RESUMO
OBJECTIVE: To explore attitudes toward immigrants and refugees living in Ecuador. DESIGN AND MEASURES: A transnationalism framework informed this qualitative study, which utilized a semi-structured interview guide to elicit responses from participants about their attitudes toward immigrants and refugees. Interviews were conducted in Spanish, audio-taped, transcribed, coded, and analyzed in Spanish to identify emergent themes. Demographic data were analyzed using SPSS. SAMPLE: Participants (n = 50) were recruited from five sectors that interact with refugees: health care, the press, the police, nongovernmental organizations, and education. Fifty interviews were conducted with adults in Quito, Ecuador, in 2017. RESULTS: Participants reported concerns about the health and well-being of immigrants and refugees, expressed a willingness to assist them, but within limits, noted discrimination and bias against refugees, and cited social policies and human rights as factors that influenced their attitudes. CONCLUSIONS: Our findings indicate that immigrants and refugees face challenges which impact their health and well-being, according to participants in the study. Social policies can influence attitudes, but are also affected by rapidly shifting immigration patterns. Migration flows in South America is an under-studied area of research, with opportunity for further public health nursing inquiry.
Assuntos
Atitude , Emigrantes e Imigrantes/psicologia , Ocupações/estatística & dados numéricos , Refugiados/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Equador , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Masculino , Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Política Pública , Pesquisa Qualitativa , Refugiados/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: To examine the mouth and body knowledge, beliefs and behaviours of Dominican, Puerto Rican and African American older adults, and their relationships to oral and general health and health care. BACKGROUND: In his seminal framework, Handwerker posited that the norms, attitudes and behaviours related to the experience of disease and treatment reflect where patients live and have lived and are seeking and have sought care, along with their webs of social and health relations. This framework guides the analysis for the present study, wherein qualitative data are used to understand mouth and body knowledge, beliefs and behaviours among racial/ethnic minority older adults, ie, why individuals do what they do and what it means to them. MATERIALS AND METHODS: Focus groups were conducted in Spanish or English with 194 racial/ethnic minority older adults living in northern Manhattan who participated in one of 24 focus group sessions about improving oral health. All groups were digitally audio-recorded, transcribed and translated into English from Spanish, where apt. Analysis involved the classification of evidence from all datasets, organised to identify patterns and relationships. RESULTS: Four themes were manifest in the data regarding cultural understandings of the mouth, the body and health: (a) the ageing mouth and its components; (b) the mouth in relation to the body, health and disease; (c) social meanings of the mouth; and (d) care of the ageing mouth. CONCLUSION: Underserved older adults from diverse cultural backgrounds understand the importance of their mouths to both their overall health and social lives.
Assuntos
Negro ou Afro-Americano , Cultura , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispânico ou Latino , Saúde Bucal/etnologia , Higiene Bucal , Idoso , Idoso de 80 Anos ou mais , Dentaduras , República Dominicana/etnologia , Feminino , Grupos Focais , Humanos , Masculino , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Doenças da Boca/etnologia , Doenças da Boca/prevenção & controle , Cidade de Nova Iorque , Porto Rico/etnologia , Pesquisa Qualitativa , Comportamento SocialRESUMO
This study explored factors affecting the health and well being of recent refugees from Colombia in Ecuador. Data collection focused on how sending-country violence and structural violence in a new environment affect immigrant health vulnerability and risk behaviors. A qualitative approach included ethnographic observation, media content analysis, focus groups, and individual interviews with refugees (N = 137). The focus groups (5) provided perspectives on the research domains by sex workers; drug users; male and female refugees; and service providers. Social and economic marginalization are impacting the health and well being of this growing refugee population. Data illustrate how stigma and discrimination affect food and housing security, employment and health services, and shape vulnerabilities and health risks in a new receiving environment. Widespread discrimination in Ecuador reflects fears, misunderstanding, and stereotypes about Colombian refugees. For this displaced population, the sequelae of violence, combined with survival needs and lack of support and protections, shape new risks to health and well-being.
Assuntos
Refugiados , Estigma Social , Violência/estatística & dados numéricos , Adulto , Colômbia/etnologia , Equador/epidemiologia , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Meios de Comunicação de Massa , Pesquisa QualitativaRESUMO
Inherent in many reproductive health and family planning programmes is the problematic assumption that the body, its processes and modifications to it are universally experienced in the same way. This paper addresses contraceptive knowledge and beliefs among Mexican-origin women, based upon data gathered by the qualitative component of the Border Contraceptive Access Study. Open-ended interviews explored the perceived mechanism of action of the pill, side-effects, non-contraceptive benefits, and general knowledge of contraception. Findings revealed complex connections between traditional and scientific information. The use of medical terms (e.g. 'hormone') illustrated attempts to integrate new information with existing knowledge and belief systems. Conclusions address concerns that existing information and services may not be sufficient if population-specific knowledge and beliefs are not assessed and addressed. Findings can contribute to the development of effective education, screening and reproductive health services.
Assuntos
Anticoncepção , Anticoncepcionais Orais , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Americanos Mexicanos , Adolescente , Adulto , Características Culturais , Serviços de Planejamento Familiar/métodos , Feminino , Humanos , Pesquisa Qualitativa , Saúde Reprodutiva , Inquéritos e Questionários , Adulto JovemRESUMO
This article draws from a study investigating the influence of institutional and psychosocial factors on adherence to antiretroviral (ARV) medications by Mexican-origin persons living with HIV (PWLH) on the U.S.-Mexico border and seeking treatment at a clinic in El Paso, Texas. Among 113 participants, many individuals reported using complementary and alternative medicines (CAM) to support general health and their immune systems and to address symptoms of HIV-related diseases and ARV side effects. CAM were seen as complementing ARV treatment; however, CAM use was often not reported to health care providers out of concern about disapproval and loss of care privileges. This finding challenges researchers and providers to consider seriously how Hispanic populations, with their CAM use, may exhibit the hybridization of health and healing. Information on CAM use needs to be available to providers to assess the benefits and contraindications of use and to develop realistic and effective care strategies.
Assuntos
Fármacos Anti-HIV/uso terapêutico , Terapias Complementares/estatística & dados numéricos , Infecções por HIV/terapia , Americanos Mexicanos/estatística & dados numéricos , Adaptação Fisiológica , Adulto , Idoso , Instituições de Assistência Ambulatorial , Fármacos Anti-HIV/administração & dosagem , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Grupos Focais , Infecções por HIV/etnologia , Humanos , Entrevistas como Assunto , Masculino , México , Pessoa de Meia-Idade , Fitoterapia/estatística & dados numéricos , Pesquisa Qualitativa , Apoio Social , Fatores Socioeconômicos , Estresse Psicológico , Texas , Estados Unidos , Adulto JovemRESUMO
High rates of sex and drug risk behaviors have been documented among Latino migrant men in the US. Whether these behaviors were established in the migrants' home countries or were adopted in the US has not been described and has implications for prevention strategies. Quarterly surveys were conducted to gather information on selected sex and drug risk practices of Latino migrant men who arrived in New Orleans after Hurricane Katrina seeking work. Both kappa scores and McNemar's tests were performed to determine if practice of these behaviors in home country was similar to practice post-emigration to the US. Female sex worker (FSW) patronage, same sex encounters (MSM), and crack cocaine use was more likely to occur post- rather than pre-emigration. Of those who ever engaged in these selected behaviors, most adopted the behavior in the US (i.e., 75.8% of FSW patrons, 72.7% of MSM participants, and 85.7% of crack cocaine users), with the exception of binge drinking (26.8%). Men who were living with a family member were less likely to adopt FSW patronage OR = 0.27, CI = 0.10-0.76, whereas men who earned >$465 per week were more likely to adopt crack cocaine use OR = 6.29 CI = 1.29, 30.57. Interventions that facilitate the maintenance of family cohesion and provide strategies for financial management may be useful for reducing sex and drug risk among newly arrived migrants.
Assuntos
Tempestades Ciclônicas , Desastres , Emigrantes e Imigrantes , Hispânico ou Latino , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/etnologia , América Central/etnologia , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Nova Orleans/epidemiologia , Classe Social , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adulto JovemRESUMO
The data discussed represent the findings from a study by the NIH-funded Hispanic Health Disparities Research Center, exploring the influence of institutional and psychosocial factors on adherence to antiretroviral medications by Mexican-origin persons living with AIDS on the US-Mexico Border. A qualitative approach was utilized consisting of clinic observations, baseline and follow-up interviews with patients (N = 113), key informant interviews (N = 9) and focus groups (5) with patients and health providers. Findings include the social-normative, institutional and geo-political factors affecting treatment and service delivery as well as individual variation and culturally patterned behaviors. ARV adherence and retention were found to depend on complex interactions and negotiation of co-occurring factors including the experience of medications and side-effects, patient/provider relationships, cultural norms and the changing dynamics of international borders. We note effects of drug-related violence which created border-crossing obstacles influencing mobility, access to services and adherence.
Assuntos
Antirretrovirais/uso terapêutico , Características Culturais , Infecções por HIV/tratamento farmacológico , Adesão à Medicação , Política , Feminino , Grupos Focais , Infecções por HIV/etnologia , Humanos , Masculino , Adesão à Medicação/etnologia , México/etnologia , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estados UnidosRESUMO
OBJECTIVE: To estimate differences in continuation of oral contraceptive pills (OCPs) between U.S. resident women obtaining pills in U.S. family planning clinics compared with over-the-counter in Mexican pharmacies. METHODS: In El Paso, Texas, we recruited 514 OCP users who obtained pills over the counter from a Mexican pharmacy and 532 who obtained OCPs by prescription from a family planning clinic in El Paso. A baseline interview was followed by three consecutive surveys over 9 months. We asked about date of last supply, number of pill packs obtained, how long they planned to continue use, and experience of side effects. Retention was 90%, with only 105 women lost to follow-up. RESULTS: In a multivariable Cox proportional hazards model, discontinuation was higher for women who obtained pills in El Paso clinics compared with those who obtained their pills without a prescription in Mexico (hazard ratio 1.6, 95% confidence interval [CI] 1.1-2.3). Considering the number of pill packs dispensed to clinic users, discontinuation rates were higher (hazard ratio 1.8, 95% CI 1.2-2.7) for clinic users who received one to five pill packs. However, there was no difference in discontinuation between clinic users receiving six or more pill packs and users obtaining pills without a prescription. CONCLUSION: Results suggest providing OCP users with more pill packs and removing the prescription requirement would lead to increased continuation.
Assuntos
Anticoncepcionais Orais , Acessibilidade aos Serviços de Saúde , Medicamentos sem Prescrição , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , México , Modelos de Riscos Proporcionais , Texas , Adulto JovemRESUMO
OBJECTIVE: To compare the estimated proportion of contraindications to combined oral contraceptives between women who obtained combined oral contraceptives in U.S. public clinics compared with women who obtained combined oral contraceptives over the counter (OTC) in Mexican pharmacies. METHODS: We recruited a cohort of 501 women who were residents of El Paso, Texas, who obtained OTC combined oral contraceptives in Mexico and 514 women who obtained combined oral contraceptives from family planning clinics in El Paso. Based on self-report of World Health Organization category 3 and 4 contraindications and interviewer-measured blood pressure, we estimated the proportion of contraindications and, using multivariable-adjusted logistic regression, identified possible predictors of contraindications. RESULTS: The estimated proportion of any category 3 or 4 contraindication was 18%. Relative contraindications (category 3) were more common among OTC users (13% compared with 9% among clinic users, P=.006). Absolute contraindications (category 4) were not different between the groups (5% for clinic users compared with 7% for OTC users, P=.162). Hypertension was the most prevalent contraindication (5.6% of clinic users and 9.8% of OTC users). After multivariable adjustment, OTC users had higher odds of having contraindications compared with clinic users (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.11-2.29). Women aged 35 years or older (OR 5.30, 95% CI 3.59-7.81) and those with body mass index 30.0 or more (OR 2.24, 95% CI 1.40-3.56) also had higher odds of having contraindications. CONCLUSION: Relative combined oral contraceptive contraindications are more common among OTC users in this setting. Progestin-only pills might be a better candidate for the first OTC product given their fewer contraindications.
Assuntos
Anticoncepcionais Orais Combinados , Adolescente , Adulto , Contraindicações , Feminino , Humanos , México , Medicamentos sem Prescrição , Medicamentos sob Prescrição , Texas , Adulto JovemRESUMO
The importance of identifying differences in HIV risk between Hispanic subgroups is the focus of this article. Data are drawn from two New York?based HIV-related studies: among Puerto Rican drug users and among new immigrants from Central America, the Dominican Republic, and Mexico. Results indicated that intercultural individuals (i.e., those involved in both Puerto Rican and mainland cultures) were less risky in terms of injection- and sex-related risk behaviors and that geographic and other contextual factors, along with cultural norms, influence risk behaviors for immigrants. Both studies indicate the need to differentiate subgroup factors affecting HIV risk and prevention behaviors to develop appropriate and effective community-based interventions. The study's limitations are noted.
Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Infecções por HIV/etnologia , Infecções por HIV/prevenção & controle , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adulto , América Central/etnologia , República Dominicana/etnologia , Usuários de Drogas , Feminino , Hispânico ou Latino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Porto Rico/etnologia , Risco , Assunção de RiscosRESUMO
This qualitative study explored partner selection in a sample of immigrant Latino men who have sex with men (MSM). In-depth interviews were conducted with men living in the greater New York metropolitan area who had been born in Brazil (n = 10), Colombia (n = 14), or the Dominican Republic (n = 9). One focus group was conducted with MSM from each of the three countries (9 Brazilian, 11 Colombian, and 5 Dominican participants). A grounded theory approach revealed three main themes relating to partner selection. The first concerned stereotypes of how Latino and Anglo-American men tend to behave in their sexual encounters and relationships. The participants perceived Latinos to be more affectionate and passionate, whereas they saw Anglo-American men as more independent and practical. These cultural discrepancies sometimes resulted in a preference for Latino partners. A second theme concerned stereotypes of the national groups, including expectations that Brazilians would be sexy and sensual and that Dominicans would have large penises. As found in other research on MSM of color, ethnic and national stereotypes were associated with experiences of sexual objectification. The third theme addressed the importance of masculine characteristics in sexual attraction and partner selection. Negative feelings towards effeminate men who did not conform to normative male physical or behavioral presentation reflect a stigma found inside and outside of the gay community. These findings suggest that gender and ethnic stereotypes play an important role in shaping partner choice and have implications for sexual risk and relationship formation.
Assuntos
Emigrantes e Imigrantes/psicologia , Hispânico ou Latino/psicologia , Homossexualidade Masculina/psicologia , Adulto , Brasil/etnologia , Colômbia/etnologia , República Dominicana/etnologia , Identidade de Gênero , Humanos , Entrevistas como Assunto , Masculino , Masculinidade , Pessoa de Meia-Idade , Cidade de Nova Iorque , Fatores Socioeconômicos , EstereotipagemRESUMO
This article reports the results of a study carried out with 30 Mexican-origin immigrants in drug user treatment in the United States-Mexico Border city of El Paso, Texas during 2007. Qualitative, semi-structured interviews were implemented to assess the dynamic social and economic factors that affect the delivery and utilization of treatment services, with emphasis on the impact of recent immigration-related laws and policies. The research provides initial data for evidence-based intervention and reinforces the need for culturally and gender appropriate treatment services for poor immigrants and their families. The study's limitations are noted.
Assuntos
Emigrantes e Imigrantes/legislação & jurisprudência , Acessibilidade aos Serviços de Saúde/legislação & jurisprudência , Política Pública , Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , México/etnologia , Pessoa de Meia-Idade , Texas , Adulto JovemRESUMO
Key informant interviews, in-depth interviews and focus groups were conducted to examine ways in which social context influenced the behavior of Brazilian, Colombian and Dominican men who have sex with men. First, we investigated how the social context in the home country affected motivation for migration. Findings suggest that Latino men who have sex with men frequently reported coming to the USA to escape homo-negativity and to achieve greater sexual freedom. The study also examined how the social context encountered in the early years after migration shaped sexual behavior and risk. A majority of the participants reported easy access to sex partners and frequent sexual encounters. The anonymity of living in a gay epicentre such as New York City, often without social connections from the past, was experienced as liberating and conducive to sexual exploration. Moreover, sex in public venues, such as parks and sex cabins, was readily available to those who do not speak English. The tendency to engage in high levels of sexual activity during the early period after arrival in New York City was particularly evident among younger men. Implications for future programme development are discussed alongside prevention efforts targeting migrants during this critical period.
Assuntos
Características Culturais , Emigração e Imigração , Liberdade , Homossexualidade Masculina/etnologia , Relações Interpessoais , Parceiros Sexuais , Adulto , Brasil/epidemiologia , Coito/psicologia , Colômbia/epidemiologia , República Dominicana/epidemiologia , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Homossexualidade Masculina/psicologia , Humanos , Masculino , Cidade de Nova Iorque/etnologia , Assunção de Riscos , Apoio Social , Inquéritos e Questionários , Saúde da População UrbanaRESUMO
Because the HIV pandemic undergoes continual change in its locations and affected populations, it is crucial to study HIV risk behaviors among mobile and immigrant groups within and across borders. The impact of cross-cultural migrations and the importance of studying that impact in terms of demographic characteristics as well as cultural and environmental factors has not received adequate attention in public health research. This collaborative analysis utilizes data from three studies of immigrant groups in New York to describe and compare these factors that provide the context for risk and prevention of HIVAIDS and other health challenges. Data discussed were obtained utilizing multi-method approaches to identify and describe HIV risks among both new and more established immigrant populations within the urban settings of North America, with NYC as a central focus. Demographic and epidemiological data situate the analysis within the larger contexts of US migration and the HIV/AIDS epidemic in NYC. The authors identify risk and protective factors embedded to varying degrees in immigrants' multiple cultures and sub-cultures. The three populations studied include: 1) new Hispanic immigrants from the Dominican Republic, Mexico and Central America; 2) West Indian (Caribbean) immigrants from Jamaica, Trinidad/Tobago and other anglophone Caribbean nations; and 3) South Asian immigrants from India (Indian Americans). The paper seeks differences and commonalities, focusing on the social, attitudinal and behavioral factors that contribute to increased HIV/AIDS vulnerability among these populations. The data presented also identify some of the attitudes and behaviors of individuals and groups, as well as other facilitators and obstacles to transmission for immigrants as they adapt to new environments. Topics addressed include factors affecting HIV/AIDS vulnerability of immigrant groups, goals and expectations, health and mental heath issues, gender role change, sexual risk, alcohol and other drug use, perception of HIV/AIDS risk and implications for prevention.
Assuntos
Atitude Frente a Saúde/etnologia , Emigração e Imigração , Infecções por HIV/etnologia , Assunção de Riscos , Síndrome da Imunodeficiência Adquirida/etnologia , América Central/etnologia , Surtos de Doenças , Feminino , Identidade de Gênero , Promoção da Saúde , Humanos , Índia/etnologia , Masculino , México/etnologia , Cidade de Nova Iorque/epidemiologia , Comportamento Sexual , Índias Ocidentais/etnologiaRESUMO
Because the HIV pandemic undergoes continual change in its locations and affected populations, it is crucial to study HIV risk behaviors among mobile and immigrant groups within and across borders. The impact of cross-cultural migrations and the importance of studying that impact in terms of demographic characteristics as well as cultural and environmental factors has not received adequate attention in public health research. This collaborative analysis utilizes data from three studies of immigrant groups in New York to describe and compare these factors that provide the context for risk and prevention of HIVAIDS and other health challenges. Data discussed were obtained utilizing multi-method approaches to identify and describe HIV risks among both new and more established immigrant populations within the urban settings of North America, with NYC as a central focus. Demographic and epidemiological data situate the analysis within the larger contexts of US migration and the HIV/AIDS epidemic in NYC. The authors identify risk and protective factors embedded to varying degrees in immigrants' multiple cultures and sub-cultures. The three populations studied include: 1) new Hispanic immigrants from the Dominican Republic, Mexico and Central America; 2) West Indian (Caribbean) immigrants from Jamaica, Trinidad/Tobago and other anglophone Caribbean nations; and 3) South Asian immigrants from India (Indian Americans). The paper seeks differences and commonalities, focusing on the social, attitudinal and behavioral factors that contribute to increased HIV/AIDS vulnerability among these populations. The data presented also identify some of the attitudes and behaviors of individuals and groups, as well as other facilitators and obstacles to transmission for immigrants as they adapt to new environments. Topics addressed include factors affecting HIV/AIDS vulnerability of immigrant groups, goals and expectations, health and mental heath issues, gender role change, sexual risk, alcohol and other drug use, perception of HIV/AIDS risk and implications for prevention.
Assuntos
Humanos , Masculino , Feminino , Emigração e Imigração , HIV , Síndrome da Imunodeficiência Adquirida , Cidade de Nova IorqueRESUMO
PURPOSE: Research on the initial stage of acculturation of new immigrants is crucial for identifying AIDS prevention policies and priorities for this vulnerable population. METHODS: This study employed an exploratory approach and qualitative data collection methods to identify and describe social and behavioral factors influencing risk for HIV infection among recent Hispanic immigrants (<3 years in the United States). Immigrants from Guatemala, El Salvador, Honduras, the Dominican Republic and Mexico were interviewed in urban, suburban and semirural settings in the New York Metropolitan Area. Data were collected through ethnographic fieldwork, in-depth interviews (N=51), focus groups (N=11; total number of participants=86) and individual interviews with health and social service providers (N=26). RESULTS: Initial stages of acculturation for immigrants reflect both retention and change in attitudes and behaviors involving their mental health, gender role norms, social and sexual behavior, and alcohol and other drug use. Current living environments may introduce conditions affecting HIV risk and prevention, while sustained connections to countries of origin may support retention of attitudes and behaviors with positive and negative risk implications. CONCLUSIONS: Specific epidemiological, environmental, economic, social and psychosocial factors are identified that provide the context for risk and prevention. The challenges and opportunities faced by these new communities must be distinguished from those of more acculturated immigrant populations if culturally appropriate interventions are to be developed.
Assuntos
Aculturação , Atitude Frente a Saúde/etnologia , Emigração e Imigração , Infecções por HIV/etnologia , Comportamentos Relacionados com a Saúde/etnologia , Hispânico ou Latino/psicologia , América Central/etnologia , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Hispânico ou Latino/etnologia , Humanos , Entrevistas como Assunto , Masculino , Cidade de Nova Iorque/epidemiologia , Pesquisa Qualitativa , Medição de Risco , Fatores de Risco , Fatores de TempoRESUMO
Migrant populations have been found to be at risk of HIV/AIDS. The growth in immigrant and migrant Hispanic populations in the United States increases the need to enhance understanding of influences on their HIV-risk behaviors. Four challenges to conducting research among these populations were identified: (1) the need to use multilevel theoretical frameworks; (2) the need to differentiate between Hispanic subgroups; (3) challenges to recruitment and data collection; and (4) ethical issues. This article describes how two studies of Hispanic immigrants and migrants in the New York area addressed these challenges. One study focused on new immigrants from Mexico, the Dominican Republic, El Salvador, Honduras and Guatemala, and a second study focused on Puerto Rican drug users. Both studies incorporated qualitative and quantitative methods to study these hard-to-reach populations. Continued study of the sociocultural and contextual factors affecting HIV risk for mobile populations, and addressing the research challenges, is crucial to developing effective intervention programs.