Muñoz-Laboy Miguel, Bamford Laura, Benitez Jose, Zisman-Ilani Yaara, Ripkin Alexandra, Del Castillo Laura, Esteves-Camacho Tracy, de la Cruz Mario, Katumkeeryil Elby
Department of Community Health and Social Medicine, School of Medicine, City University of New York, 160 Covenant Avenue, Suite 310, New York, NY, 10031, USA.
Jonathan Lax Treatment Center, Medical Leadership, FIGHT Community Health Centers, Philadelphia, PA, USA.
J Immigr Minor Health. 2020 Oct 30:1-13. doi: 10.1007/s10903-020-01091-6.
Clínica Bienestar is a comprehensive HIV primary care clinic for Spanish-speaking Latinx with opioids use disorders (OUD). This article describes the barriers and trajectories to HIV viral suppression for Puerto Ricans with a transnational profile and dual diagnoses (HIV and OUD), and the strategies applied to increase retention in care.
Case study methodology was used to select two patient life histories that illustrate the most common pathways to success in reducing HIV viral load to undetectable and achieving OUD long-term recovery.
Patients' major challenges included: (1) Persistent migrating while seeking substance use treatment services with limited or no support from their sending and hosting communities; (2) Intersectional stigmas; (3) Untreated trauma; (4) Language and cultural barriers. Clínica Bienestar's service model included ten strategies to retain patients in care (e.g., Case management to identify cases with high social isolation), six emerged as central to addressing transnational challenges.
“福利诊所”（Clínica Bienestar）是一家为讲西班牙语的拉丁裔阿片类药物使用障碍（OUD）患者提供全面艾滋病毒初级护理的诊所。本文描述了具有跨国背景和双重诊断（艾滋病毒和阿片类药物使用障碍）的波多黎各人在实现艾滋病毒病毒抑制方面的障碍和轨迹，以及为提高护理留存率而采取的策略。
采用案例研究方法，选取了两个患者的生活史，以说明将艾滋病毒病毒载量降至不可检测水平并实现阿片类药物使用障碍长期康复的最常见成功途径。
患者面临的主要挑战包括：（1）在寻求物质使用治疗服务时持续迁移，且在其原籍社区和所在社区获得的支持有限或没有支持；（2）交叉污名化；（3）未治疗的创伤；（4）语言和文化障碍。“福利诊所”的服务模式包括十种让患者接受护理的策略（例如，通过病例管理来识别社会隔离程度高的病例），其中六种被认为是应对跨国挑战的核心策略。
