“Service Delivery Gaps HIV and Substance Abuse and New Technologies”

Latino migrants are some of the United States’ most medically underserved populations (Aranda- Naranjo, Gaskins, Bustamante, & Rodriquiz, 2000), as such the risk of contracting HIV/AIDS is influenced by identity, environment, politics, economics, and culture (Careaga, 2009). These “multiple vulnerabilities” (Careaga, 2009) result in the difficulty of creating appropriate and effective prevention strategies. Latino migrant workers who are at high -risk for HIV/AIDS infection are often difficult to target with prevention programs. This is because they tend not to live in the same place for long, are not fluent in English, are often fearful of deportation, and may have co-occurring behaviors (such as alcoholism) that puts them at high-risk for HIV/AIDS infection (i.e. engage in unprotected sex, or unclean needle exchanges). This study reports findings from a feasibility study to develop a mobile intervention that can be accessed easily and culturally relevant to the new waves of migrant worker populations.

Methods

Eight focus groups (in Spanish and English) took place in the summer of 2014 with migrant farmworkers in Lenawee County, Michigan. Data was gathered over an eight week period from June to August 2014. The study partnered with a local community social service agency. A total of 83 people participated in the study including 53 men and 30 women; 75% were under 30 (youngest 18, oldest 67).

Focus groups used open ended questions, taken from the literature on Health literacy, HIV/AIDS literacy, and substance use. In addition, questions about cell phone use and capability were asked. Interviewees were compensated with a $15 gift card.  University IRB was secured. All interviews were digitally recorded and transcribed in rich text format to be analyzed using MaxQDA. Interviews were coded using content analysis for categories and then themes (Patton, 2002) using an iterative inductive approach.

Results

Overall, this feasibility study found that a mobile technology app would be best used by the new waves of Latino migrant workers. A few highlights include the following. (1) Technology, Cell Phone use. All participants 30 and under had a smartphone; those over 30, 70% had access to a cell phone. Interviewees preferred news texts, versus comic books or phone calls. In addition, they report high use of social media such as Facebook.  (2) Health Literacy. Most had low to poor health literacy with regards to HIV and its causes and treatment. Alcohol and substance use were recognized as a problem. (3) Context. The context of disparities included fear of police, immigration control, costs to travel, work insecurity, work accidents, and language and cultural barriers.

Implications

This study shows that there is a unique opportunity to provide prevention and intervention services to migrant workers. New waves of workers are highly linked to social networks and these spaces can be an important venue for health literacy and promotion. In addition, such an intervention could be easily taken to scale for other Spanish speaking populations across the United States.