Department of Medicine, University of California San Francisco, San Francisco, CA, United States of America.
Department of Social Work, Temple University, Philadelphia, PA, United States of America.
PLoS One. 2020 Feb 18;15(2):e0229291. doi: 10.1371/journal.pone.0229291. eCollection 2020.
Changes in the United States federal-level political landscape have been felt within immigrant communities, and the public health clinics that serve them. We sought to document how HIV prevention and care clinics are reaching and retaining their immigrant community patients during a period of retrenchment of accessible public resources and immigrant rights. From May 2018 through January 2019, we conducted 20 in-depth interviews with clinicians, case workers, advocates, legal experts, and peer navigators in Northern and Central California. Interviews were recorded and transcribed. Several themes emerged which can be grouped into three primary areas: changes post-election, challenges meeting the needs of patients, and best practices for maintaining access to prevention and care services. Post-election, providers reported some of their patients skipping clinic appointments due to fear of Immigration and Customs Enforcement (ICE) raids and deportation while other patients had moved to locations that they felt were less policed. Challenges emerged around linguistic competency, meeting basic needs such as housing stability and employment, and treating mental health sequelae resulting from trauma experienced in home countries or during migration itself. Best practices included hiring bi-lingual and bi-cultural staff, linking to legal services to assist with immigration status, holding trainings around immigrant rights and responses to ICE raids, and building trust with immigrant patients by assuring them that their status would not be collected or reported. In light of adverse policy changes affecting immigrants, agencies have begun to institute best practices to mitigate the negative impact of those policies on their clients and patients.
美国联邦政治格局的变化已经影响到移民社区及其服务机构，例如公共卫生诊所。我们试图记录在公共资源和移民权利受到限制的情况下，艾滋病毒预防和护理诊所如何在这一时期接触并留住他们的移民社区患者。2018 年 5 月至 2019 年 1 月，我们在加利福尼亚州北部和中部对 20 名临床医生、个案工作者、倡导者、法律专家和同行导航员进行了深入访谈。采访进行了录音和文字记录。出现了几个主题，可以分为三个主要领域：选举后的变化、满足患者需求的挑战以及维护预防和护理服务获取的最佳实践。选举后，提供者报告说，他们的一些患者由于担心移民和海关执法局（ICE）突袭和驱逐出境而跳过诊所预约，而其他患者则搬到了他们认为警察较少的地方。围绕语言能力、满足住房稳定和就业等基本需求以及治疗因在原籍国或移民过程中遭受创伤而产生的心理健康后遗症等方面出现了挑战。最佳实践包括聘请双语和双文化工作人员、与法律服务机构联系以协助移民身份、围绕移民权利和对 ICE 突袭的反应进行培训，以及通过向移民患者保证不会收集或报告他们的身份来建立信任。鉴于影响移民的不利政策变化，各机构已开始实施最佳实践，以减轻这些政策对其客户和患者的负面影响。
