íTu vales!: An HIV Testing Campaign for Latino Day Laborers

Victor Martinez, Bienestar Human Services Inc, Los Angeles;
Frank Galvan, Charles Drew University, Los Angeles
Research on Systems of Prevention and Care
Thematic Priority Area: Immigrants, Migrant Populations, and Issues in HIV Health Care Access and Community
Community Collaborative Research Awards

A recent study of Latino male immigrant day labors in Los Angeles County found that engaging in risk behaviors, such as having sex with men, was not associated with HIV testing. Thus some day laborers at high risk may not be accessing HIV testing services. However, increasing HIV testing among Latino day laborers may not solely be a function of offering the HIV test to them. Unique ways of offering HIV testing may be required in order to increase HIV testing. Some Latino men involved in high risk behaviors have been found to be more likely to choose to get tested for HIV when the HIV test is “bundled” with other tests compared to when it is offered by itself. The objective of this study is to increase HIV testing among day laborers at risk for HIV. The specific aims of this study are (1) to determine if a “bundled” HIV testing protocol directed at day laborers results in more immigrants accessing HIV testing compared to an HIV-only testing protocol., and (2) to determine if a “bundled” HIV testing protocol results in more men engaging in HIV prevention services among those involved in high-risk activities compared to when an HIV-only testing protocol is used. The “bundled” HIV testing protocol will include tests or screeners for syphilis, gonorrhea, Chlamydia, alcohol problems, drug dependence, depression and HIV. Individuals in the HIV-bundled protocol will be able to choose to be tested for all conditions or just some of them.

In contrast to previous studies with day laborers, this study will involve a random recruitment of day laborers using a spatial-temporal sampling frame. Two HIV testing protocols, one “bundled” and the other “HIV-only,” will be carried out at day labor sites in Los Angeles County. In the formative stage of our project, we plan to determine which day labor sites contain the largest number of day laborers reporting high-risk activities. We will use the Service Planning Areas (SPAs) of Los Angeles County. We will utilize SPAs 4, 6, 7 and 8. By doing so, we will be focusing on the areas in which 73.9% of all male Latino HIV/AIDS cases were identified between 2004 and 2007. Once all day labor sites in these SPAs are identified, we will visit them at randomly selected times and randomly sample 15% of the individuals who are present when we arrive. These participants will be administered a short screener to assess HIV-related high-risk behaviors. After determining which sites contain the largest number of day laborers reporting high-risk activities, we will develop a sampling unit of “site-day-shift,” where “site” refers to the day labor site, “day” to the day of the week, and “shift” to a 5-hour time period within the day. The sampling plan for the study recruitment for the main part of the study will involve 4 stages: the random assignment of the 4 SPAs to either the HIV-only protocol or the HIV-bundled protocol, the monthly random selection of the day labor sites, the monthly random selection of the sampling units and the random selection of participants at the day labor sites.

A total of 800 participants will be recruited, with one-half being recruited through the HIV-testing only protocol and the other half through the HIV-bundled protocol. Tallies will be kept of the number of people who are approached and asked to participate for each testing protocol and those who accept and decline HIV testing. Rates of HIV testing for the two HIV testing protocols will then be compared.

This study is interested also in which protocol results in greater engagement in HIV prevention services among those reporting high-risk activities. Those reporting HIV-related high risk behaviors will be contacted 2 months later for a brief phone interview to determine if they subsequently utilized the referrals to HIV prevention programs. The two HIV testing protocols will then be compared to determine which resulted in a greater use of HIV prevention services by day laborers.

Information on potential increased HIV testing by day laborers using a “bundled” testing protocol would contribute to advancing HIV prevention science and also provide important information for prevention programs throughout California. Thus, this project is very attentive to the needs of public health and community based organizations in California attempting to counter the present trend of late testing among Latinos.