Hispanics account for 17% of all US AIDS cases, yet they make up less than 10% of the US population. Lack of English language skills and cultural differences create barriers to reaching this cultural group with strategies and resources for prevention. The purpose of this study is to develop and test the effectiveness of culture specific/competent community-based interventions to decrease the transmission of HIV among recently immigrated Mexican Americans in the Southeastern U.S. The research development plan includes 4 phases, and 'home base' for all phases is the Hispanic Center in Durham, NC. In phase one, the candidate will conduct an ethnographic study of the socio-cultural environment and sexual negotiations of newly immigrated Mexican Americans. The participants will include adult men and women who occupy various roles that have differing status in the community. Staging of the ethnography will follow Wilson's recommendations. To assure reliability, validity, and credibility of the data, multiple methods of triangulation will be used. Data collection includes participant observation and interviews which will be conducted in Spanish. Phase two will involve the development of a lay health advisor program to provide ongoing health-related social support and training in the community for the prevention of HIV. Ten to twelve lay health workers will be recruited and trained in 8 workshops focusing on HIV/AIDS, methods of prevention and ways to negotiate for safer sex, referrals and appointments, and confidentiality and ethical conduct. The program will be evaluated based on effectiveness in meeting the lay advisors' needs, their ability to share information, and the amount of knowledge the advisors have about HIV/AIDS. Phase three will involve curriculum development and pilot testing of a curriculum that is both grounded in and delivered in a culturally relevant context. Phases two and three will occur concurrently and the lay health workers will be involved in assuring cultural relevance of the curriculum. The curriculum will be based on principles of empowerment for learning. Phase four will involve the test of a culture-specific AIDS intervention. The sample will include 54 couples randomly assigned to either intervention or control groups. The intervention group will receive two formal sessions and a booster session with the lay health worker. The control group will receive a parallel program related to non-HIV related issues of concern such as community violence. The curriculum will be delivered by Dr. McQuiston, Ms. Laura Doerfer, and the lay health advisors using a flip chart presentation and vignette formate which has been successfully used for AIDS interventions in Mexico. Ms. Doerfer is a public health consultant at the UNC Schools of Nursing and Public Health. Measures will be taken at baseline, immediately following the intervention, after a one-hour booster session with the lay health worker, and one month later. Repeated measures MANOVA will be conducted for each outcome variable with couple as the unit of analysis. In addition to quantitative and qualitative analysis, a process evaluation of the intervention is also planned.
| McQuiston, Chris; Flaskerud, Jacquelyn H (2003) ""If they don't ask about condoms, I just tell them"": a descriptive case study of Latino lay health advisers' helping activities. Health Educ Behav 30:79-96 |
| McQuiston, Chris; Larson, Kim; Parrado, Emilio A et al. (2002) AIDS knowledge and measurement considerations with unacculturated Latinos. West J Nurs Res 24:354-72 |
| McQuiston, C; Choi-Hevel, S; Clawson, M (2001) Protegiendo Nuestra Comunidad: empowerment participatory education for HIV prevention. J Transcult Nurs 12:275-83 |
