Browsing by Author "Seña, Arlene C"
Now showing 1 - 2 of 2
- Results Per Page
- Sort Options
Item Open Access Feasibility and Acceptability of Door-to-Door Rapid HIV Testing Among Latino Immigrants and Their HIV Risk Factors in North Carolina(2010) Seña, Arlene C; Hammer, Juliana P; Wilson, Kate; Zeveloff, Abigail; Gamble, JuliaLatino immigrants in the United States are disproportionally impacted by the HIV epidemic but face barriers to clinic-based testing. We assessed a community-based strategy for rapid HIV testing by conducting "door-to-door'' outreaches in apartments with predominately Latino immigrants in Durham, North Carolina, that has experienced an exponential growth in its Latino population. Eligible persons were 18 years or older, not pregnant, and reported no HIV test in the previous month. Participants were asked to complete a survey and offered rapid HIV testing. Of the 228 Latino participants, 75.4% consented to HIV testing. There was a high prevalence of sexual risk behaviors among participants, with 42.5% acknowledging ever having sex with a commercial sex worker (CSW). Most (66.5%) had no history of prior HIV testing. In bivariate analysis, perceived HIV risk, no history of HIV testing, sex with a CSW, sex in exchange for drugs or money, living with a partner, and alcohol use were significantly associated with test acceptance. In the multivariate analysis, participants who had never been tested for HIV were more likely to consent to rapid HIV testing than those who had tested in the past (adjusted odds ratio 2.5; 95% confidence interval [CI], 1.1, 5.6). Most participants supported rapid HIV testing in the community (97%). Door-to-door rapid HIV testing is a feasible and acceptable strategy for screening high-risk Latino immigrants in the community. Factors associated with HIV risk among Latino migrants and immigrants in the United States should be considered along with novel testing strategies in HIV prevention programs.Item Open Access The increasing impact of human immunodeficiency virus infections, sexually transmitted diseases, and viral hepatitis in Durham County, North Carolina: a call for coordinated and integrated services.(N C Med J, 2011-11) Kolman, Marc; DeCoster, Mary; Proeschold-Bell, Rae Jean; Hunter, Genevieve Ankeny; Bartlett, John; Seña, Arlene CBACKGROUND: Durham County, North Carolina, faces high rates of human immunodeficiency virus (HIV) infection (with or without progression to AIDS) and sexually transmitted diseases (STDs). We explored the use of health care services and the prevalence of coinfections, among HIV-infected residents, and we recorded community perspectives on HIV-related issues. METHODS: We evaluated data on diagnostic codes, outpatient visits, and hospitalizations for individuals with HIV infection, STDs, and/or hepatitis B or C who visited Duke University Hospital System (DUHS). Viral loads for HIV-infected patients receiving care were estimated for 2009. We conducted geospatial mapping to determine disease trends and used focus groups and key informant interviews to identify barriers and solutions to improving testing and care. RESULTS: We identified substantial increases in HIV/STDs in the southern regions of the county. During the 5-year period, 1,291 adults with HIV infection, 4,245 with STDs, and 2,182 with hepatitis B or C were evaluated at DUHS. Among HIV-infected persons, 13.9% and 21.8% were coinfected with an STD or hepatitis B or C, respectively. In 2009, 65.7% of HIV-infected persons receiving care had undetectable viral loads. Barriers to testing included stigma, fear, and denial of risk, while treatment barriers included costs, transportation, and low medical literacy. LIMITATIONS: Data for health care utilization and HIV load were available from different periods. Focus groups were conducted among a convenience sample, but they represented a diverse population. CONCLUSIONS: Durham County has experienced an increase in the number of HIV-infected persons in the county, and coinfections with STDs and hepatitis B or C are common. Multiple barriers to testing/treatment exist in the community. Coordinated care models are needed to improve access to HIV care and to reduce testing and treatment barriers.