Initial Acculturation and HIV Risk among New Hispanic Immigrants: RESULTS

Sample
Men and women (n=51) from each of the target countries participated in individual interviews. Eleven focus groups were conducted (n=86), organized by nationality, sex and site. Overall, the average age of respondents was 31, with a length of residence in the United States of <2 years. One focus group and individual interviews (n=26) were conducted with key informants.

Immigrant Characteristics and Realities
New immigrants from the target groups were generally young single men. Single women immigrated to join family members, to accompany partners and/or children or to join partners already living in the areas. Educational attainment was generally between fifth and sixth grade, and most had only partial elementary schooling. While Mexicans were present in all locations (urban, suburban and semirural), Central Americans were more visible within the smaller towns and semirural areas. Dominicans were most visible in urban and suburban locations in Westchester County. Interviews revealed a lack of documentation for most interviewees, although the question was not asked directly. Most respondents stated that they were in the United States for the first time. Not speaking English was identified as the key obstacle in their lives, along with the scarcity and cost of housing. Single men in particular reported difficulty finding housing and sharing rooms in overcrowded and expensive apartments and houses in poor condition.
cialis professional online

Obligations to relatives in their countries of origin, the urgency to repay coyotes (individuals who provide illegal transportation across borders) and the need to survive made work the focus of new immigrants’ lives. Because employment options were limited, seasonal or irregular, many respondents reported long workdays and long periods without income.

Health and Mental Health Issues
Immigrants’ long-standing health concerns emerged frequently during interviews and focus groups. HIV (еreating HIV infection when used along with other medicines) and other health providers in these areas reported serious pre-existing health conditions among these groups, including: malnutrition, anemia, diabetes, asthma, toxoplasmosis, STIs (syphilis and gon orrhea), parasitic infections, hypertension, cardiovascular problems/high cholesterol (especially among Dominicans), malaria, tuberculosis and dental decay. The lack of communication skills and the urgency of generating income, however, resulted in a lack of attention to their health unless the ability to work or care for families was threatened.
Most interviews revealed the salience of mental health issues as well. Participants perceived “stress” and “depression” as consequences of the “suffering” they endured while migrating as well as from leaving families and increasing debts. Central American men spoke of “desperation” and expressed feelings of social isolation as well as frustration at not knowing U.S. and local laws or acceptable behaviors and expectations. Mexican women discussed the negative effects of disillusionment with their new lives along with perceived discrimination toward them and their families.
viagra plus

Domestic Violence
Men and women reported physical mistreatment of women by male partners. However, laws against domestic violence appeared to support women in protecting themselves, including calling police even when deportation was a risk. The resource of 911 was seen as an important benefit of living in the United States. Nevertheless, women and providers reported that family violence was still a serious issue within these communities.

Social and Sexual Behavior
Geographic location emerged as an important factor in immigrants’ interactions with social venues and networks. In less urban areas, men appeared to have few opportunities to socialize in local bars. They met men from other ethnic/national groups through work or sports activities. Women with children in school had more social contact with other women than those without children. Young women, some with infants, without employment or social or family networks, were frequently isolated in small apartments or rooms with almost no social contacts other than their partners.

Central American men reported a scarcity of women as potential sex partners, especially in rural locations. Some male respondents also alluded to their involvement with sex workers for this reason. As one participant explained:

I see a lot of Hispanic men on the street, but to see a Hispanic woman, I have to go into a restaurant, to a Hispanic bar to see a woman. So we have a more difficult time finding a woman, conquering her. She becomes more important than in our country. So many guys use prostitution.

Employers were said to permit or even arrange for sex workers on payday for the “use” of dormitory-housed farm workers. The use of alcohol with sex and a reliance on the sex worker to provide condoms were also reported to be common practices. If the sex worker did not provide condoms, men said that they would have sex anyway, especially if they were “drunk or not thinking clearly.” Some stated feeling “forced” to use condoms by “prostitutes,” especially since most men came from countries without a condom culture and where HIV infection (еreating HIV infection when used in combination with other medicines) was not perceived as a personal threat. Having a seiiora (partner/wife) was said to help control risk as well as having sex only with women deemed “clean” or “safe,” regardless of whether they were wives, girlfriends in either country or women they dated for weeks or months. In addition, Mexican men explained that they did not associate condoms with “pure love” and thus would not use them with long-term partners or spouses. Women, however, reported perceiving a risk of HIV/AIDS from their partners. Some women said they immigrated to protect themselves and their families from diseases by keeping their men from having sex with other women. Mexican women were especially reluctant to discuss condoms in a group. They did not agree on whether men would use them or not. Other than for contraception, there was little expectation among female respondents from all groups that partners would use condoms.

The subject of men having sex with other men was difficult to broach with immigrant men, although women were generally more aware and willing than the men to discuss same-sex sexual behavior among men. Most male respondents denied knowledge of MSM behavior in their community. Key informants, nonetheless, reported hearing about MSM behavior within some of the all-male households.
levitra plus

Alcohol and Other Drugs
Respondents and key informants cited alcohol as the drug of choice, particularly for Mexican and Central American men. While drinking was reported to be the basis of most socializing, men and women suggested that socializing frequently took place in their houses. Women reported heavy drinking by men on weekends and that men were frequently jailed locally because they were drunk in public or were driving drunk. Respondents also perceived alcohol consumption as part of the process of meeting women and having sex. Men and women saw alcohol as an outlet for men who were alone, depressed and coping with stresses of a new environment. Although occasional drinking among women in the sending countries was noted—especially among women from the larger cities—it was suggested that women “consume more [alcohol] than normal” after migration. “Here, they are not ashamed of going out already drunk.”

Most respondents said they came from communities where drug use other than alcohol and marijuana was rare. They agreed that new immigrant involvement in use and sale of drugs was initiated in the United States. Men’s discussions of drug availability in their communities suggested that decisions of whether or not to use drugs might be influenced more by finances than by social norms or health concerns. As one Salvadoran respondent explained:
sildenafil tablet 100mg

When I arrived at that place to buy food, at 11 in the evening, they [drug dealers] would say, they would come close to me and they would ask me if I wanted and they would say, “25 …”I would say, “$25 for this? No.” I would say, “I will eat five lunches for that amount”

Participants also suggested that generational differences exist in immigrants’ attitudes towards drugs, with younger men being more likely to use marijuana and cocaine, while older men continue alcohol use, including beer binge drinking.

Knowledge of HIV/AIDS and Perception of Risk
Many rural male respondents illustrated only a superficial knowledge of HIV/AIDS. The hispano (Hispanic), they agreed, was not aware of the prevalence of AIDS, the risk of infection, symptoms or consequences. Most men and women did not know the difference between HIV and AIDS. Women appeared to know more about HIV/AIDS than men, although with many gaps in their information. Exceptions were indigenous Mexican women, who did not appear to have even a basic understanding of the virus or epidemic. Some acknowledged their concern about HIV risk (treating HIV infection) because of their partners’ other relationships. Others discussed risks from their partners’ use of sex workers and the “behavior of men alone.” Women saw themselves at risk even if in a monogamous relationship with husbands and boyfriends, and believed they could be infected more easily being in the United States. But even women who knew little about HIV/AIDS believed they knew more than men because they were more likely to get information from prenatal/maternal and child health clinics and services, children’s schools and from watching television.

Category: HIV

Tags: acculturation, health I HIV/AIDS, Hispanic communities