Barriers to access, treatment, and retention in quality HIV/AIDS Care: Interventions with Latina immigrant and migrant farm workers

One of the components of successful HIV intervention programs with hard-to-reach populations has been to identify and remove barriers along the continuum of care. The present intervention targets one a high-risk populations with greatest unmet needs – the Latina immigrants and migrant farm workers. The mobility of this population, in conjunction with high poverty rates and low education, compounds the difficulty in implementing HIV intervention programs and providing services. We describe the results of an ongoing program that has improved retention in quality HIV care for target population, by 1) establishing a referral network with local organizations that provides comprehensive care, including mental health and substance abuse treatment, 2) providing a linguistically and culturally appropriate case management system, 3) reducing the likelihood that mobile populations of migrant farm workers fall out of care by enrolling patients in Migrant Clinical Network. The program also implements an innovative intervention called “Yo Me Cuido” (I Take Care of Myself) specifically designed for the target population. The intervention addresses psychosocial barriers to proactive HIV care by increasing knowledge of HIV, safer sex behaviors; developing positive attitudes toward safer sex, enhancing condom negotiation skills. and increasing control over sexual situations. Outcome evaluation is being conducted at baseline, 3 months, and 6 months post intervention, and includes barriers to seeking HIV, physical and mental health indicators, risk behaviors, treatment adherence. Preliminary findings (n=11) indicate that successful retention is dependent upon providing secondary services in terms of service location, transportation, legal services, which we have incorporated.