Juli-Ann Carlos

County of Los Angeles Public Health, Los Angeles, California, United States

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Publications (3)6.18 Total impact

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    ABSTRACT: Background: Urban Latino day laborers endure many hardships as they struggle to adjust as an immigrant community in the United States. Stress can place day laborers at risk for high allostatic load (a measure of the physiologic effects of chronic stress). This study sought to identify the extent of chronic stress reported by day laborers and the factors associated with this stress. Method: 725 Latino day laborers were interviewed in Los Angeles County, California. Participants provided information on 21 different potential sources of stress. Information was also obtained on relevant sociodemographic data as well as HIV-related risk behaviors. Results: The most frequent reported sources of stress were having immigration-related problems (M = 3.53; SD = 1.009); not having enough money to cover basic needs (M = 3.47; SD = 0.834), having no savings (M = 3.46; SD = 0.842) and having work hours change for the worse (M = 3.26; 1.125). Higher chronic stress was associated with homelessness (b=3.42, SE=.88, p<.001), income levels of $5,000-$10,000 (b=1.84, SE=.68, p<.01) and greater than $10,000 (b=3.12, SE=.77, p<.001) compared to less than $5,000 and engaging in HIV-related risk behaviors in the previous twelve months (b=2.86, SE=1.25, p<.05). Lower chronic stress was associated with having a partner (b=-1.45, SE=.62, p<.05) or being single (b=-2.06, SE=.60, p=.001) compared to being married. Conclusion: Addressing the stress experienced by day laborers is necessary to prevent potential negative health and mental health consequences among this population. This will require interventions directed at individual, community and structural levels.
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    ABSTRACT: Little research has examined differences in HIV stigma versus MSM stigma and the role of these stigmas in depression for HIV-positive Latino and African American men who have sex with men (MSM), subgroups disproportionately impacted by HIV in the US. MSM stigma, HIV stigma, depression, stress and social support were examined among HIV-positive Latino (n = 100) and African American (n = 99) MSM patients at five HIV clinics in Los Angeles County, California. In multiple regression models, Latino MSM had higher HIV stigma scores (p = 0.002) but lower MSM stigma scores (p < 0.001) compared to African American MSM. General support and stress were associated with HIV stigma (p < 0.001), but not MSM stigma. Both HIV stigma (p < 0.0001) and MSM stigma (p < 0.0001) were associated with depression. These data underscore the differences in experienced stigma for Latino and African American MSM and can be used to shape effective stigma reduction programs and behavioral counseling.
    AIDS and Behavior 12/2012; DOI:10.1007/s10461-012-0385-9 · 3.49 Impact Factor
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    ABSTRACT: Abstract HIV-infected patients frequently experience depression, drug use, and unstable housing but are often unable to access supportive services to manage these challenges. Data on barriers to needed supportive services are critical to improving patient access. Data from the Medical Monitoring Project (MMP), a national supplemental surveillance system for HIV-infected persons in care, was used to examine barriers to support service use and factors associated with need and unmet need for services. Interview data for 333 patients in care in 2007 and 2008 in Los Angeles County (LAC) showed that 71% (n=236) reported needing at least one supportive service and of these, 35% (n=83) reported at least one unmet need for services (46% Latino; 25% white; 83% male; 92% 30+; 77% gay/bisexual; 40% response rate). The main reasons that supportive services were not accessed included lack of information (47%; do not know where to go or who to call); an agency barrier (33%; system too confusing, wait list too long); or a financial/practical barrier (18%; too expensive, transportation problems). In a logistic regression that included all participants (n=333), African Americans (OR=3.1, 95% CI: 1.1-8.7) and those with incomes less than $10,000 were more likely to have service needs (odds ratio [OR]=3.5; 95% confidence interval [CI]: 1.3-9.3). Among those with at least one service need (n=236), those who were gay or bisexual were more likely to report at least one unmet service need (OR=2.8; 95% CI: 1.3-6.1). Disparities were found for need and unmet need for supportive services by race/ethnicity; income and sexual orientation. The reported reasons that services were not obtained suggest needed improvements in information dissemination on availability and location of HIV support services and more streamlined delivery of services.
    AIDS patient care and STDs 09/2011; 25(9):525-32. DOI:10.1089/apc.2011.0149 · 2.68 Impact Factor