Evaluation of a Community Health Worker Intervention to Reduce HIV/AIDS Stigma and Increase HIV Testing Among Underserved Latinos in the Southwestern U.S.
OBJECTIVE
Latinos are at an elevated risk for HIV infection. Continued HIV/AIDS stigma presents barriers to HIV testing and affects the quality of life of HIV-positive individuals, yet few interventions addressing HIV/AIDS stigma have been developed for Latinos.


METHODS
An intervention led by community health workers (promotores de salud, or promotores) targeting underserved Latinos in three southwestern U.S. communities was developed to decrease HIV/AIDS stigma and increase HIV knowledge and perception of risk. The intervention was led by HIV-positive and HIV-affected (i.e., those who have, or have had, a close family member or friend with HIV/AIDS) promotores, who delivered interactive group-based educational sessions to groups of Latinos in Spanish and English. To decrease stigma and motivate behavioral and attitudinal change, the educational sessions emphasized positive Latino cultural values and community assets. The participant pool comprised 579 Latino adults recruited in El Paso, Texas (n=204); San Ysidro, California (n=175); and Los Angeles, California (n=200).


RESULTS
From pretest to posttest, HIV/AIDS stigma scores decreased significantly (p<0.001). Significant increases were observed in HIV/AIDS knowledge (p<0.001), willingness to discuss HIV/AIDS with one's sexual partner (p<0.001), and HIV risk perception (p=0.006). Willingness to test for HIV in the three months following the intervention did not increase. Women demonstrated a greater reduction in HIV/AIDS stigma scores when compared with their male counterparts, which may have been related to a greater increase in HIV/AIDS knowledge scores (p=0.016 and p=0.007, respectively).


CONCLUSIONS
Promotores interventions to reduce HIV/AIDS stigma and increase HIV-related knowledge, perception of risk, and willingness to discuss sexual risk with partners show promise in reaching underserved Latino communities.
California State University, Monterey Bay, College of Health Sciences and Human Services, Seaside, CA ; National Council of La Raza/California State University, Long Beach Center for Latino Community Health, Evaluation and Leadership Training, Long Beach, CA.
Britt
B
Rios-Ellis
Kaiser Permanente, Pasadena, CA.
Davida
D
Becker
California State University, Fullerton Department of Health Science, Fullerton, CA.
Lilia
L
Espinoza
California State University, Long Beach, Department of Health Science, Long Beach, CA.
Selena
S
Nguyen-Rodriguez
National Council of La Raza/California State University, Long Beach Center for Latino Community Health, Evaluation and Leadership Training, Long Beach, CA.
Gaby
G
Diaz
National Council of La Raza/California State University, Long Beach Center for Latino Community Health, Evaluation and Leadership Training, Long Beach, CA.
Ana
A
Carricchi
National Council of La Raza/California State University, Long Beach Center for Latino Community Health, Evaluation and Leadership Training, Long Beach, CA.
Gino
G
Galvez
National Council of La Raza/California State University, Long Beach Center for Latino Community Health, Evaluation and Leadership Training, Long Beach, CA.
Melawhy
M
Garcia
D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D003150:Community Health Workers; D003159:Community-Institutional Relations; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control* / Q000523:psychology; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D015397:Program Evaluation; D017678:Sex Distribution; D012725:Sexual Behavior / Q000208:ethnology / Q000706:statistics & numerical data; D012747:Sexual Partners; D057545:Social Stigma; D013781:Texas / Q000453:epidemiology; D055815:Young Adult