Category Archives: Hispanic Health

Bring doctors to patients who need them most

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Jennifer Vargas, a second year resident at Riverside County’s Regional Medical Center, treats patient Maria Sanchez, 54, at Riverside County’s Regional Medical Center on April 21, 2015.    Sanchez says she feels comfortable with Vargas because she speaks Spanish (Photo by Heidi de Marco/KHN).

Jennifer Vargas, a second year resident at Riverside County’s Regional Medical Center, treats patient Maria Sanchez, 54, at Riverside County’s Regional Medical Center on April 21, 2015. Sanchez says she feels comfortable with Vargas because she speaks Spanish (Photo by Heidi de Marco/KHN).

By Andrew L. Wang and Heidi de Marco

MORENO VALLEY, Calif. — Jennifer Vargas’ path toward becoming a doctor took her from UCLA to Guadalajara before it ultimately led back home, to California’s vast Inland Empire east of Los Angeles.

“Today, our country is largely training the sons and daughters of wealthy people to be physicians… You wonder why we have a problem with people not serving in underserved communities; it’s because they don’t know what an underserved community looks like.”

When the Chino Hills, Calif. native graduated from medical school in Mexico, her first choice for residency training was Riverside County’s public medical center, which serves among the fastest growing and most medically deprived parts of California.

It was just what she wanted:  To serve a vulnerable patient population facing high barriers to care, particularly immigrant patients from Mexico who would benefit from a Spanish-speaking physician.

“It offered the best fit for me,” said Vargas, 32, a second-year resident in family medicine at Riverside County Regional Medical Center. Continue reading

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Why I love family-run restaurants: Insights from a food inspector

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cropped-eyob-in-idBy Eyob Mazengia, PhD, RS, Food Protection Program
Public Health – Seattle & King County

When I started as a food inspector, I was assigned to the International District. And I liked it. It was almost like walking into a new culture, a new era.

What fascinated me was that as a public health worker, I had permission to walk into people’s personal spaces. I liked the smells, the sounds of their languages, their wall hangings and the way things looked.

It was a privilege, really, to be allowed into their personal spaces. Going on food inspections in the I.D., it was like walking into 3-4 different countries every day, without traveling outside the neighborhood.

Over the years, I established good relationships with the restaurant establishments. They were no longer just restaurant operators—they were mothers, fathers, grown kids. They’re not just businesses—there’s a family behind every door, people who had often gone through difficult times to be here.

And as I got to know them, I could recognize the sacrifices they made to give their children better opportunities in the U.S., and what they left behind. Even those born and raised here, you could recognize the sacrifices they were making. Continue reading

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International Community Health Service recognized as ‘National Quality Leader’

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International Community Health ServicesInternational Community Health Services (ICHS)  been cited by the federal government as a “National Quality Leader” for exceeding national clinical benchmarks for chronic disease management, preventive care, and perinatal/prenatal services.

The Seattle-based health center also was recognized for achieving some of the best overall clinical outcomes nationally for health centers and for showing significant improvement in clinical quality measures between 2012 and 2013.

ICHS is a non-profit community health center that specializes in providing affordable health care services to Seattle and King County’s Asian, Native Hawaiian, Pacific Islander, and other underserved communities.

It operates medical and dental centers in Seattle’s International District and Holly Park neighborhoods, as well as in the cities of Bellevue and Shoreline; a school-based health center at the Seattle World School, and a primary care clinic at ACRS, a social and mental health services agency in Seattle.

In recognition of its accomplishment and to fund further quality improvement, ICHS will receive $84,169 in Affordable Care Act funding by the U.S. Department of Health and Human Services.

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How Obamacare went south in Mississippi

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In the country’s unhealthiest state, the failure of Obamacare is a group effort.

By Sarah Varney
KHN / October 29, 2014

The lunch rush at Tom’s on Main in Yazoo City, Mississippi, had come to a close, and the waitresses, having cleared away plates of shrimp and cheese grits, seasoned turnip greens and pitchers of sweet tea, were retreating to the counter to cash out and count their tips.

It didn’t take long: The $6.95 lunchtime specials didn’t land them much, and the job certainly didn’t come with benefits like health insurance. For waitress Wylene Gary, 54, being uninsured was unnerving, but she didn’t try to buy coverage on her own until the Affordable Care Act forced her to. She didn’t want to be a lawbreaker.

Months earlier, she had gone online to the federal government’s new website, signed up and paid her first monthly premium of $129. But when her new insurance card arrived in the mail, she was flabbergasted.

“It said, $6,000 deductible and 40 percent co-pay,” Gary told me at the check-out counter, her timid drawl giving way to strident dismay. Confused, she called to speak to a representative for the insurer Magnolia Health. “’You tellin’ me if I get a hospital bill for $100,000, I gotta pay $40,000?’ And she said, ‘Yes, ma’am.’”

Never mind that the Magnolia worker was wrong — her out-of-pocket costs were legally capped at $6,350. Gary figured with a hospital bill that high, she would have to file for bankruptcy anyway. So really, she thought, what was the point?

“This ain’t worth a tooth,” she said.

She canceled her coverage.

The first year of the Affordable Care Act in Mississippi was, by almost every measure, an unmitigated disaster. In a state stricken by diabetes, heart disease, obesity and the highest infant mortality rate in the nation, President Barack Obama’s landmark health care law has barely registered, leaving the country’s poorest and perhaps most segregated state trapped in a severe and intractable health care crisis. Continue reading

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Vaccination rates lower among US adults born abroad

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Vaccine SquareBy Milly Dawson
Health Behavior News Service

Nationality at birth appears to play a significant role in whether or not adults in the United States are routinely vaccinated for preventable diseases, a new study in the American Journal of Preventive Medicine finds, reflecting a risky medical lapse for more than one in ten people nationwide.

Foreign-born adult U.S. residents, who make up about 13 percent of the population, receive vaccinations at significantly lower rates than U.S.-born adults.

Foreign-born adult U.S. residents make up about 13 percent of the population.

This gap poses special risks for certain groups of people who are vulnerable to many serious and sometimes deadly diseases that vaccines can prevent.

The study’s lead author, Peng-Jun Lu, MD, PhD, a researcher at the Center for Disease Control and Prevention, noted the rise in the foreign-born population in the United States, which stood at only five percent in 1970.

“As their numbers continue to rise, it will become increasingly important to consider this group in our efforts to increase vaccination and eliminate coverage disparities,” he said. Continue reading

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One in four Latinos remain uninsured

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By Teresa Wiltz
Stateline

In the “sala de espera,” or waiting room, at La Clinica del Pueblo, a community health center in Washington, D.C., signs in Spanish encourage patients to “Empower yourself!” and sign up for insurance coverage through the Affordable Care Act.

Adults slump in chairs, scribbling on application forms, texting friends, waiting. In a tiny office a few feet away, William Joachin, the center’s patient access manager, faces down the frustrations of trying to navigate the federal health care program for the thousands of mostly Central American immigrants who flood the clinic each year. He’s not alone.

A year after open enrollment for the ACA began, one in four Latinos living in the U.S. does not have health insurance, according to new census data, more than any other ethnic population in the country—and most states have few backups in place to help those in the coverage gap.

Latino health insurance graphic

 

Latino immigrants are the hardest hit: Foreign-born Hispanics are more than twice as likely to be uninsured than are U.S.-born Hispanics, according to census data compiled by the Pew Research Center. (Pew also funds Stateline.) Continue reading

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Federal judge blocks Texas restriction on abortion clinics

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200px-Flag-map_of_TexasBy Carrie Feibel, KUHF
AUGUST 30TH, 2014, 10:18 AM

This story is part of a partnership that includes Houston Public MediaNPR and Kaiser Health News.

In a highly anticipated ruling, a federal judge in Austin struck down part of a Texas law that would have required all abortion clinics in the state to meet the same standards as outpatient surgical centers.

The regulation, which was set to go into effect Monday, would have shuttered about a dozen abortion clinics, leaving only eight places in Texas to get a legal abortion — all in major cities.

. . . state’s regulation was unconstitutional and would have placed an undue burden on women, particularly on poor and rural women.”

The regulation, which was set to go into effect Monday, would have shuttered about a dozen abortion clinics, leaving only eight places in Texas to get a legal abortion — all in major cities.

Judge Lee Yeakel ruled late Friday afternoon that the state’s regulation was unconstitutional and would have placed an undue burden on women, particularly on poor and rural women living in west Texas and the Rio Grande Valley. Continue reading

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Say what? Many patients struggle to learn the foreign language of health insurance

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Jessie Yuan, physician at the Eisner Pediatric & Family Health Center in Los Angeles, treats diabetic patient Oscar Gonzales. Gonzalez was unaware he had been switched to Medi-Cal until Yuan informed him about the change (Photo by Anna Gorman/KHN).

This KHN story also ran in .

As soon as Deb Emerson, a former high school teacher from Oroville, Calif., bought a health plan in January through the state’s insurance exchange, she felt overwhelmed.

She couldn’t figure out what was covered and what wasn’t.

Why weren’t her anti-depressant medications included?

Why did she have to pay $60 to see a doctor?

The insurance jargon – deductible, co-pay, premium, co-insurance – was like a foreign language. What did it mean?

“I have an education and I am not understanding this,” said Emerson, 50. “ I wonder about people who don’t have an education — how baffling this must be for them.” Continue reading

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How states are tackling ‘health disparities’

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Question Q&ABy Michael Ollove
Stateline Staff Writer

African-Americans are more likely to suffer heart disease and diabetes than whites. The cancer death rate for men is a good deal higher than it is for women.

American Indians and Alaska Natives are more likely to smoke tobacco than Hispanics, blacks or whites.

And Native Hawaiian adults are less likely to exercise than other ethnic groups.

These differences are called “health disparities,” and in the last two decades, the federal government and the states have focused on eliminating them. Continue reading

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Why hospitals are failing civilians who get PTSD

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Gunby Lois Beckett
ProPublica, March 4, 2014

More than 20 percent of civilians with traumatic injuries may develop PTSD. Trauma surgeons explain why many hospitals aren’t doing anything about it.

Undiagnosed post-traumatic stress disorder is having a major impact on injured civilians, particularly those with violent injuries, as Propublica detailed last month.

One national study of patients with traumatic injuries found that more than 20 percent of them developed PTSD.

But many hospitals still have no systematic approach to identifying patients with PTSD or helping them get treatment.

We surveyed 21 top-level trauma centers in cities with high rates of violence. The results show that trauma surgeons across the country see PTSD as a serious problem.  Continue reading

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California bill would extend coverage to undocumented residents

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Flag_of_CaliforniaBy Anna Gorman
KHN
FEB 18, 2014

In a push to cover immigrants excluded from the nation’s health reform law, a California state senator has proposed legislation that would offer health insurance for all Californians, including those living here illegally.  Continue reading

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The PTSD crisis that’s being ignored: Americans wounded in their own neighborhoods

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GunBy Lois Beckett
ProPublica, Feb. 3, 2014

Chicago’s Cook County Hospital has one of the busiest trauma centers in the nation, treating about 2,000 patients a year for gunshots, stabbings and other violent injuries.

So when researchers started screening patients there for post-traumatic stress disorder in 2011, they assumed they would find cases.

They just didn’t know how many: Fully 43 percent of the patients they examined – and more than half of gunshot-wound victims – had signs of PTSD.  Continue reading

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Prevención del VIH/SIDA en la comunidad Latina/Hispana

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Distrito de salud de Snohomish:

Durante el mes de octubre, Distrito de salud de Snohomish reconoce Nacional Latina sobre el SIDA, una campaña destinada a involucrar a la comunidad Hispana/Latina en promover la sensibilización sobre el VIH a través de pruebas, prevención y educación.

El tema de este ano es “Comprométete a Hablar.”

En el estado de Washington, el 12% de todas las personas que actualmente viven con el VIH/SIDA son latinos, pero los latinos sólo representa aproximadamente el 9,4 % del total de la población. Las tasas de nuevas infecciones entre hombres latinos fueron más del doble que el de los hombres blancos. La tasa de infección por el VIH entre las mujeres de origen Latino fue casi cuatro veces mayor que la de las mujeres blancas.

Para abordar esta disparidad y aumentar la conciencia, personal del distrito de salud de Snohomish estará ofreciendo pruebas gratis para los miembros de las comunidades latinas y generales que califican basan en sus factores de riesgo en lugares comunitarios:

  • Tuesday, Oct. 22, from 1 – 5 p.m. at Monroe Sea Mar Behavioral Clinic, 14090 Fryeland Blvd. SE, Ste. #347
  • Tuesday, Oct. 22, from 4 – 6 p.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
  • Wednesday, Oct. 23, from 9 – 11 a.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
  • Wednesday, Oct. 23, from 4 – 5 p.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
  • Thursday, Oct. 24, from 4 – 8 p.m. at Everett Sea Mar Medical Clinic, 1920 100th Street SE, Bldng. B
  • Friday, Oct. 25, from 12 – 4 p.m. at Monroe Sea Mar Medical Clinic, 17707 West Main Street
  • Thursday, Oct. 31, from 1 – 4 p.m. at Marysville Sea Mar Medical Clinic, 9710 State Avenue

Los Centros para el Control de enfermedades y prevención dice que el impacto del VIH en los Hispanos/Latinos no está directamente relacionado a la raza o grupo étnico, sino a los retos que enfrentan por algunas comunidades, incluyendo menos conocimiento del estado serológico, la pobreza, acceso a la atención medica, estigma, aculturación de la migración (el proceso de adopción de los rasgos culturales o los patrones sociales de otro grupo) y la homofobia. Aprenda más sobre la campaña de sensibilización nacional del sitio web AIDSinfo, http://aidsinfo.nih.gov/education-materials/hiv-aids-awareness-days/169/national-latino- aids-awareness-day.

El distrito de salud ofrece gratis y confidencial del VIH pruebas y Consejería para individuos de alto riesgo durante todo el año, en nuestra clínica 3020 Rucker Avenue, con resultados en 30 minutos. Individuos con riesgo también pueden ser probados para la Hepatitis A, B, C y sífilis. Para una cita, llame al 425-339-5298.

Según la Washington State Department of Health, 730 personas en el Condado de Snohomish se supone que se viven con el VIH/SIDA.

Para obtener más información sobre la prevención del VIH/SIDA y las pruebas, llame al distrito de salud al 425-339-5298, o visite www.snohd.org.

Establecido en 1959, el Snohomish Distrito de Salud trabaja para un más seguro y más sano Condado Snohomish a través de la prevención de enfermedades, la promoción de la salud y la protección de las amenazas ambientales. Encontrar más información sobre el Distrito de Salud en http://www.snohd.org.

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Snohomish County campaign seeks to raise HIV/AIDS awareness in Latino/Hispanic community.

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nlaad-logoDuring the month of October, Snohomish Health District will present a National Latino AIDS Awareness campaign aimed at engaging the Hispanic/Latino community in promoting HIV awareness through testing, prevention and education.

This year’s theme is “Commit to Speak”/“Comprométete a Hablar.”

In Washington state, 12% of all individuals currently living with HIV/AIDS are Latino – but Latinos only compromise approximately 9.4% of the total population.

The rates of new infections among Latino men were more than double that of white men. The rate of HIV infection among Latino women was nearly four times that of white women.

To address this disparity and increase awareness, staff from the Snohomish Health District will be offering free testing at community locations to members of the Latino and general communities who qualify based on their risk factors:

  • Tuesday, Oct. 22, from 4 – 6 p.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
  • Tuesday, Oct. 22, from 1 – 5 p.m. at Monroe Sea Mar Behavioral Clinic, 14090 Fryeland Blvd. SE, Ste. #347
  • Wednesday, Oct. 23, from 4 – 5 p.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
  • Wednesday, Oct. 23 from 9-11 a.m. at Everett Sea Mar Behavioral Clinic, 5007 Claremont Way
  • Thursday, Oct. 24, from 4 – 8 p.m. at Everett Sea Mar Medical Clinic, 1920 100th Street SE, Bldng. B
  • Friday, Oct. 25, from 12 – 4 p.m. at Monroe Sea Mar Medical Clinic, 17707 West Main Street
  • Thursday, Oct. 31, from 1 – 4 p.m. at Marysville Sea Mar Medical Clinic, 9710 State Avenue

The Centers for Disease Control and Prevention states the impact of HIV on Hispanics/Latinos is not directly related to race or ethnicity, but rather to challenges faced by some communities, including less awareness of HIV status, poverty, access to care, stigma, migration acculturation (the process of adopting the cultural traits or social patterns of another group) and homophobia.

Learn more about the national awareness campaign from the AIDSinfo website, http://aidsinfo.nih.gov/education-materials/hiv-aids-awareness-days/169/national-latino-aids-awareness-day.

The Health District offers free and confidential HIV testing and counseling for high-risk individuals year-round, in our Everett clinic location, with test results in 30 minutes. Individuals with risk can also be tested for hepatitis A,B, C, and syphilis. For information about HIV/AIDS prevention and testing, call the Health District at 425.339.5298, or visit www.snohd.org.

According to the Washington State Department of Health, 730 people in Snohomish County are assumed to be living with HIV/AIDS.

Information from the US Centers for Disease Control and Prevention:

 Centros para el Control y la Prevención de Enfermedades

Datos breves

  • El VIH afecta de manera desproporcionada a los latinos.
  • En el 2009, los latinos representaron el 20% de las infecciones nuevas con el VIH en los Estados Unidos, aun cuando solamente constituían alrededor del 16% de la población total de los EE. UU.
  • HSH están particularmente afectados con el VIH.

El VIH es un problema de salud pública en la comunidad latina1. En el 2009, los latinos representaron el 20% (9,400) de las infecciones nuevas por VIH en los Estados Unidos, aun cuando solamente formaban alrededor del 16% de la población total de los EE. UU. La tasa de infecciones por el VIH en los latinos en el 2009 fue casi el triple que la de los hombres de raza blanca (26.4 comparado con 9.1 por cada 100,000 habitantes).

Las cifras

Infecciones nuevas por VIH

  • En el 2009, los hombres latinos representaron el 79% (7,400) de las infecciones nuevas en toda la población latina y la tasa de infecciones nuevas entre los hombres latinos fue dos veces y media más alta que la de los hombres de la raza blanca (39.9/100,000 comparado con 15.9/100,000).
  • En el 2009, los hombres latinos que tuvieron relaciones sexuales con hombres (HSH)3 representaron el 81% (6,000) de las infecciones nuevas por VIH entre los hombres latinos. Y a su vez representaron el 20% de todos los HSH. Entre los HSH latinos, el 45% de las infecciones nuevas por VIH correspondió a hombres menores de 30 años de edad.
  • Aunque las mujeres latinas representaron el 21% (2,000) de las infecciones nuevas en los latinos durante el 2009, su tasa de infección por el VIH fue más del cuádruple que en las mujeres blancas (11,8/100,000 comparado con 2,6/100,000).

Estimados sobre infecciones nuevas por el VIH en los Estados Unidos para las subpoblaciones más afectadas, 2009

Esta gráfica no incluye las subpoblaciones que representan el 2% o menos de la epidemia general en los EE. UU.

Diagnósticos y muertes por VIH y SIDA

  • En algún momento de su vida, 1 de cada 36 hombres latinos recibirá un diagnóstico de VIH, al igual que 1 de cada 106 mujeres latinas
  • En el 2009, los latinos representaron el 19% de los 42,959 diagnósticos nuevos de infecciones por VIH en los 40 estados y las 5 jurisdicciones dependientes de los EE. UU. que cuentan con sistema de notificación de infección por VIH de forma confidencial basada en el nombre.
  • En el 2009, se estima que 7,442 latinos recibieron un diagnóstico de sida en los EE. UU. y las 5 jurisdicciones dependientes. Esta cifra ha disminuido desde el 2006.
  • Para finales del 2008, se calcula que 111,438 latinos habían fallecido en los Estados Unidos y las jurisdicciones dependientes con diagnostico de SIDA. En el 2007, el VIH fue la cuarta causa principal de muerte en latinos de 35 a 44 años de edad y la sexta en los latinos de 25 a 34 años en los EE. UU.

Desafíos para la prevención

Varios factores contribuyen a la epidemia del VIH en las comunidades latinas.

  • Los factores de la conducta de riesgo relacionados con la infección por VIH varían de acuerdo al país de origen.Los datos indican que los porcentajes más altos de infecciones con el VIH diagnosticadas en hombres latinos se atribuyen a contacto sexual con otros hombres, independientemente del país de origen, pero los hombres nacidos en Puerto Rico tienen un porcentaje considerablemente más alto de infecciones por el VIH atribuidas al uso de drogas inyectables (UDI) que los hombres latinos nacidos en otros países.
  • Los hombres y mujeres latinas tienen más probabilidad de adquirir la infección por VIH como resultado del contacto sexual con hombres. Las mujeres latinas podrían no estar conscientes de los factores de riesgo de su pareja masculina.
  • El uso de drogas inyectables continúa siendo un factor de riesgo entre los latinos, especialmente para los que viven en Puerto Rico. Además, los usuarios ocasionales y crónicos de alcohol o estupefacientes tienen más probabilidad de practicar conductas sexuales de alto riesgo, como son las relaciones sexuales sin protección debido a que están bajo la influencia de las drogas o el alcohol.
  • Tener ciertas infecciones de transmisión sexual (ITS)puede aumentar, en forma significativa, la posibilidad de que una persona contraiga la infección por el VIH. Una persona que tiene la infección por el VIH y ciertas ITS tiene más posibilidad de infectar a otros con el VIH. Las tasas de ITS permanecen altas entre los latinos.
  • Los factores culturales pueden afectar el riesgo de infección por el VIH. Es posible que latinos eviten hacerse pruebas del VIH y buscar consejería o tratamiento para la infección por temor a la discriminación o la estigmatización o debido a su estatus migratorio. Los roles tradicionales de los hombres y las mujeres y el estigma contra la homosexualidad pueden dificultar la prevención.
  • Una mayor aculturación adoptando la cultura estadounidense tiene efectos tanto negativos (adopción de conductas que aumentan el riesgo de adquirir la infección del VIH) como positivos (comunicación con las parejas sobre las relaciones sexuales más seguras o de menor riesgo) en las conductas relacionadas con la salud de los hombres y mujeres latinos.
  • Los factores socioeconómicos, como la pobreza, los patrones migratorios, el bajo nivel de estudios académicos, la falta de seguro médico, el acceso limitado a la atención médica, o las barreras del lenguaje, contribuyen a las tasas de infección por VIH en los latinos. Estos factores pueden limitar la concientización de los latinos sobre los riesgos de infectarse con el VIH y las oportunidades para participar en consejería, pruebas de detección y tratamiento.
  • Debido al miedo a ser descubiertos y deportados, los inmigrantes indocumentados pueden ser menos propensos a recibir servicios de prevención del VIH, a hacerse pruebas de detección o a recibir atención médica y tratamiento adecuados si es que son diagnosticados positivos o que viven con el VIH.
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