Medicine and Health Sciences Commons^™

Health Care Use Experiences Of Ethnoculturally Diverse Immigrant Older Adults: A Meta-Ethnography, Lorna De Witt, Kathryn A. Pfaff, Roger Reka, Noeman Ahmad Mirza

Nursing Publications

Purpose

Current and predicted continued dramatic increases in international migration and ethnocultural diversity of older adult cohorts pose challenges for health care services. Review studies on ethnoculturally diverse older adults and health care show a lack of focus on their service use experiences. This study aims to report a meta-ethnography that addresses this knowledge gap through answering the review question: How do ethnoculturally diverse older adults who are immigrants experience health care services?

Design/methodology/approach

The authors applied a seven-phase method of meta-ethnography to guide the review. The authors conducted two literature searches (April 2018 and June 2020) in MEDLINE, CINAHL, …

Colon Cancer Care Of Hispanic People In California: Paradoxical Barrio Protections Seem Greatest Among Vulnerable Populations, Keren M. Escobar, Mollie Sivaram, Kevin M. Gorey, Isaac N. Luginaah, Sindu M. Kanjeekal, Frances C. Wright

Social Work Publications

Background: We examined paradoxical and barrio advantaging effects on cancer care among socioeconomically vulnerable Hispanic people in California. Methods: We secondarily analyzed a colon cancer cohort of 3,877 non-Hispanic white (NHW) and 735 Hispanic people treated between 1995 and 2005. A third of the cohort was selected from high poverty neighborhoods. Hispanic enclaves and Mexican American (MA) barrios were neighborhoods where 40% or more of the residents were Hispanic or MA. Key analyses were restricted to high poverty neighborhoods. Results: Hispanic people were more likely to receive chemotherapy (RR=1.18), especially men in Hispanic enclaves (RR=1.33) who were also advantaged on …

Healthcare Avoidance Due To Anticipated Discrimination Among Transgender People: A Call To Create Trans-Affirmative Environments, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Sean Esteban Mccabe

Social Work Publications

Transgender people encounter interpersonal and structural barriers to healthcare access that contribute to their postponement or avoidance of healthcare, which can lead to poor physical and mental health outcomes. Using the 2015 U.S. Transgender Survey, this study examined avoidance of healthcare due to anticipated discrimination among transgender adults aged 25 to 64 (N ¼ 19,157). Multivariable logistic regression analysis was conducted to test whether gender identity/expression, socio-demographic, and transgender-specific factors were associated with healthcare avoidance. Almost one-quarter of the sample (22.8%) avoided healthcare due to anticipated discrimination. Transgender men had increased odds of healthcare avoidance (AOR ¼ 1.32, 95% CI …

“Hiv-Related Syndemic Pathways And Risk Subjectivities Among Gay And Bisexual Men: A Qualitative Investigation, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

Life history interviews were conducted with 40 gay and bisexual men to identify modes of syndemic experience and risk practice. Out of the interview narratives emerged one major and two minor modes of developmental pathways whereby syndemic conditions are navigated and expressed: (1) a combination of adverse childhood events with later episodes of depression and/or substantial substance use, (2) personal disruption that led to periods of depression and anxiety associated with the stresses of migration, and (3) a disorientation and an unravelling of life trajectory in the transition from family of origin to college or work. Risk practices fell into …

Migration And Sexual Health Among Gay Latino Migrants To Canada, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

This paper enquires into the nexus of migration with sexual health among gay Latino migrants in Canada. Interviews with 25 Spanish-speaking interviewees are examined in light of models developed from studies of Latinos in the United States. Canadian immigration policy appears to result in a somewhat different selection of immigrants compared to the United States. Migrants come from a wide range of national and regional backgrounds intersected by race, generation, and social class that influence their perceptions of and adjustment to Canadian society. Pre-migration HIV knowledge varied strongly by generation with older men recalling public panic concerning HIV and younger …

Profound Barriers To Basic Cancer Care Most Notably Experienced By Uninsured Women: Historical Note On The Present Policy Considerations, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

America is considering the replacement of Obamacare with Trumpcare. This historical cohort revisited pre-Obamacare colon cancer care among people living in poverty in California (N = 5,776). It affirmed a gender by health insurance hypothesis on nonreceipt of surgery such that uninsured women were at greater risk than uninsured men. Uninsured women were three times as likely as insured women to be denied access to such basic care. Similar men were two times as likely. America is bound to repeat such profound health care inequities if Obamacare is repealed. Instead, Obamacare ought to be retained and strengthened in all states, …

Promoting Hiv Testing For Gay And Bisexual Men: An Evaluation Of The 2011-2012 Campaign In Toronto And Ottawa, Barry D. Adam, Sandra Gardner, Carol Major, Diana Campbell, Lucia Light, Jason Globerman

Sociology, Anthropology, and Criminology Publications

This paper reports on a social marketing campaign directed toward high-risk men who have sex with men (MSM) in Toronto and Ottawa to: encourage testing for HIV and syphilis; improve knowledge about HIV transmission, seroconversion symptoms, and the HIV window period; and heighten awareness of syphilis transmission and its relationship to facilitating HIV transmission. Evaluation data were collected from a large-scale online pre-and post-campaign survey of sexually active MSM and from laboratory testing data. Men who turned up to be tested also filled out an exit survey. The campaign websites attracted some 15,000 unique visitors, 54% of whom had an …

Hivpositive People's Perspectives On Canadian Criminal Law And Non-Disclosure, Barry D. Adam, Jason Globerman, Richard Elliott, Patrice Corriveau, Ken English, Sean Rourke

Sociology, Anthropology, and Criminology Publications

The largest survey to date of people living with HIV regarding attitudes toward criminalization of HIV non-disclosure, this study investigates: sources of legal information available to HIV-positive people; perceptions of how criminal prosecutions and media coverage affect understanding of rights and responsibilities of self and others; and where HIV-positive people themselves stand on the role the criminal justice system should play. While mainstream media constructions of criminal iconography do affect PHA views, those who have higher levels of formal education, are active in the dating scene, and have been living longer with HIV hold less punitive views than those who …

Delinquency And Crime Prevention: Overview Of Research Comparing Treatment Foster Care And Group Care, Gershon K. Osei, Kevin M. Gorey, Debra M. Hernandez Jozefowicz

Social Work Publications

Background: Evidence of treatment foster care (TFC) and group care’s (GC) potential to prevent delinquency and crime has been developing.

Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have greater impacts than larger homes with a meta-analytic update.

Methods: Research literatures were searched to 2015. Five systematic reviews were selected that included seven independent studies that compared delinquency or crime outcomes among youths ages 10–18. A similar search augmented by author and bibliographic searches identified six additional studies with an …

Impacts Of The Criminalization On The Everyday Lives Of People Living In With Hiv In Canada, Barry D. Adam, Richard Elliott, Patrice Corriveau, Ken English

Sociology, Anthropology, and Criminology Publications

As part of a study on the social consequences of the criminal justice system on people living with HIV or AIDS (PHAs) in Canada, this article focuses on how heightened public identification of HIV with criminal matters is having wide ranging effects on perceived personal security and in particular on negotiating potential romantic and sexual interactions. As articulated by the Supreme Court of Canada, the courts have been enforcing a requirement that HIV-positive people disclose their sero-status to prospective partners, relying on the notion that “through deterrence it [the Criminal Code] will protect and serve to encourage honesty, frankness and …

Hivstigma.Com, An Innovative Web-Supported Stigma-Reduction Intervention For Gay And Bisexual Men, Barry D. Adam, James Murray, Suzanne Ross, Jason Oliver, Stephen Lincoln, Vicki Rynard

Sociology, Anthropology, and Criminology Publications

An intervention to address stigma directed toward HIV-positive men and to enhance the sexual health of gay and bisexual men was developed through a community-based process involving HIV prevention workers, public health, government, and researchers. The intervention aimed to diminish stigma, create greater support for HIV-positive men, make disclosure safer and easier, discourage reliance on disclosure to prevent transmission, and encourage testing. The question, “If you were rejected every time you disclosed, would you?” was widely disseminated in the gay community and supported by the website, hivstigma.com, to encourage participation in blog-based discussions. Eight bloggers moderated lively discussions over 5 …

Development Of An Hiv Prevention And Life Skills Program For Spanish Speaking Gay And Bisexual Newcomers, Barry D. Adam, Gerardo Betancourt, Angel A. Serrano Sanchez

Sociology, Anthropology, and Criminology Publications

This paper reports on the creation, implementation, and evaluation of a life skills and HIV prevention program for Spanish-speaking gay, bisexual, and other men who have sex with men (MSM) who are within three years of arrival in Canada. The Mano en Mano program consists of an initial day-long session followed by four two-hour evening sessions addressing HIV prevention, social isolation, social service, and migration issues. Evaluation showed a significant shift toward safer sex practice and decreased sense of social isolation as expressed in exit interviews. The Mano en Mano intervention shows movement in the right direction in HIV prevention …

Silence, Assent And Hiv Risk, Barry D. Adam, Winston Husbands, James Murray, John Maxwell

Sociology, Anthropology, and Criminology Publications

Based on interviews with 34 men, almost all of whom have unprotected sex with men most or all of the time, this paper documents the interactional process, narrative elements, and meaning construction in situations of ‘bareback’ sex. Narratives show the differentiated cultural capital circulating among distinct circuits of gay and bisexual men that define the taken-for-granted rules of conduct for sexual interactions and give rise to high risk situations. Many of the positive men speak of being part of a social environment where ‘everybody knows’ a set of rules whereby sex without condoms can happen as a default circumstance to …

Effects Of The Criminalization Of Hiv Transmission In Cuerrier On Men Reporting Unprotected Sex With Men, Barry D. Adam, Richard Elliott, Winston Husbands, James Murray, John Maxwell

Sociology, Anthropology, and Criminology Publications

This paper reports on the perceptions and practices of men who have frequent unprotected sex with men in a socio-legal environment defined by the 1998 decision of the Supreme Court of Canada in R. v. Cuerrier. HIV-positive people are increasingly finding themselves in court since Cuerrier and many are trying to take account of legal reasoning in their own conduct. The judicial construction of behaviour likely to transmit HIV relies on a set of presumptions concerning individual responsibility, rational and contractual interaction, and consenting adults that raise a series of ambiguities and uncertainties among HIV-positive people attempting to implement …

Infectious Behaviour: Imputing Subjectivity To Hiv Transmission, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

This paper examines the sometimes implicit models of human behaviour circulating in science, government, and media that assign agency to HIV transmission, and contrasts these institutional ideas with the narratives of people at risk as they go about their everyday lives. Three kinds of risk talk, arising from interviews, show the limitations and paradoxes of leading constructions of the subjectivity of HIV transmission. The first shows a lack of fit, when the social conditions and presumptions that hold up the leading discourses are missing, and so choices and actions correspondingly follow alternative logics. The second type concerns “semiotic snares” that …

Prevalent Low Income Status In Canadian And United States Metropolitan Areas, 1980 And 1990, Kevin M. Gorey

Social Work Publications

As compared to Toronto’s poor people, three to four-fold as many of upstate New York’s poor live in severely impoverished neighborhoods, areas where 40% or more of the residents have annual incomes below the federally established low income or poverty criterion. However, the prevalence of such extremely degraded living conditions increased similarly (two-fold) on both sides of the Canadian-US border during the 1980s. This urban problem, of the concentration of poor people, seems to predominantly be an inner-city problem in the US, whereas it was found to be nearly equivalently extant in the inner-city, mid-suburban and outlying suburban areas of …

The Prevalence Of Elder Care Responsibilities Among The Work Force Population: Response Bias Among A Group Of Cross-Sectional Surveys, Kevin M. Gorey, Robert W. Rice, Gary C. Brice

Social Work Publications

This review synthesizes the findings of 17 independent studies dealing with the prevalence of elder care responsibilities among the work force population. Across-study, summative findings were: (a) approximately one fifth (M = 21.1%) to one quarter (Md = 23.1%) of employees provide care for an elderly dependent; primary study findings varied by a factor of nearly 25, ranging from a high estimate of 46.0% to a low of 1.9%; (b) the average response rate was fairly low (M = 45.0% and Md = 41. 1%), indicating that the studies captured only slightly more than one third, but less than half …