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Marginalized/Vulnerable Populations

Marginalized Populations are defined as: diverse populations such as Lesbians, Gay, Bisexual, Transsexuals; Incarcerated and Newly Released; Migrants; Immigrants; Seniors; Pregnant Women; Homeless; English as a Second Language communities; Dually and Triply Diagnosed.

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The following resources are available from the AETC NMC Electronic Library as well as repository locations of our collaborative partners. Materials are listed with most recent items first.

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African Americans/Blacks

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American Indians/Alaska Natives

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  • Use this link to access the latest citations about Arab Americans and HIV/AIDS fom PubMed, the National Library of Medicine's database of biomedical literature.

Arab Americans

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Asian Americans

Health Literacy

  • How Effective Healthcare Communication Contributes to Health Equity
    This video addresses provider health literacy, contribute to improving the quality of services for culturally and linguistically diverse populations as well as people with limited health literacy skills
    Source: PubMed 2012
  • Doctor/Patient Communication | Our Stories, Our Health
    This video discusses how many Southeast Asian immigrants are unable to obtain adequate healthcare because of language barriers. They can't effectively communicate with healthcare providers, and are unable to navigate the complicated system
    Source: PubMed 2010
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  • Use this link to access the latest citations about Homelessness and HIV/AIDS fom PubMed, the National Library of Medicine's database of biomedical literature.

Homelessness and HIV/AIDS

  • Improving the Health of the Homeless: Advice for Physicians.
    Homeless individuals suffer from a constellation of health issues, experience barriers to medical care that are both recognizable and hidden, and score worse on measures of health outcomes than the general population. The article   describes common conditions affecting homeless people and discusses how patient-centered comprehensive primary care, collaboration between health care providers and social service organizations, and innovative delivery of medical respite services can result in better care for this population. Source: PubMed 2012
  • Addressing Cultural and Linguistic Competence in the HCH (Health Care Homeless) Setting: A Brief Guide. HCH providers are sensitive to their client's attitudes,beliefs, and behaviors, many of which are shaped by their direct experience of poverty and homelessness. 2011
  • Use of Complementary & Alternative Therapies in Homeless Health Care. This issue of Healing Hands explains what is meant by CAM, describes the major theoretical systems and practices it comprises, and discusses therapies currently used by Health Care for the Homeless (HCH) practitioners—including nutritional supplements, acupuncture, and mindfulness-based stress reduction—and the extent to which their efficacy has been tested.
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Incarcerated Patients Living with HIV/AIDS

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Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ)

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  • Use this link to access the latest citations about MSM and HIV/AIDS fom PubMed, the National Library of Medicine's database of biomedical literature. PubMed
  • More about PubMed

Men who have Sex with Men (MSM)

Mental Health

  • Mental Health of Deaf People.
    In this article discrepancies are described  between a high burden of common mental health disorders and barriers to health care. Research into factors affecting mental health of deaf children shows that early access to effective communication with family members and peers is desirable. Improved access to health and mental health care can be achieved by provision of specialist services with professionals trained to directly communicate with deaf people and with sign-language interpreters. Source: PubMed 2012
  • Assessing the Mental Health Needs and Barriers to Care among a Diverse Sample of Asian American Older Adults.
    The study sought to compare the prevalence rates of mental distress of Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese older adults (aged 55 and older) to that of non-Hispanic whites; and to examine subgroup differences in utilization of mental health services. The findings of the study  not only highlighted the unmet mental health needs among older Asian Americans, but also illustrated significant variations among the various Asian subgroups. Source: PubMed 2011
  • Language Concordance and Patient-physician Communication regarding Mental Health Needs.
    This article discusses language-related communication barriers between minority patients and their physicians may contribute to racial and ethnic disparities in mental health care. Accordingly, the current study sought to examine whether perceived mental health needs and discussion of these needs differed as a function of race or ethnicity and language concordance in older Latinos and Asian and Pacific Islanders (APIs). There were no significant differences in respondents' perceptions of their mental health needs across race or ethnicity or level of language concordance status (Ps > .41), although there were significant differences in whether respondents had discussed their mental health needs with their physicians according to participant race or ethnicity and language concordance status (adjusted odds ratio = 0.47, P = .04). These findings underscore the importance of overcoming language-related and cultural barriers to improve patient-provider discussions of older adults' mental health needs. Source: PubMed 2011
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Migrant and Immigrant Communities

  • 2012 East Coast Migrant Stream Forum: October 18 - 20, 2012
    This conference, to be held in Virginia Beach, is for health care providers and outreach workers serving migrant and seasonal farmworkers.
  • Use of Commercial Sex Workers among Hispanic Migrants in North Carolina: Implications for the Spread of HIV
    This study examines commercial sex workers use among a randomly selected sample of foreign-born Hispanics in Durham, North Carolina
    Source: GI 2011
  • Impact of culture on healthcare seeking behavior of Asian Indians. This article explores the influence of culture at each of these stages in the context of Asian Indian culture. Although Asian-Indians constitute only 1.5% of the US population they are among the fastest growing minorities in the United States.
    Source: PubMed 2010
  • Improving communication between patients and providers using health information technology and other quality improvement strategies: focus on Asian Americans. Disparities in provider-patient communication have been shown to exist among Asian Americans, especially those who are low-income and have limited English proficiency.
    Source: PubMed 2010
  • Risk perception and beliefs regarding HIV infection among Ethiopian immigrants
    In Ethiopia, approximately 7.5% of the urban population is HIV-positive. Nationally, 1.5 million people are living with HIV. Between 1990 and 2000, immigration into the United States by African-born immigrants increased by 130%.  Individuals from Ethiopia comprise a significant portion of this immigrant population. Although there is a rich literature addressing the beliefs regarding HIV and risk perception among some immigrant populations in the United States, few studies target Ethiopian-born residents. Thus, a survey-based study addressing demographics, acculturation, awareness, beliefs and risk perception, attitudes toward susceptibility for infection, and risk behaviors targeted Ethiopian-born residents of San Diego, California.
    Source: October 2009
  • Healthcare experiences of limited english-proficient asian american patients: a cross-sectional mail survey. This survey evaluated the degree of health education and the quality of interpersonal care that occurs during patient visits, and their associations with patient satisfaction, in LEP Asian American patients.
    Source: PubMed 2009
  • Access to regular HIV care and disease progression among black African immigrants
    The objective of this study wass to describe the characteristics of human immunodeficiency virus (HIV)-infected black African immigrants living in King County,Washington. Authors evaluated delay in HIV diagnosis, access to HIV care, and risk of progression to AIDS or death. Once having initiated HIV care, African-born blacks accessed HIV care and progressed to AIDS at similar rates compared to U.S.-born individuals. However, African-born blacks initiated care with more advanced HIV disease. Results underscore the need for health interventions promoting HIV testing among black African immigrants and reducing barriers to HIV testing.
    Source: December 2009
  • LGBT Immigrant and Immigrant Living with HIV
    The report presents results of a survey of LGBT immigrants and immigrants living with HIV. The survey assessed experiences with health care refusal and other barriers to health care access.
    Source: PubMed 2009
  • HIV screening and care for immigration detainees.
    The detention of immigrants in the United States is a rapidly expanding endeavor with serious health consequences for the detainees. This detainee population represents non-criminal immigrants who are detained because of a visa violation or other immigration issue but who are not charged with any crime and do not enter the criminal justice system. HIV-positive detainees are especially vulnerable to lapses in proper medical care. Press reports have highlighted deaths and adverse medical outcomes among HIV-positive detainees.
    Source: PubMed 2009
  • Health Programs for Immigrants
    Overview of the African Services project and its methods of providing culturally appropriate care to African Immigrants Source: African Services Committee, New York 2009

Mobility Impairment

  • Health Care under the ADA: A Vision or a Mirage?
    This study identified health care access barriers using recent studies documenting the health disparities experienced by people with disabilities. Some of these health care access barriers qualify as discrimination prohibited under the Americans with Disabilities Act. The broad challenge for the coming decade is to develop means to achieve effective communication and eliminate physical and programmatic barriers in more health care provider settings more consistently. The ADA can be a vigorous force in this effort as part of a multipronged strategy. Source: PubMed 2010

Multimedia: Videos to View

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Muslim Americans

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Native Hawaiians/Pacific Islanders

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Over 50

  • Top Health Issues for LGBT Populations Information & Resource Kit
    This publication informs health care providers and prevention specialists about the health experiences of LGBT populations. Source: SAMHSA 2012
  • A systematic review of education for the prevention of HIV/AIDS among older Adults,  PubMed 2012
    Through a comprehensive literature search, the authors of this systematic review identified 21 articles focused on primary prevention of HIV/AIDS for adults aged 50 and over. Three major challenges to providing HIV/AIDS education for older adults include health professionals' ageism, older adults' reluctance to discuss sexuality, and their misconception of their HIV risk.
    Source: PubMed 2012
  • Inclusive Services for LGBT Older Adults:  A Practical to Guide to Creating a Welcoming Agencies NRC on LGBT Aging
    This guide was created to answer these questions and help you as service providers to
    understand the unique barriers that LGBT older adults face, as well as the many ways
    to improve and expand the continuum of care and services available
    Source: PubMed 2012
  • A systematic review of education for the prevention of HIV/AIDS among older adults
    The authors conducted a systematic literature review on primary prevention of HIV/AIDS among adults aged 50 and older.  They summarize challenges to prevention, clinical guidelines, and HIV/AIDS education models. The authors conclude that additional research on effective prevention and additional outreach efforts are needed to provide adequate services to people in this age group.
    Source: PubMed 2012
  • The National HIV/AIDS and Aging Awareness Day (NHAAAD), observed on September 18. National HIV/AIDS and Aging Awareness day focuses on the challenging issues facing the aging population with regards to HIV prevention, testing, care and treatment. In addition, there is an increased need for prevention, research, and data targeting the aging population, medical understanding of the aging process and its impact on HIV/AIDS. Resources: AIDS Institute. The AIDS Institute: Announces over twenty registered events for the 5th annual National HIV/AIDS and Aging Awareness Day (NHAAAD).
  • HIV/AIDS and Older Adults: Fact Versus Fiction
    This article talks about the many myths and misconceptions surround HIV and AIDS, particularly for people over 50 living with the disease. HIV and AIDS have long been subject to many myths and misconceptions, many of which concern older adults. Thanks to recent advancements in HIV/AIDS treatments, particularly highly active antiretroviral therapies (HAART), many people living with HIV/AIDS are living long, healthy lives, transforming HIV into a chronic but manageable illness. Therefore, it is no surprise that research shows that adults age 50 and over comprise a significant—and growing—number of people living with HIV/AIDS (PLWHA), as well as those newly diagnosed with HIV and AIDS each year. Source: NRC-LGBT Aging 2011
  • What's Hard About Living with HIV/AIDS When You're Over 50? 2011
    Source: PubMed 2011
  • "I'm not going to die from the AIDS": resilience in aging with HIV disease
    This study seeks to examine the lived experiences of older adults with HIV/AIDS as it relates to strengths and resilience in dealing with this devastating disease.
    Source: Pubmed 2011
  • HIV/AIDS interventions in an aging U.S. population
    HIV prevention for people over 50 is an important health concern, especially as the U.S. population grows older. This article reviews the current interventions and proposes possible HIV/AIDS prevention effort for older adults.
    Source: Pubmed 2011
  • Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic
    This paper presents a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided.
    Source: Pubmed 2011
  • What do we know about older adults and HIV? A review of social and behavioral literature
    This review assesses the state of knowledge of the sociocultural and behavioral factors associated with aging with HIV.
    Source: Pubmed 2011
  • Growing older with the epidemic: HI V and aging
    This paper details what we know about HIV among older adults, what we do not yet understand, and what improvements can be made to better prepare the country to care for this population.
    Source: Pubmed 2010
  • A Tool for Serving Diverse Communities US Administration on Aging
    This Toolkit provides the Aging Network and its partners with replicable and easy-to-use methods for providing respectful, inclusive, and sensitive services for any diverse community….
    Source: USAA
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Physically Challenged

  • Addressing Intersections in HIV/AIDS and Mental Health: The Role of Organizations for d/Deaf and Hard of Hearing Individuals in South Africa.
    This article reveals  that deaf and hard of hearing South Africans, just like the general population, are at risk of acquiring HIV/AIDS and having mental disorders, resulting from barriers to communication and care. The need to focus on HIV/AIDS education, prevention, and mental health services were seen as activities to reduce communication barriers. Source: PubMed 2012
  • Deaf Community Health Workers Provide Culturally Appropriate Education and Support to Deaf Patients, Improving Patient Knowledge and Engagement
    Under a program known as the Deaf Community Health Worker Initiative, trained deaf individuals assist members of the Minnesota Deaf community, including deaf immigrants, in understanding medical information and becoming active participants in their own care. Source: AHRQ 2012
  • Assuring Health Equity for Minority Persons with Disabilities ACMH July
    Along with poorer health and higher use of health care, the NCD report documents that barriers to preventive services disproportionately affect people with disabilities: for example, persons with disabilities are less likely to receive counseling for smoking cessation than are persons without disabilities. Other barriers include health care provider stereotypes about disabilities; lack of appropriate provider training; and a lack of accessible medical facilities and examination equipment, sign language interpreters, and individualized accommodation
    Source: PubMed July 2011
  • A handbook on best practices regarding HIV and AIDS for people with disabilities
    This handbook aims to increase awareness of disability and HIV, to share knowledge and to give examples of best practices. It also invites study of the impact of the AIDS epidemic on people with disabilities and seeks to incite a wider action to achieve universal access for people with disabilities to HIV prevention, treatment, care and support.
    Source: PubMed February 2011
  • Assessing Deaf Cultural Competency of Physicians and Medical Students.
    This report suggests training medical students in deaf cultural competency can significantly increase their capacity to care for community members and reduce the health disparities experienced by deaf community. Source: PubMed 2011
  • Impact of Communication on Preventive Services among Deaf American Sign Language Users.
    The goal of this study was to determine whether provider language concordance is associated with improved receipt of preventive services among deaf respondents.  Deaf American Sign Language (ASL) users face communication and language barriers that limit healthcare communication with their providers. Prior research has not examined preventive services with ASL-skilled clinicians. Source: PubMed 2011
  • Role-reversal Exercise with Deaf Strong Hospital to Teach Communication Competency and Cultural Awareness.
    This paper discusses a role-reversal exercise to increase first-year pharmacy students' awareness of communication barriers in the health care setting, especially for deaf and hard-of-hearing patients. Source: PubMed 2011
  • Sensitive Care for the Deaf: A Cultural Challenge.
    This article discusses the deaf community, their culturally based health care needs, and health care providers' (HCPs) lack of understanding and recognition of deafness as a distinct culture, which individually or cumulatively result in barriers to receiving culturally sensitive care that can lead to disparities in care. It suggests transcultural methods can be used to narrow the cultural divide. Source: PubMed 2011
  • What do deaf high school students know about HIV?
    Deaf adolescents who use American Sign Language (ASL) as their main communication mode are, like their hearing age peers, at risk for acquiring HIV. Many sources of HIV information (radio and television) are not accessible to these adolescents. The authors discuss this population’s need for school-based linguistically and culturally accessible HIV prevention education.
    Source: PubMed December 2010
  • Sexual vulnerability and HIV seroprevalence among the deaf and hearing impaired in Cameroon
    This quantitative cross-sectional study examines sexual behaviour of a target group of hearing-impaired persons in Yaounde, the capital city of the Republic of Cameroon. It measures their HIV prevalence to enable assessment of their sexual vulnerability and to help reduce the gap in existing HIV serology data among people with disabilities in general and the deaf in particular.
    Source: PubMed February 2010
  • Access to Medical Care for Individuals with Mobility Disability, U.S. Department of Justice and U.S. Department of Health and Human Services, ADA Act 2010
    Accessibility of doctors’ offices, clinics, and other health care providers is essential to providing medical care to people with disabilities. Due to barriers individuals with disabilities are less likely to get routine preventive medical care than people without disabilities. The Americans with Disabilities Act defines requirements for accessible medical facilities. This technical assistance publication provides guidance on meeting those requirements.
    Source: PubMed 2010
  • Knowledge, Attitudes and Practices regarding HIV/AIDS Among Disabled Youth in Maputo (Mozambique)].
    This study deals with knowledge, attitudes and practices regarding HIV/AIDS amongst disabled youth (motor disabilities, visually or hearing impaired) aged 15 to 29 years in Maputo (Mozambique) where the prevalence rate of HIV is 20.7%. The study analyzed reasons for these differences and showed that there is a need to improve access to HIV/AIDS information, counseling and screening for young people with disabilities. A series of recommendations have been proposed based on our results. Source: PubMed 2010
  • Managing mentally and physically challenged HIV patients
    Management of mentally and physically challenged patients is complex, as it can involve ethical, social, and medical issues.Adding the provision of human immunodeficiency virus (HIV) care further complicates management. There continues to be limited information in the literature on caring for these types of patients. The authors presenttwo unique HIV cases--one who is mentally challenged and the other who is blind--and how management was approached. A list of select resources to aid both providers and patients is provided.
    Source: PubMed December 2009
  • The Fields of HIV and Disability: Past, Present and Future
    This article provides an historic overview of the field of disability and HIV.
    Source: PubMed November 2009
  • Disability and AIDS Policy Brief
    The relationship between HIV and disability has not received due attention, although persons with disabilities are found among all key populations at higher risk of
    exposure to HIV. In addition, people living with HIV may develop impairments as the disease
    progresses, and may be considered to have a disability when social, economic,
    political or other barriers hinder their full and effective participation in society on an equal basis with others.
    Source: PubMed April 2009
  • Barriers to Health Care for People with Hearing Loss: A Review of the Literature. 
    This paper aims to make health professionals more aware of the needs and cultural differences that must be considered when providing care to the Deaf population. Source: PubMed 2009
  • Managing Mentally and Physically Challenged HIV Patients.
    The management of mentally and physically challenged patients is complex, as it can involve ethical, social, and medical issues, and adding the provision of human immunodeficiency virus (HIV) care further complicates patient management. Source: PubMed 2009
  • The Relation between Deaf Patients and the Doctor.
    This study discusses that non-verbal communication is important when caring for deaf patients, fostering excellence in health care. When deaf patients and physicians meet, they need to overcome communication barriers that may hinder the necessary bond in healthcare and the care that is provided; this may also affect the diagnosis and treatment. It is clear that public institutions should create programs for training healthcare professionals in the appropriate care of deaf patients. Source: PubMed 2009
  • The Deaf and Hard of Hearing and HIV /AIDS
    This article discusses how adults with hearing loss have poorer health and increased risk of engaging in health risk behaviors than adults with good hearing. For example, the rate of substance use disorder among deaf or hard of hearing is higher than among the general population. Substance use, in turn, is linked to higher risk for HIV infection.  The article discusses HRSA response in developing specific strategies to address the service needs of hearing impaired individuals who are at risk of  acquiring HIV/AIDS. Source: HRSA 2008
  • Position Statement on Health Care Access for Deaf Patients
    This paper discusses that healthcare is routinely inaccessible to deaf people due to communication and linguistic barriers. The evidence is compelling that deaf individuals have insufficient access to health care. This results primarily from communication barriers in the health care system. Access in the form of effective communication must be created and consistently provided to create an optimal health care system.  Providers should identify and document the needs of their patients and provide a range of effective communication options to ensure that quality services are delivered.  At the very minimum, existing federal laws under Section 504 and the ADA require health care providers to ensure that such effective communication is achieved. Source: NAD 2008
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Racial/Ethnic Minorities

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  • Identifying the needs of LGBTQ immigrants and refugees in Southern Arizona
    This article reports on the results of a needs assessment conducted for lesbian, gay, bisexual, transgender, and queer (LGBTQ) immigrants, asylees, refugees, and their allies in Southern Arizona. It is the first study of its kind in the United States. The most significant result of this study is that respondents perceived that providers lacked awareness of LGBTQ culture and did not provide culturally competent care.
    PubMed 2011
  • Refugee resettlement to the United States: recommendations for a new approach
    This article compares outcomes of resettlement strategies for two Laotian immigrant populations: Hmong and Thai Dam. Authors discuss the prevalence of psychosocial challenges faced by many Hmong immigrants to the United States, including difficulties with acculturation, welfare dependency, psychiatric disorder, mistrust, malignant youth gangs, and violence. These issues are much less prevalence among members of the Thai Dam tribal group. Strategies used for resettlement of these two groups differed greatly. Based on these differences, the author recommends a refugee resettlement strategy aimed at improved mental health and optimal acculturation for future refugee groups.
    PubMed  Aug, 2011
  • Overcoming health literacy barriers: a model for action
    A large influx of Indonesian immigrants seeking asylum from racial and religious persecution alerted providers in a New Hampshire community to the need for specific cultural knowledge about this ethnic group, in order to provide effective care. The providers sought to develop health education programs that provided knowledge and tools to overcome misunderstandings between providers and clients. The goal was to improve communication, improve health literacy, and prevent health disparities. A framework to understand factors that affect health literacy for local Indonesian asylum seekers guided community health education. Written educational materials for programs informed providers about health literacy barriers for this population. Community outreach engaged local pastors and interpreters as cultural brokers who collaborated with nurses to develop and implement culturally sensitive programs.
    PubMed  2011
  • Barriers to health care access among refugee asylum seekers
    Asylum seekers have poor access to health care. Qualitative data portraying their experience is lacking. Authors conducted focus groups and interviews with 35 asylum seekers, and 15 care providers and advocates, mostly male and mostly from African countries.  The study identified several barriers to care, which they categorized as internal (mental illness, fatalism), structural (service availability, food, shelter, and employment insecurity), and social assimilation barriers (system navigation difficulty, inadequate community support). The authors make recommendations for improving access, including promoting community-based organizations, enforcing the use of trained medical interpreters, and improving cultural competency.
    PubMed May 2011
  • Cultural competence among nurse practitioners working with asylum seekers
    Asylum seekers often have complex medical needs. Little is known about the cultural competences health care providers should have in their contact with asylum seekers in order to meet their needs. This study explores the cultural competencies that nurse practitioners working with asylum seekers thought were important. Results showed that participants thought providers should have knowledge of several key factors in the country of origin: the political situation, judicial context, and common diseases. In addition, providers should understand the effects of refugeehood on health, be able to deal with asylum seekers' traumatic experiences, and be able to explain the host country's health care system. Using interpretation services was also reported to be critical.
    Source: PubMed Nov 2010
  • Screening for HIV-Infection During the Refugee Domestic Medical Examination
    This paper summarizes Centers for Disease Control and Prevention (CDC) guidelines regarding HIV screening for refugees.  Since January 4th, 2010 refugees are not screened for HIV prior to arrival in the U.S. Current CDC guidelines recommend that all persons between 13 and 64 years of age be screened for HIV in health care settings. CDC also encourages screening for people of all ages. CDC recommends screening for HIV-2 for refugees who test positive for HIV and who may have been exposed in identified high-risk African countries. CDC recommends opt-out screening as part of the domestic screening examination. Guidelines emphasize the importance of cultural and linguistic competence in providing testing, diagnostic, treatment, and referral services.
    CDC April, 2012
  • Building community-based participatory research partnerships with a Somali refugee community
    This study examined Somali immigrant women's experiences with the U.S. healthcare system, exploring how attitudes, perceptions, and cultural values, influence their use of reproductive health care. The authors report that Somali women tend to under-utilize health care. Cultural beliefs, communication barriers and low health literacy may lead to health disparities in the U.S. health system.  Authors successfully used a community-based approach to eliciting community input to address these issues.
    PubMed Dec 2009
  • Partnering with community agencies to provide nursing students with cultural awareness experiences and refugee health promotion access
    Refugees' cultural beliefs, communication barriers, and low health literacy may lead to health disparities. This article describes a teaching-learning strategy emphasizing the community partnership between a baccalaureate school of nursing, an immigrant-refugee program, and a community literacy program in a rural state. Senior community health nursing students partnered with an immigrant-refugee program and a community literacy program to provide health promotion and prevention services to recently immigrated Hmong and Russian refugees. The group identified refugees’ priority health needs. Based on the needs assessment, nursing students designed and implemented culturally appropriate health promotion and prevention education modules. Students collaborated with community agencies and businesses to increase access to health resources for these vulnerable populations. Students increased their cultural awareness and refugees increased their understanding of U.S. health care, and experienced increased care access.
    PubMed Sept 2009
  • Physicians' attitude towards treating refugee patients
    The refugee patient's complex problems represent a challenge for primary and secondary health care. Language problems and cultural differences may cause difficulties in understanding symptoms and ailments. The authors conducted this study to assess how physicians relate to and perceive their competence for treating this patient group. The study sample was Norwegian physicians, who answered survey questions to self-report on issues related to cultural competence and challenges in providing care. Large percentages of respondents reported difficulties in getting expert advice and with referring patients to psychiatric care when it was needed.
    PubMed Aug 2009
  • HIV Infection in Refugees: A Case-control Analysis of Refugees in Rhode Island.
    The number of HIV-infected refugees entering the USA is increasing. There is little data describing the HIV-infected refugee population and the challenges encountered when caring for them. This article discusses clinicians caring for West African HIV-infected refugees should be knowledgeable about likely co-morbidities and the impact of cultural differences on HIV care. Further studies are needed to develop culturally competent HIV treatment, education, and prevention programs for refugees who are beginning a new life in the USA. Source: PubMed March 2009
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Substance Use/Abuse

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  • Websites Focused on Veterans:
  • National HIV/AIDS Strategy Operational Plan 2011
    The National HIV/AIDS Strategy Operational Plan was designed to promote a coordinated effort between Federal agencies, community organizations, and other health care settings to respond to the domestic HIV epidemic. The three primary goals of the strategy include:  Reducing the n umber of Veterans who become infected with HIV; Increasing access to care and improving health outcomes for Veterans living with HIV; and reducing HIV-related health disparities. 2011
  • Late diagnosis of HIV infection contributes to poor medical outcomes and helps sustain continued transmission of virus. Published evidence suggests that despite current public health recommendations, patients receiving care in the Veterans Health Administration (VHA) system are not being routinely tested for HIV infection. 2010
  • Understanding the Military: The Institution, the Culture, and the People. This preliminary report contains information for behavioral health specialists working with veterans and service members. It provides civilians, specifically behavioral healthcare specialists working with military personnel, with a basic understanding of the unique life and culture that is the military.
    Source SAMHSA 2010.
  • Primary Care of Veterans with HIV – Manual. 2009
  • The State of Care for Veterans with HIV/AIDS
    The purpose of this report is to characterize the US Department of Veterans Affairs’ (VA) Veterans Health Administration (VHA) state of care for its population of Veterans in care for HIV disease. The first step in providing responsive care is to learn about the affected population. This State of Care report describes the distribution of Veterans with HIV/AIDS within VHA and provides basic demographic data on this population. Additionally, the report describes pharmacologic treatment, other conditions commonly seen with HIV, monitoring, screening, and vaccinations. This report is intended to provide data which can be used to assess and guide intervention to improve the quality of care VHA delivers to Veterans with HIV/AIDs. 2009
  • A system-wide intervention to improve HIV testing in the Veterans Health Administration
    Although the benefits of identifying and treating asymptomatic HIV-infected individuals are firmly established, health care providers often miss opportunities to offer HIV-testing.The objective of this study is to evaluate whether a multi-component intervention increases the rate of HIV diagnostic testing.
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  • Ensuring the Health Care Needs of Women: A Checklist for Health Exchanges. To inform the development of the state health insurance Exchanges under the Affordable Care Act, this checklist identifies key coverage, affordability and access issues that are important for women. Based on lessons learned from women’s health research and the Massachusetts experience, the checklist considers essential health benefits, implementation of no-cost preventive services including contraception, provider networks and affordability, outreach and enrollment efforts, and the importance of including gender and other demographic characteristics in data collection and reporting standards.
    Source: Kaiser Family Foundation 2013
  • Fact Sheet: Women and HIV/AIDS in the United States. This updated fact sheet highlights the impact of HIV/AIDS on women in the United States, providing current data and trends over time.
    Source: Kaiser Family Foundation 2013
  • Confronting the Crisis 2012: Women and HIV Conference: November 1 - 2, 2012
    Rutgers University, Student Center; New Brunswick, NJ
    This conference will provide education and networking opportunities for women living with HIV/AIDS, care providers, researchers, and policy makers. Focus topics include: care and treatment, prevention, policy/advocacy, social and reproductive justice, co-morbidities, and wellness.
  • Women and HIV/AIDS in the United States  Fact Sheet
    Women have been affected by HIV/AIDS since the beginning of the epidemic, an impact that has grown over time. Women of color, particularly Black women, have been especially hard hit and represent the majority of new HIV infections and AIDS diagnoses among women, and the majority of women living with the disease
    Source: KFF July 2012
  • National Women & Girls HIV/AIDS Awareness Day is March 10.
    Women have been affected by HIV/AIDS since the beginning of the epidemic, an impact that has grown over time. In partnership with Community Education Group, Greater Than AIDS is mobilizing women and girls to increase knowledge about HIV/AIDS and confront the stigma surrounding the disease.
  • Care for women with HIV: gender perspectives
    When women face social and cultural inequality they inevitably bear increased HIV infection risks. The success of antiretroviral therapies in suppressing HIV's viral load and prolonging patient lives has made HIV a treatable chronic disease. Given the same follow-up treatments, research shows no significant differences between men and women in terms of either clinical, immunological or virological parameters at baseline or mortality after one year of antiretroviral therapy. Gender equality is essential to effective HIV prevention. Nurses must take all appropriate measures to eliminate discrimination against women in HIV prevention, treatment and care programs in order to ensure equal gender access to critical healthcare services.
    Source: PubMed December 2011
  • YOUR Blessed Health: an HIV-prevention program bridging faith and public health communities.
    African American faith-based institutions are not necessarily equipped to balance their moral and spiritual missions and interpretation of religious doctrine with complex health issues such as human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). YOUR Blessed Health (YBH) is a faith-based, six-month pilot project designed to increase the capacity of faith-based institutions and faith leaders to communicate about and address HIV/AIDS and sexually transmitted infections (STIs) in 11- to 19-year-old African Americans. In addition to increasing the knowledge and skills of young people, the intervention seeks to change churches' norms to provide more open settings where young people can talk with faith leaders about sex, relationships, STIs, and HIV/AIDS. YBH expands the roles of adult faith leaders, particularly pastors' spouses, to include health education as they implement the intervention in their congregations and communities. The intervention includes a flexible menu of activities for faith leaders to select from according to their institutional beliefs, doctrines, and culture.
    Source: PubMed January-February 2011
  • Efficacy of a Health Educator-Delivered HIV Prevention Intervention for Latina Women: A Randomized Controlled Trial
    This study developed and assessed AMIGAS (Amigas, Mujeres Latinas, Inform andonos, Gui andonos, y Apoy andonos contra el SIDA [friends, Latina women, informing each other, guiding each other, and supporting each other against AIDS]), a culturally congruent HIV prevention intervention for Latina women adapted from SiSTA (Sistas Informing Sistas about Topics on AIDS), an intervention for African American women.
    Source: Pubmed 2011
  • Keeping Our Hearts from Touching the Ground: HIV/AIDS in American Indian and Alaska Native Women
    HIV/AIDS is a critical and growing challenge to American Indian and Alaska Native (AIAN) women's health. Conceptually guided by the Indigenist Stress-Coping Model, this paper explores the historical and contemporary factors implicated in the HIV epidemic among AIAN women and the co-occurring epidemics of sexual violence and substance abuse.
    Source: Pubmed 2011
  • Women and HIV/AIDS in the United States KFF Fact Sheet 2011
    Women of color, particularly Black women, have been especially hard hit and represent the majority of new HIV infections and AIDS diagnoses among women
    Source: KFF 2011
  • A Qualitative Study of the Barriers and Facilitators to Retention-in-Care Among HIV-Positive Women in the Rural Southeastern United States: Implications for Targeted Interventions
    The objective of the current study was to assess barriers and facilitators to HIV clinic visit adherence among HIV-positive women in the rural southeastern region of the United States
    Source: PubMed 2010
  • The Missing Element: Incorporating Culturally-Specific Clinical Practices in HIV Prevention Programs for African-American Females
    This article describes behavioral change interventions tailored to address cultural and socioeconomic aspects of HIV prevention among African-American females who attend historically black colleges and universities and is relevant for the African-American
    community at large
    Source: PubMed 2010
  • HIV and Pregnancy
    These fact sheets on HIV and pregnancy are intended especially for HIV-infected women who are pregnant or thinking about becoming pregnant.
    Source: AIDSINFO 2010



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