Immigration Legal Services as a Structural HIV Intervention for Latinx Sexual and Gender Minorities
- 334 Downloads
Lack of legal immigration status is associated with poor HIV-related outcomes for immigrant Latinx sexual and gender minorities (LSGM). LSGM often meet eligibility criteria for legal immigration relief. A Medical-Legal Partnership (MLP) may thus be strategic to improve their health. We know little about the challenges LSGM face during the immigration legal process. We conducted in-depth interviews with six key informants and sixteen LSGM who recently applied for immigration legal relief. We coded and analyzed the data for emergent themes. Challenges to instituting an MLP for LSGM included lack of specialized training on working with SGM for immigration attorneys, and for clients: knowledge about legal deadlines, lack of housing and family support, and re-traumatizing experiences. Clients’ outcomes were positive when attorneys and mental health providers collaborated. For LSGM, the benefits of immigration relief included reduced HIV risk. An MLP that addresses the surmountable challenges could improve HIV-related outcomes among LSGM.
KeywordsLegal immigration status Undocumented Structural intervention Medical legal Partnership HIV LGBT Transgender MSM
This research was made possible by a CFAR Adelante award funded by the National Institutes of Health-funded Centers for AIDS Research (P30AI050409 and P30AI117970) and the U.S. National Institutes of Health. The project was also supported by the District of Columbia Center for AIDS Research, an NIH funded program (AI117970), and a Dean’s Summer Research Award from American University’s School of International Service. We thank Sarah Palazzolo for research support and the UCLA Emerging Immigration Scholars Conference for feedback during the beginning stage of the project. We are tremendously grateful to our resilient study participants who generously gave their time and shared their moving stories.
- 1.Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2015. HIV Surveill Rep. 2016;27.Google Scholar
- 3.Centers for Disease Control and Prevention. Division of HIV/AIDS prevention’s strategic plan. Atlanta; 2017. https://www.cdc.gov/hiv/dhap/strategicplan/.
- 4.James SE, Salcedo B. 2015 U.S. Transgender survey: report on the experiences of Latino/a respondents. Washington, DC and Los Angeles, CA; 2017. http://www.ustranssurvey.org/reports#USTS.
- 5.Ayala G, Bingham T, Kim J, Wheeler DP, Millett G. Modeling the impact of social discrimination and financial hardship on the sexual risk of HIV among Latino and Black men who have sex with men. Am J Public Health. 2012;102(Suppl):242-9.Google Scholar
- 10.Rhodes SD, Mann L, Simán FM, Song E, Alonzo J, Downs M, Lawlor E, Martinez O, Sun CJ, O’Brien MC, Reboussin BA, Hall MA. The impact of local immigration enforcement policies on the health of immigrant Hispanics/Latinos in the United States. Am J Public Health. 2015;105(2):329–37.CrossRefGoogle Scholar
- 14.Salas-Wright CP, Robles EH, Vaughn MG, Cordova D, Perez-Figueroa RE. Toward a typology of acculturative stress: results among Hispanic immigrants in the United States. Hisp J Behav Sci. 2015; 1–20.Google Scholar
- 20.Regenstein M, Trott J, Williamson A. The state of the medical-legal partnership field: findings from the 2016 National Center for Medical-Legal Partnership surveys. Washington, DC; 2017. https://medical-legalpartnership.org/mlp-resources/2016-ncmlp-survey-report/.
- 22.Rhodes SD, Hergenrather KC, Aronson RE, Bloom FR, Felizzolag J, Wolfson M, Vissman AT, Alonzo J, Boeving Allen A, Montaño J, McGuire J. Latino men who have sex with men and HIV in the rural south-eastern USA: findings from ethnographic in-depth interviews. Cult Health Sex. 2010;12(7):797–812.CrossRefGoogle Scholar
- 23.8 US.Code. § 1158.Google Scholar
- 24.Immigration Equality. Immigration Equality—Legal services. 2015. http://www.immigrationequality.org/our-work/#legal-services. Accessed March 21 2015
- 25.Millman J. Why sexual minorities have an inside track to a U.S. green card. The Wall Street Journal. 2014. http://www.wsj.com/articles/why-sexual-minorities-have-an-inside-track-to-a-u-s-green-card-1402676258. Accessed June 13 2014.
- 26.District of Columbia HIV/AIDS, Hepatitis, STD and TB Administration. The district of Columbia HIV/AIDS epidemiology annual report 2012. Washington, DC; 2013. https://dchealth.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/2013%20Annual%20Report%20Final%20Edit.pdf.
- 27.Centers for Disease Control and Prevention. HIV among Latinos; 2011. http://www.cdc.gov/hiv/resources/factsheets/pdf/latino.pdf.
- 28.Passell JS, Cohn D. Unauthorized immigrant totals rise in 7 states, fall in 14. Washington, DC; 2014. http://www.pewhispanic.org/interactives/unauthorized-immigrants-2012/.
- 29.Office of Planning, Analysis and Statistics. FY2016 Statistics Yearbook. Church F, VA; 2017. https://www.justice.gov/eoir/page/file/fysb16/download.
- 30.Miles M, Huberman A. Qualitative data analysis: an expanded sourcebook. 2nd ed. London: Sage Publications; 1994.Google Scholar
- 31.8 U.S.Code. § 1101(a)(15)(U).Google Scholar
- 32.8 C.F.R. 214.14.Google Scholar
- 34.Regenstein M, Teitelbaum J, Sharac J, Phyu E. Medical-legal partnership and health centers: addressing patients’ health-harming civil legal needs as part of primary care. Washington, DC; 2015. http://medical-legalpartnership.org/new-issue-brief-medical-legal-partnership-health-centers/.