Online Program

HIV treatment delays among immigrant latinos: Testing a model for social influence and trust

Tuesday, November 5, 2013 : 1:30 p.m. - 1:45 p.m.

Aaron T. Vissman, MPH, Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
Frank Wong, Ph.D., Dept of Behavioral Sciences and Health Education, Hubert Department of Global Health (Joint Appointment), Rollins School of Public Health, Atlanta, GA
Scott Rhodes, PhD, MPH, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Background: Annual incidence of HIV among Latinos in the U.S. is three times higher than non-Latino whites. Compared to U.S.-born Latinos, immigrants from Mexico and Central America have greater odds of a late HIV diagnosis, are more likely to have an opportunistic infection at HIV diagnosis, and experience increased risk of death. The objectives of this study were to validate the internal factor structure of a Spanish-language physician trust scale among immigrant Latino men and women living in North Carolina and estimate the structural relationships between sojourner social support, acculturative factors, and physician trust adjusting for length of residence in the U.S. Methods: Data were collected from immigrant Latinos using respondent driven sampling and venue based sampling. Assessments were administered by native Spanish-speakers. Data were analyzed using EQS software and structural equation modeling. Results: Eighty four percent of participants (N=366) were from Mexico. Preliminary results indicate a second-order factor structure for Physician Trust (the second-order factor) with first-order factors of Provider and Researcher Trust. The effects of Social-ethnic Relations and Language/media Preference on Physician Trust were mediated by Social Support. These structural relationships were not significantly different for men and women. Conclusions: The hypothetical factor structure of physician trust was confirmed. Multiple pathways to physician trust suggest interrelationships between language/media use and social influences may be leveraged to reduce HIV testing and treatment delays during the processes of migration and accommodation. Directionality of associations will be established in longitudinal research currently underway.

Learning Areas:

Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the internal factor structure of the Wake Forest University Physician Trust Scale (Spanish Language Version). Compare Physician Trust scores among immigrant Latinos in North Carolina and structural relationships with aculturative and social influence factors. Describe implications for HIV/STI prevention interventions in the southeastern USA.

Keyword(s): HIV Interventions, Immigrants

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently a 3rd year doctoral student. I have conducted state and federally funded research addressing migration, acculturation, and HIV/AIDS outcomes under the supervision of principal-investigators in schools of medicine and public health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4226.0: HIV and Latino communities