Luz Marilis López

Latino AIDS immigrants in the Western Gulf states: a different population and the need for innovative prevention strategies.

Abstract Immigrant HIV infected Latinos, and those at highest risk for infection, demonstrate strikingly different patterns of risk behaviors and origins. This complicates the already complex acculturation process impacting their lives. By weaving together immigration and AIDS epidemiological patterns, the impact of tightening immigration policy, and masked sexual behaviors, the authors express concern for a lack of communication with, and lack of health care access for, Latinos in the Western Gulf Coast. To combat this deficit, health care and social workers need to be aware of different social, cultural, and behavioral contexts in Latino populations. Policy makers should support efforts to provide health care workers with skills through appropriate language and cultural sensitivity workshops. HIV prevention strategies specific to Latinos are also discussed.

Needle Sharing Among Puerto Rican Injection Drug Users in Puerto Rico and Massachusetts: Place of Birth and Residence Matter

This study explored whether place of birth and residence was associated with needle sharing for Puerto Rican injection drug users (IDUs) (N = 348). In-person interviews were conducted in Puerto Rico and Massachusetts during 2005–2007. Multivariate regression analyses revealed IDUs born and living in Puerto Rico were four times more likely to have shared needles compared to those residing in Massachusetts. Respondents residing in Massachusetts were 76% less likely to have ever shared needles with an HIV-positive individual, controlling for covariates. Findings highlight the increased HIV-risk of Puerto Rican IDUs born and residing in Puerto Rico. Prevention and treatment needs are discussed.

Making Effective Referrals to Alcoholics Anonymous and Other 12-step Programs

This chapter will describe 12-step programs, explain what occurs at meetings, and address common mis-conceptions. Our central goal is to present practical guidelines to help primary care physicians make referrals to 12-step programs. Effective referrals include introducing patients to these programs, motivating them to attend meetings, having follow-up conversations with them about their experiences at meetings, and encouraging them to consider on-going affiliation. The guidelines presented here can help you talk with patients who are new to 12-step programs as well as patients who attended in the past but found the experience unhelpful. Since you may wonder whether 12-step programs actually work, we briefly describe the accumulating research evidence for their effectiveness. Perhaps most important, we discuss why your role as a primary care physician is so pivotal.

Use of a Smartphone Recovery Tool for Latinos with Co-Occurring Alcohol and Other Drug Disorders and Mental Disorders

ABSTRACT Objective: Addressing alcohol and other drug disorders and other mental disorders among adult Hispanics/Latinos is of critical concern, as they are one of the fastest-growing ethnic groups with a disproportionate rate of disease, mental disorders, and poverty. Although improvement in outcomes is associated with sustained participation in ongoing treatment for co-occurring alcohol and other drug disorders/mental disorders, continuing care is rare for these chronic conditions, especially for Latinos with more limited access to culturally and linguistically competent services. Methods: The evidence-based smartphone recovery application Addiction–Comprehensive Health Enhancement Support System (A-CHESS) was translated and adapted for Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders, thus developing CASA-CHESS to address a high level of need for services, high rates of relapse, and lack of existing culturally competent services for Latinos. Results: Of the 79 Latino clients who completed residential treatment and received a smartphone equipped with CASA-CHESS, 26.6% discontinued using CASA-CHESS and 73.4% remained active for four or more months. CASA-CHESS usage was sustained over the four months across all three tenets of self-determination theory (competence, relatedness, and autonomy), with the most commonly utilized services being relevant to relatedness (e.g., messaging, discussion boards). CASA-CHESS clients demonstrated a similar pattern of usage to A-CHESS clients. Conclusions: Findings illustrate that Spanish-speaking Latinos with alcohol and other drug disorders/mental disorders will use a smartphone application to assist with their recovery, continuing their access to resources, case management, and quality information after leaving residential treatment. Consistent with previous findings, our results also emphasize the importance of social support during the four months post-discharge. Such evidence-based, theory-driven digital interventions may extend access to culturally and linguistically competent services.

Injection of Xylazine mixed with heroin associated with poor health outcomes and HIV risk behaviors in Puerto Rico

Background and purpose Recent studies of injection drug users (IDUs) in Puerto Rico indicate widespread use of xylazine, also known as horse anesthesia (a veterinary analgesic sedative) mixed with heroin and cocaine. Research shows that xylazine contributes to more severe symptoms of withdrawal. This study explored the association between the use of heroin+xylazine and poor health outcomes, including hepatitis C and HIV risk among Puerto Rican drug users.

Effectiveness of a cognitive-behavioral group intervention for Latino families in management of Alzheimer's disease neuropsychiatric symptoms

Background: By 2050, Alzheimer’s disease (AD) rates among Latinos in the U.S. are projected to increase from 200,000 to 1.3 million. Yet, there is ample evidence that many Latino elders and their families are underrepresented in the health care system and not receiving services to reduce their risk or manage their dementia. Boston University sought to address this gap through the development and testing of Circulo de Cuidado, a Spanish-language, culturally-sensitive approach, which uses a cognitive behavioral framework to teach caregivers how to manage neuropsychiatric symptoms through: 1) increasing pleasant activities and interactions with their AD relative, 2) reinforcing positive experiences for their AD relative; and (3) reducing caregiver distress. Methods: A randomized controlled trial was conducted with caregivers assigned to 1 of 2 study arms: the cognitive behavioral (CBT)experimental condition or the psycho-educational (PE) control condition. Led by Spanish-speaking social workers, the 2 interventions’ structures were identical; a series of 5-weekly, 90-minute group sessions followed by booster telephone calls at 3-, 6-, 9and 12-weeks. However, the 2 groups’ objectives and content differed; the CBT group taught the principles and skills of behavioral change through individualized exercises while the