugués. A través de análisis de contenido de las transcripciones del grupo focal, se identificaron los principales temas. Resultados: Los participantes identificaron el abuso de sustancias, violencia y conductas sexuales de riesgo como problemas íntimamente relacionados de gran preocupación en las mujeres latinas en los Estados Unidos. Tres importantes aspectos surgieron de los grupos focales: “Vivir en los Estados Unidos y la devaluación de la cultura latina”, el “círculo vicioso del abuso” y “rompiendo el silencio”. Conclusiones: Los resultados de este estudio sugieren que el abuso de sustancias, violencia y VIH debe abordarse de una manera integrada y global. Se dan recomendaciones para el desarrollo de políticas, programas y servicios referidos a abuso de sustancias, violencia y riesgo de VIH entre los latinos...

Objectives: To explore the collective and individual experiences that Latin American females in the U. S. have with substance abuse, violence and risky sexual behaviors. Methods: This study was conducted in two phases that were carried out from July 2006 to June 2007 in south Florida. This paper covers Phase 1. In Phase 1, focus groups were conducted among 93 women in English, Spanish and Portuguese. Through content analyses of the focus group transcriptions, major themes were identified. Results: Participants identified substance abuse, violence and risky sexual behaviors as closely related problems of great concern in Latina women in the U.S. Three important themes emerged from the focus groups. These included “Living in the US and the Devaluing of Latino Culture,” the “Vicious Cycle of Abuse” and “Breaking the Silence”. Conclusions: The results from this study suggest that substance abuse, violence and HIV should be addressed in an integrative and comprehensive manner. Recommendations for the development of policies, programs and services addressing substance abuse, violence and risk for HIV among Latinos are provided...