Abstracts

Abstract 1

Effectiveness and predictors of hepatitis C virus (HCV) screening and post-test counseling in HCV-positive clients taking action to prevent HCV transmission and liver disease progression.

Recently, treatments for hepatitis C have greatly improved, but because these treatments are new, there is little evidence to date that screening and subsequent treatment affect long-term outcomes. However, there are other potential benefits of screening such as preventing further transmission by stopping injection drug use, reducing the risk of cirrhosis by abstaining from alcohol, preventing fulminant liver failure from hepatitis A by hepatitis A vaccination, and preventing hepatitis B co-infection by hepatitis B vaccination. There is very little in the published literature demonstrating that screening can bring about these potential benefits.

For the past three years, the Miami-Dade County Health Department (MDCHD) Hepatitis and Liver Failure Prevention Program (HLFPP) has provided hepatitis C testing and pre- and posttest counseling to Miami-Dade County residents. To date, the program has identified about 400 clients who tested HCV-antibody positive. These HCV-positive clients received brief pre- and posttest counseling sessions and were offered the hepatitis A and B vaccine. This pilot study will determine if the hepatitis C testing and counseling program causes clients to take steps to prevent liver disease and hepatitis C transmission and to describe benefits and harms that the clients experienced.

The first step involves abstracting HLFPP screening records to obtain demographic and risk factor information and HLFPP vaccination records of HCV-positive clients who were tested between April 2001 and October 2003. The second step involves interviewing the clients to determine if they followed advice, what barriers they faced, and if they experienced any harm as a result of testing.

* School of Health , College of Health and Urban Affairs, Florida International University **Associate Professor, School of Social Work, College of Health and Urban Affairs, Florida International University. ***Research Professor, AIDS Prevention Program, College of Health and Urban Affairs, Florida International University .      

Abstract 2

The Impact of HIV/AIDS Among Latina/o Suicide Victims  

Ramiro Martinez, Jr.  

Latinos are a growing yet under-examined ethnic minority group in the United States . Although they have high rates of some health-related problems, including HIV, suicide and a host of other problems, Latinas and Latinos have been a severely understudied but increasingly visible population across urban America . The proposed study aims to examine how HIV/AIDS influences the likelihood of committing suicide while controlling for a number of community factors such as level of poverty, unemployment, percent recent immigrants and other factors. Latinos, especially immigrants, face an array of obstacles due to assimilation problems, language barriers, poverty, lack of affordable housing, violent crime and other problems. These factors, to which Latinos are disproportionately exposed, also influence health-related problems and behaviors, such as HIV/AIDS, suicide, homicide, alcohol and other drug use. These factors also vary by age, gender, year of immigration and other characteristics that could influence exposure to HIV/AIDS and in turn have implications for suicide. For example, immigrant Latinos and Latinas with AIDS might be more likely to commit suicide than those who were born in the United States or who reside in communities with larger numbers of older immigrants, reside in homes with intact families and those who are less likely to move back and forth between the U.S. and country of origin. Furthermore, newcomers might have less knowledge of safe sex practices and less access to healthcare than do Latinas and Latinos who have resided in the U.S for longer periods of time. These factors in turn influence the likelihood of exposure to HIV/AIDS, which may result in greater numbers of suicides. This study will gather three years (1999-2001) worth of Miami-Dade County Medical Examiner data on suicide. This will include over 700 deaths by suicide. Each death certificate lists the decedent's race, age, gender, surname and nativity status. A variety of other factors are listed, including the presence of alcohol, level of alcohol in the blood-stream, drug use and HIV status at the time of death. Each of these reports will be read, coded into a format permitting statistical analyses and analyzed. To explore these issues, I plan to:

1. Address the lack of research on the relationship between HIV/AIDS and suicide among Latino populations in Miami-Dade County .
2. Investigate differences and similarities which may exist in the HIV/AIDS/suicide nexus within predominately non-Latino White, Latino and non-Latino Black neighborhoods in Miami-Dade County , and
3. Take advantage of unique data access and create innovative measures of the level of suicide associated with HIV/AIDS in census tracts (or census block group) to further our knowledge of this social problem.

This is an intense data gathering study since each suicide file has to be manually retrieved from the Miami-Dade Medical Examiners office (ME), read, copied and coded into a file permitting data analysis. However, I have significant experience using the ME data to explore the factors associated with Latino homicide in an earlier timeframe (1980-1995) and expect this knowledge to yield dividends in conducting and completing this study in timely manner. My specific timeline includes:

1. Drawing, reading and coding the suicide data between December 15 and May 15, 2004 .
2. Cleaning data, conducting analyses, writing up the results and completing the first draft of a paper on "HIV prevalence Among Suicide Victims in Miami , 1999-2001) May 15-August 15, 2004.