Elias Provencio Vasquez

Hispanic women's experiences with substance abuse, intimate partner violence, and risk for HIV.

Hispanic females are disproportionately affected by substance abuse, intimate partner violence, and HIV. Despite these disparities, research describing the cultural and gender-specific experiences of Hispanic women with regard to these conditions is lacking. The purpose of this study is to describe the experiences that Hispanic community-dwelling women have with regard to substance abuse, violence, and risky sexual behaviors. Eight focus groups with 81 women were conducted. A bilingual, bicultural moderator asked women open-ended questions regarding the experiences that Hispanic women have with these conditions. Focus groups were audiotaped, transcribed, translated, verified, and then analyzed using qualitative content analysis. Participants discussed substance abuse, violence, and risky sexual behaviors interchangeably, often identifying common risk factors associated with these. Nevertheless, intimate partner violence was the most salient of conditions discussed. Three major themes emerged from the analysis: Transplantadas en otro mundo (Uprooted in another world), El criador de abuso (The breeding ground of abuse), and Rompiendo el silencio (Breaking the silence). This study supports the importance of addressing substance abuse, violence, and risk for HIV in an integrated manner and stresses the importance of addressing associated cultural factors (e.g., acculturation, machismo ) in interventions targeting Hispanics.

Increasing Minority Research Participation Through Community Organization Outreach

Recruitment is one of the most significant challenges in conducting research with ethnic minority populations. Establishing relationships with organizations that serve ethnic minority communities can facilitate recruitment. To create a successful recruitment process, a strategic plan of action is necessary prior to implementing community outreach efforts. For this study population of women who were HIV+ and recovering from substance abuse disorder, the authors found that establishing trust with community organizations that serve these women allows for a productive referral relationship. Although the majority of women in this study are African American, the authors were particularly challenged in recruiting Hispanic women. This article presents a recruitment process model that has facilitated our recruitment efforts and has helped the authors to organize, document, and evaluate their community out-reach strategies. This model can be adopted and adapted by nurses and other health researchers to enhance engagement of minority populations.

HIV Risks, Substance Abuse, and Intimate Partner Violence Among Hispanic Women and Their Intimate Partners

Hispanic women in the United States are disproportionately affected by HIV infection. Substance abuse and intimate partner violence (IPV) are conditions that have been associated with risk for HIV in the general population. However, few studies have explored the intersection of these three conditions within one integrated framework. The purpose of this exploratory study was to describe the relationships between HIV risks, substance abuse, and IPV among Hispanic community‐dwelling women. A total of 82 structured interviews were conducted with Hispanic women between the ages of 18 and 60. Data regarding the participants and her partners histories of sexually transmitted infections, substance abuse, risky sexual behaviors, and IPV were collected. Relationships between the participants history of sexually transmitted infections, her partners substance abuse, risky sexual behaviors, and IPV were explored. Results from this study support the importance of targeting HIV, substance abuse, and IPV prevention among Hispanics within one integrated framework.

Intimate partner violence, depression, and resource availability among a community sample of hispanic women

This study investigated the relationships among resource availability, IPV, and depression among Hispanic community-dwelling women. The Vulnerable Populations Conceptual Framework (15) was used to conceptualize and test relationships among these variables. Cross-sectional questionnaires assessed resource availability (i.e., income, education, employment, insurance status, and self-esteem), depressive symptoms (CES-D), and intimate partner violence (IPV) by a current/recent partner. Linear and logistic regressions were conducted to explore relationship among variables. Although most of the relationships among resource availability, IPV, and depression supported the conceptual framework, the importance of incorporating additional cultural, relationship, and social factors are stressed.

The relationship of depressive symptoms, self-esteem, and sexual behaviors in a predominantly hispanic sample of men who have sex with men

Despite public health campaigns and safer sex messages, many men who have sex with men (MSM) continue to participate in high-risk sexual behaviors, which may make them vulnerable to HIV infection and sexually transmitted infections. The purpose of this study was to determine the relationship of depressive symptoms, self-esteem, and sexual behaviors in a predominantly Hispanic sample of MSM. This correlational study sampled 205 MSM (M = 37 years of age, SD = ±8) representing the diverse ethnic composition of South Florida. This sample consisted of ethnic minorities (79%) with a large number of foreign-born men (69%). Participants completed measures of depressive symptoms, self-esteem, and sexual behaviors. Results indicated that higher levels of depressive symptoms and higher levels of self-esteem had a statistically significant relationship to lower levels of safer sexual behaviors. Lower income, lower educational level, and preference for Spanish language were associated with higher levels of depressive symptoms; lower income was associated with lower levels of self-esteem; and foreign birth and a preference for Spanish language were associated with lower levels of safer sex behaviors. Higher levels of depressive symptoms and higher levels of self-esteem were associated with high-risk sexual behaviors in this sample of MSM. Further research needs to be directed at culturally specific mental health and HIV prevention strategies for these vulnerable MSM.

La Mancha Negra: Substance Abuse, Violence, and Sexual Risks Among Hispanic Males

Hispanics are disproportionately affected by substance abuse, intimate partner violence, and HIV. Although the relationship between these conditions has been documented in the literature, few studies have explored the intersection of these health problems and their culture-related risk factors in an integrative manner. The purpose of this study is to explore the experiences that Hispanic heterosexual males in South Florida have with substance abuse, violence, and risky sexual behaviors. Three focus groups with a total of 25 Hispanic adult men are completed and analyzed using grounded theory. Three core categories emerge from the data. These include la cuna de problemas sociales (the cradle of social problems), ramas de una sola mata (branches from one same tree), and la mancha negra (the black stain). This study suggests that substance abuse, violence, and risky sexual behaviors are linked conditions with common cultural and socioenvironmental risk factors and consequences.

Acculturation, Depression, Self-Esteem, and Substance Abuse among Hispanic Men

The demographics of the United States are rapidly changing as a result of immigration from Latin America. Predictions indicate that by the year 2050, one of every four persons in the United States will be of Hispanic ethnicity. If health disparities relating to substance abuse and related mental health conditions among Hispanics are not fully understood and addressed, these will continue grow along with this population. The purpose of this pilot study was to describe the relationships among acculturation, depression, self-esteem, and substance abuse among a community sample of Hispanic men in South Florida (N = 164, 82 heterosexual men and 82 men who have sex with men). Standardized instruments measuring acculturation, depression, self-esteem, and substance abuse were administered in English or Spanish in a face-to-face interview format. Descriptive statistics and multiple logistic regression were used to illustrate participant characteristics and test relationships among the variables. Despite the fact that the majority of participants were more acculturated to the Hispanic culture than US culture, reported low levels of education and income, were depressed, and used substances, this group of men reported high levels of self-esteem. However, age and depression were the only predictors of substance abuse. Acculturation and self-esteem were not predictors of substance abuse. Clinicians need to be aware of the high rates of depression and substance abuse in this population and screen frequently for signs and symptoms of depression and substance abuse during health care encounters.

Reaching African American Men: A Qualitative Analysis

African American men are disproportionately affected by most illnesses and associated complications. These men are also less likely to participate in primary and secondary prevention interventions. Little is known about reaching them. The purpose of this study1 was to explore factors associated with effectively reaching African American men. Ethnographic methods were used. Key and general informants from an urban Northeastern community were recruited for this study. The data revealed 3 major themes as essential to reaching African American men: a trusted and respected community member providing the outreach, a perceived safe and caring environment during outreach, and a perceived benefit from participating in the outreach. The findings from this study provided a foundation for designing community interventions that will increase participation among African American men. Future research efforts should focus on operationalizing these findings in the community.

Psychosocial and cultural correlates of depression among Hispanic men with HIV infection: a pilot study.

Depression is a common mental health condition among persons with human immunodeficiency virus (HIV) infection. Depression influences quality of life, social relationships and adherence to medication therapy. Little is known about depression among Hispanic men with HIV infection. The purpose of this pilot study was to describe the relationships of depression to other psychosocial factors (self-esteem, Hispanic stress, substance abuse and violence) and cultural factors (familism and Hispanic stress) among a sample of Hispanic men with HIV infection. Using a cross-sectional, descriptive research design a convenience sample of 46 Hispanic men with HIV infection was recruited and surveyed from the South Florida area of the USA. The majority of the participants (65%; n = 30) were depressed. In addition, the majority of participants reported high familism and self-esteem and low Hispanic stress. A history of substance abuse and childhood and adult violence were common. Significant relationships were noted between depression, and self-esteem, Hispanic stress, substance abuse, and adult physical violence. Healthcare providers need to be aware of the high rates of depression, substance abuse and violence that may occur among Hispanic men with HIV infection. More research is needed to further explore the relationship of these factors, as well as to determine the impact that these variables have on adherence to medication therapy among Hispanic men with HIV infection.

Sexual orientation and demographic, cultural, and psychological factors associated with the perpetration and victimization of intimate partner violence among Hispanic men

Hispanics are disproportionately affected by intimate partner violence (IPV). Most of the research describing factors associated with intimate partner violence among Hispanics has focused on Hispanic women or Hispanics in heterosexual relationships. The purpose of this study was to explore the relationship among sexual orientation (heterosexual, homosexual, and bisexual), and demographic, cultural, and psychological factors and intimate partner violence among Hispanic men. A cross sectional questionnaire was administered to 160 Hispanic heterosexual men and men who have sex with men. Demographic factors (age, education, and income), acculturation, depressive symptoms, and self-esteem were assessed using standardized instruments. Data was analyzed using ANOVA, and simple and multiple logistical regression. Differences in education, income, and self-esteem were noted across participants identifying as heterosexual, homosexual, and bisexual. Bisexual Hispanic men had almost four times greater odds of reporting the perpetration of IPV than homosexual Hispanic men, even when differences in education, income, and self-esteem were controlled for (AOR = 3.92, 95%CI = 1.11, 14.19). This study suggests the importance of specifically targeting bisexual Hispanic men in IPV research and services.