Abstract
The CDC recommends that persons aged 13–64 receive an HIV test at least once in their lifetime and that some groups test annually or more frequently. Nearly one-half of US Latino immigrants have never been tested for HIV. To the extent that immigration-related laws deter documented and undocumented immigrants from engaging in communicable disease control measures, these laws undermine public health efforts. 1750 noncitizen adult, sexually active, Spanish-speaking Latino immigrants across four cities in the US completed a cross-sectional survey assessing perceptions of immigration-related laws and immigration consequences related to HIV testing and diagnosis. Participants were recruited in-person by staff in community settings, through flyers posted in places frequented by Latino immigrants, and by word-of-mouth through snowball sampling. Outcomes were whether participants had ever received an HIV test and whether they tested in the previous 12 months. Multivariable analyses examined the relative contribution of perceived immigration laws and consequences on HIV testing behaviors when considering established predictors of HIV testing. Perceptions of HIV-related immigration laws and immigration consequences was a significant predictor of never having had an HIV test even when considered relative to common predictors of HIV testing. The influence of perceived immigration laws and consequences on testing in the previous 12 months was not significant in multivariable analysis. Perceived HIV-related immigration laws and consequences appear to be a substantial contributor to reluctance to be tested for HIV among Latino immigrants who have never been tested. Effective interventions should be developed to address these.
Resumen
El CDC recomienda que las personas de 13 a 64 años se hagan una prueba del VIH al menos una vez en la vida y que algunos grupos se hagan la prueba anualmente o con mayor frecuencia. Casi la mitad de los inmigrantes latinos de los Estados Unidos nunca se han hecho la prueba del VIH. En la medida en que las leyes relacionadas con la inmigración disuadan a los inmigrantes documentados e indocumentados de participar en medidas de control de enfermedades transmisibles, estas leyes socavan los esfuerzos de salud pública. 1750 inmigrantes latinos adultos no ciudadanos, sexualmente activos y de habla hispana en cuatro ciudades de EE. UU. completaron una encuesta transversal que evaluó las percepciones de las leyes relacionadas con la inmigración y de las consecuencias de la inmigración relacionadas con las pruebas y el diagnóstico del VIH. Los participantes fueron reclutados en persona en contextos comunitarios, a través de volantes publicados en lugares frecuentados por inmigrantes latinos y de boca en boca a través de muestras de bola de nieve. Las variables dependientes fueron si los participantes se habían hecho una prueba del VIH alguna vez y si se habían hecho la prueba en los últimos 12 meses. Los análisis multivariados examinaron la contribución relativa de la percepción de las leyes de inmigración y de las consecuencias de inmigración sobre los comportamientos relativo a las pruebas del VIH, controlando por predictores conocidos de las pruebas del VIH. Las percepciones de las leyes de inmigración relacionadas con el VIH y las consecuencias de la inmigración fueron un predictor significativo de nunca haberse realizado una prueba del VIH, aun considerando los predictores comunes de la prueba del VIH. La influencia de la percepción de las leyes de inmigración y de las consecuencias de la inmigración sobre la prueba en los últimos 12 meses no fue significativa en el análisis multivariado. Las leyes de inmigración y las consecuencias percibidas relacionadas con el VIH parecen contribuir sustancialmente a la renuencia a hacerse la prueba del VIH entre los inmigrantes latinos que nunca se han hecho la prueba. Deben desarrollarse intervenciones efectivas para abordar esta renuencia.
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Acknowledgements
We would like to acknowledge the contribution of the following Proyecto Luz 2.0 research team members: Ruzanna Aleksanyan, MS, Nora Bouacha, MPP, Andrea L. Dakin, PhD, Joanna Barreras, PhD, MSW, Samantha Garza, MS, Sara LeGrand, PhD, Celina Lopez, Elizabeth Ortiz de Valdez, MD, Juan Reyes, Silvia Valadez-Tapia, MA, Angel Rosado, and Juan Flores.
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Research reported in this document was supported by the National Institute on Minority Health and Health Disparities under Award Number R01MD011573 and the National Institute of Mental Health under Award Number P30MH052776. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
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Galletly, C.L., McAuliffe, T.L., Dickson-Gomez, J.B. et al. The Relative Influence of Perceived Immigration Laws and Consequences on HIV Testing Among US Latino Immigrants. AIDS Behav 28, 1301–1313 (2024). https://doi.org/10.1007/s10461-023-04159-0
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DOI: https://doi.org/10.1007/s10461-023-04159-0