Latinos in the Deep South is a program coordinated by the Latino Commission on AIDS.  The program serves to leverage health equity for the emerging Latino community in the southern region of the United States by providing capacity building assistance, community-based participatory research, and community organizing.

Poon, K.K, Dang, B.N., Davila, J.A., et al. Treatment outcomes in undocumented Hispanic immigrants with HIV infection. PLoS ONE. (8)3: e60022. Doi; 10.1371

Little is known about the treatment outcomes of HIV-infected, undocumented Hispanic immigrants. Research has indicated that undocumented Hispanic immigrants may avoid accessing publicly funded clinics due to concerns about deportation. In addition, this population may have difficulty accessing and navigating care due to language barriers. To explore this issue, the researchers sought to compare the treatment outcomes of undocumented and document patients 12-months after entering HIV care.

The researchers conducted a retrospective cohort study of 1,620 HIV-infected adults receiving HIV treatment at the Thomas Street Health Center (TSHC) between 2003 and 2008.  TSHC is a publicly funded, free-standing HIV clinic in Houston, Texas, supported in part by several Ryan White funding streams. It provides care regardless of ability to pay. Proof of residency in the metropolitan area is required to receive care but legal residency in the United States is not.

The findings indicate that undocumented Hispanic patients entered care with more advanced HIV disease (i.e., lower initial CD4 cell counts) compared with documented Hispanic patients, White patients, and Black patients. They also had the highest HIV viral load. Once in care, undocumented patients did as well or better than documented Hispanic patients. One year after entering care, the undocumented patients had similar rates of retention and HIV viral suppression as documented Hispanic and White patients. It is important to note that Black patients were significantly less likely to be regularly retained in care or achieve HIV viral suppression.

In their discussion, the researchers raised the "healthy migrant effect." Undocumented persons often face significant challenges during their journey to the United States. Once in the United States, many work in physically demanding jobs. As a result, undocumented migrants may have high levels of resilience and self-efficacy. Possible explanations of the healthy migrant effect include selective migration, avoidance of adverse health behaviors, and greater social support. In the study, the undocumented Hispanic patients were younger than all other patients. Also, the undocumented patients were more likely to be married, which may be an indication of social support.

The researchers conclude that safety net providers such as TSHC are important sources of care for undocumented Hispanic immigrants living with HIV. Given the late entry into care that the researchers found, HIV testing and linkage to care activities that target this population should be intensified.