Download Latino Immigrant Day Laborers and HIV

Welcome to the Acción Mutua web-seminar
Latino Immigrant Day Laborers & HIV
Before we begin, a little about our format
 Presentation by seminar speaker ≈ 40 min
 Question and answer session ≈ 20 min
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Acción Mutua
is a capacity building assistance (CBA)
program of
AIDS Project Los Angeles
in collaboration with the
César E. Chávez Institute
of San Francisco State University
Funded by the Centers for Disease Control
and Prevention
Latino Immigrant Day Laborers & HIV
Paula Worby, DrPH, MPH
Associate Director
Multicultural Institute
[email protected]
Focus of today’s presentation
Learning Objectives

Who are day laborers
 Direct HIV risks
 Background factors affecting risk
 Maximizing assets for prevention
The reason I came to the U.S. was to look
for a better life… but once you’re here,
there are all kinds of problems like
loneliness, depression, separation from
your family. One can fall into depression
and when… depressed, then you resort
to alcoholism and drugs…and then you
get more problems… You can forget the
reason you came here in the first place…
Organista, Alvarado, Balblutin-Burnham, Worby and Martinez (2006)
Who are day laborers
Recent immigrants from
different countries
Construction, painting and
landscaping
Higher hourly wages but
irregular work
Some move on, others are
permanent
117,000 to 260,000 workers
seek work daily
PHOTO/MEGAN MCCALL,
Daily Californian 2001
Who are day laborers
Almost exclusively male (98%)
 Majority without work authorization (75%)
 All low-income

National Day Labor Study 2004-2005 (sampling of 264 sites in 20 states)
Who are day laborers

Diverse
countries of origin
 time in U.S.
 ages
 education
 community involvement
 work skills
 other languages/indigenous identity

National Day Labor Study 2004-2005 (sampling of 264 sites in 20 states)
County of origin
Years of residence in the U.S.
Age range
10%
39%
20%
Ages 18-29
Ages 30-39
Ages 40-49
Ages 50+
31%
Source: National Day Labor Study; personal communication Enriquez-Haass, 2007
Mapping HIV risk
DIRECT RISK
(unsafe sex &
IDU)
MEDIATORS
Context matters….
Photo: Erik Oeverndiek/San Mateo Daily Journal
Greater Context (the Setup)
Discrimination (undervalued)
 Loneliness, sadness (far from home)
 Financial hardships (overwhelming debts)
 Limited housing options
 Difficult, painful, dangerous work
 Pressure to not fail family
 Lack of English imposes limits

Desesperación
Vulnerability…
“There are guys who lose morale, you
understand? The only thing they do is
drink, smoke marihuana. Why? To
forget, you know, to forget a little while
that they have problems because
everyone has a bunch of problems—pay
the rent, pay the bills, send money to
Mexico”
Worby (2002)
…and resilience
“You can get to the point where you don’t
have anything, not even to eat...you feel
so desperate, so upset. You walk along
and don’t know what to do you are so
desperate. Then later, you find some
friend who helps you and it makes you
think, you feel so good again...”
Organista (2002 unpublished)
“Desesperación”
 Need intimacy, pleasure, distraction
 Male bonding and avoiding boredom
(drinking and seeking sex)
 Can’t escape negative peers
 Desperate measures to get cash
 Pathways to the “fall into vice”
(“caerse en vicio”)
“Because there is a lot of—what would
you say—a lot of vices. It’s very easy to
buy cigarettes here, a beer or whatever,
cocaine, heroin. This is what I’ve
observed and really that is why I say that
life [in the U.S.] is very nice but it is very
dangerous…”
Worby (2002)
Mediating influences (the causes)
 Which
sex partners
 Control & expectations about
protection (condoms)
 Alcohol and/or drug use with sex
 Injection drug use
Sexual contact with women
 Sex
workers’ availability
 Men arriving single or separated
 Men with partners or families at home
Challenges to remain faithful despite good
intentions
 History of non-monogamy
 Estrangement over time

“The problem is that at times you
have to have relations with a
prostitute because, what are you
going to do? You can’t flirt with
someone because here before you
know it they’ll want to have the
police after you. It is really different,
you know?”
Organista, Alvarado, Balblutin-Burnham, Worby and Martinez (2006)
Sexual contact between men
 Stigmatized
and hidden
 Not determined by sexual identity
 Migrating away from cultural norms
 New chances to explore
 Survival sex (money for sex)
“My friends had homosexual friends,
but they had them only so they
could give them oral sex, not to
have sexual relations…”
Gonzalez-Lopez (2005)
Alcohol and drug use
Not
everyone drinks
Heavy drinking & weekend
binging
 Alcohol
goes with sex “to relax”
 Marijuana versus hard drug use
Condom use
 Low
or inconsistent use
 Assuming which women are ‘clean’
 Condoms for- ‘other’ partners
(not for main partner)
 Men
picking up men at day laborer
sites
 STD history
“I did use [condoms], but only a few
times …90% but not 100% and
wouldn’t use any with a woman that
I knew.
The risk was when I got drunk; I
wouldn’t use any.”
Injection drug use
Heavy drug use ≠ regular at day labor
 But some drug users are
former day laborers

Providers can ask about:
 Injections used in self medical care
Direct risk (the result)
DIRECT RISK
MEDIATORS
(Unsafe sex & IDU)
Alcohol/drugs with sex?
Which sex partners?
Control over encounters?
Positive approaches
Building on day laborers’
individual strengths
and community
assets
Photo: Multicultural Institute 2008
Tips for agencies
Reinforcing what already works:
 Staying well is best way to help families
 Communicating back home
 Obtaining safe work safely
 Finding decent housing & housemates
 Health, legal, and educational services
that match needs
Photo: Multicultural Institute 2008
Tips for agencies
Reinforcing what works for communities:
 Mutual helping
 Peer information networks
 Hometown and family networks
 Working through trusted organizations
 Connecting through cultural and sports
activities, church communities
Photo: Multicultural Institute 2007
Tips for agencies
Service delivery in general:
Sensitivity
and language skills
of all staff
 Bring
services to
workers instead of
bringing workers to
services
Service delivery in general (cont.)
 Flexible
requirements &
scheduling
 Limited usefulness of most written
materials
 Mix it up! stories, movies, skits,
music triggers for discussion
Photo: Multicultural Institute 2007
HIV prevention education
 Address
common fears and
misunderstandings as a given
 Peer influence vs. influential “experts”
 Good intentions vs. actual behaviors
 Assume sexual activity but reaffirm
those with other choices
Photo:
Multicultural
Institute 2005
iGracias ~ Thank You!
Questions & Answers
Thanks for Your Participation
For more information or to learn
how to receive CBA services, contact us at:
213.201.1345
www.accionmutua.org
Future Acción Mutua web seminars:
October 2, 2008 11am (PT)
HIV/AIDS Stigma in the Latino Community, Dr. Brit Rios-Ellis
November 13, 2008 11am (PT)
Substance Use and HIV: An Overview, Paul Simons
Please register at: [email protected]
For questions about today’s seminar
Please contact Dr. Worby: [email protected]