title: The impact of acculturation on utilization of HIV prevention services and access to care among an at-risk Hispanic population.
abstract: BACKGROUND
  HIV/AIDS disproportionately affects Hispanics in the United States, a diverse and heterogeneous population. The purpose of this study was to evaluate the relationship of acculturation with HIV and hepatitis C testing, and access to care among Hispanics at risk for HIV.
  
  
  METHODS
  We recruited 600 Hispanics from STD clinics, community-based organizations, and needle exchange programs in Los Angeles County.
  
  
  RESULTS
  Low levels of acculturation were significantly associated with having fewer HIV tests (OR 1.98, 95% CI 1.24, 3.15), no hepatitis C tests (OR 2.61, 95% CI 1.77, 3.84), testing positive for HIV (OR 2.67, 95% CI 1.04, 6.83), and low levels of access to care (beta=0.06; p<.05).
  
  
  CONCLUSIONS
  Low levels of acculturation are an important barrier to the use of HIV-related health care services. Our findings may inform the development of effective interventions that address the cultural and behavioral differences among Hispanic subgroups.
authors.affiliation: Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, USA. jkinsler@mednet.ucla.edu
authors.forename: Janni J
authors.initials: JJ
authors.lastname: Kinsler
authors.forename: Sung-Jae
authors.initials: SJ
authors.lastname: Lee
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Sayles
authors.forename: Peter A
authors.initials: PA
authors.lastname: Newman
authors.forename: Allison
authors.initials: A
authors.lastname: Diamant
authors.forename: William
authors.initials: W
authors.lastname: Cunningham
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D003153:Community Health Services / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000208:ethnology* / Q000517:prevention & control; D006679:HIV Seropositivity; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006526:Hepatitis C / Q000208:ethnology / Q000517:prevention & control; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult