Hightow-Weidman Lisa B, Choi Seul Ki, Higgins Isabella Carolyn Aida, Knudtson Kelly, Barrington Clare
Institute on Digital Health and Innovation, College of Nursing, Florida State University, Tallahassee, Florida, USA.
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
AIDS Behav. 2025 Jan;29(1):294-302. doi: 10.1007/s10461-024-04522-9. Epub 2024 Oct 14.
Latinos in the United States are disproportionately affected by HIV and experience sub-optimal levels of viral suppression. Enlaces Por La Salud is an individual-level intervention implemented by personal health navigators and guided by the transnational framework to improve HIV care outcomes among newly diagnosed and out-of-care Mexican and Mexican American men and transgender women in North Carolina. The purpose of this study was to assess: (1) changes in HIV care and treatment outcomes among Enlaces participants and (2) intervention engagement and experiences. Ninety-one participants were recruited between October 2014 and August 2017 for a single-arm, mixed-methods design including surveys at baseline, 6 and 12 months and qualitative in-depth interviews immediately following the intervention with an embedded cohort (n = 19). Mean participant age was 36.8 years and most identified as cisgender male (90%). Participants were significantly more likely to have an undetectable viral load at baseline (18%) compared to 6-months (78%) (p < .001). Outcomes were sustained but not significantly increased from 6 to 12 months. Intervention engagement was high with 81% completing all six intervention sessions. In qualitative interviews, participants emphasized the importance of their relationship with the personal health navigators, who provided information, instrumental, and emotional support. A person-centered intervention guided by the lived experience of migration could be an effective way to support Latinos with HIV from diverse countries of origin to achieve viral suppression and improve overall wellbeing.
美国的拉丁裔受艾滋病毒影响的比例过高，且病毒抑制水平未达最佳。“健康纽带”（Enlaces Por La Salud）是一项由个人健康导航员实施的个体层面干预措施，以跨国框架为指导，旨在改善北卡罗来纳州新诊断出感染艾滋病毒以及未接受治疗的墨西哥裔和墨西哥裔美国男性及跨性别女性的艾滋病毒治疗效果。本研究的目的是评估：（1）“健康纽带”参与者在艾滋病毒护理和治疗效果方面的变化，以及（2）干预参与情况和体验。2014年10月至2017年8月期间招募了91名参与者，采用单组混合方法设计，包括在基线、6个月和12个月时进行调查，并在干预结束后立即对一个嵌入式队列（n = 19）进行定性深入访谈。参与者的平均年龄为36.8岁，大多数人认定为顺性别男性（90%）。与6个月时（78%）相比，参与者在基线时病毒载量不可检测的可能性显著更高（18%）（p <.001）。治疗效果得以维持，但从6个月到12个月没有显著提高。干预参与度很高，81%的人完成了所有六个干预环节。在定性访谈中，参与者强调了他们与个人健康导航员关系的重要性，这些导航员提供信息、工具性和情感支持。以移民生活经历为指导的以人为本的干预措施可能是支持来自不同原籍国的感染艾滋病毒的拉丁裔实现病毒抑制并改善整体健康状况的有效方法。
