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HRSA-funded HIV/AIDS Project Tailors Services to Fit Border Environment
SPNS U.S. - Mexico Border Initiative Grantee Meeting in Tucson, AZ. From left to right, Dr. Maria Luisa Zuñiga and Alisa Olshefsky from the University of California at San Diego, who served as evaluators for a border project at the San Ysidro Health Center.
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A recently concluded HIV/AIDS demonstration project along the U.S.-Mexico border at the San Ysidro, CA Health Center reached out in a “bicultural” manner to serve its patients.
More than 90 percent of the 354 HIV-positive patients treated during the project’s three-year intervention period had low or very low “acculturation” to mainstream culture in the United States. Acculturation is defined as a measure of the adaptation individuals from one culture make when they live in another.
The demo at the San Ysidro Health Center was one of five along the border funded by a Special Projects of National Significance (SPNS) grant through the Ryan White HIV/AIDS Program. The others were in Arizona, New Mexico and Texas, which had two demos.
At San Ysidro, the project concentrated on improving early detection of HIV, increasing access to comprehensive HIV care, and enhancing the provision of culturally competent care. The six-year grant began in mid-2000 and ended last September.
The demo’s outreach and treatment activities emphasized language, staffing and cultural issues, said Rosana Scolari, director of HIV services at the health center. |
Information brochures and pamphlets that explained the project to local residents were printed primarily in Spanish, the language clients felt most comfortable using. “The translation reflected the population, with terms and images they commonly use,” she added.
Scolari and her staff also made sure their material reflects the literacy level of the population.
Outreach went beyond written material to include television and radio ads—media that many health center clients frequently use to gather information—and one-on-one interaction with the population.
Scolari said that hiring people who represent and live in the communities served by the demo was important to the project’s success. Scolari, who grew up in the area, said most of the project’s staff are bilingual and bicultural.
“They know the challenges—and the benefits—of living along the border,” she said. “Having that background makes it easier for us to communicate with our clients.”
The health center sought to further its outreach and treatment adherence goals by developing leaders from its patient base. “We trained patients to serve as peer advocates to share their experiences and help patients navigate the system,” Scolari noted.
Clients who access services at the health center are welcomed into what Scolari describes as “a warm, friendly, caring and personable environment.” Staffers commonly greet clients with a hug or a kiss. “It makes them want to come back,” she explained.
Outreach and other events sponsored by the project reflect local cultural traditions and include refreshments. “We always have food,” she said. “Food is a very important part of our culture and a great way to motivate people to attend.”
Did You Know....
Border Crossings
Frequent border crossings were reported by many of the project's clients: 24 percent made more than 48 border crossings annually, while about the same percentage (22 percent) made no crossings. Scolari said the border should be seen not as two separate areas, but as a distinct environment with its own habits and customs. As a child living in San Ysidro, she crossed the border daily to attend school in Mexico.
Clients in the demo often obtained medical care on both side of the border. Ninety-four (27 percent) of the 354 clients in the demo also received HIV medical care in Mexico. An even larger number, 152 (43 percent), filled their prescriptions in Mexico. |
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Printer-friendly September 2007 Inside HRSA (Acrobat/PDF)
