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o,

At Migrant Health Promotion, we have a group of Promotoras who next week are

going to begin doing testing and counseling using Orasure in the colonias

here in the Lower Rio Grande Valley. The Orasure is easy to learn to use.

The minimal paraphenalia it requires makes it convenient to use in mobile

settings. I'd be happy to share our experiences with you once it gets under

way.

Dara Winfield

>From: o Astorga <manchego99@...>

>Reply- egroups

> egroups

>Subject: [ ] Orasure

>Date: Wed, 17 Jan 2001 15:03:41 -0800 (PST)

>

>Hello!

>My name is o AStorga. I work as a health

>educator. I need information about the ORA SURE.

>I am planning to implement anonymous HIV testing at

>the camps this summer.

>

>Thank you!

>

>

>

>=====

>

>Namaste!

>

>

>

>

>

>

>__________________________________________________

>

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Share on other sites

I'm wondering what other perspectives are on testing migrant farmworkers with

Orasure. I've

been involved with health education and migrant farmworkers for years and would

like to

hear what others are doing with HIV screening.

While there is certainly a need for education with HIV/STD's, I'm wondering if

health

screenings for a chronic disease in a population with low prevalence is the

right approach?

The last studies that I have seen indicate that with the exception of very small

pockets(the Belle Glade study) rates of HIV infection are extremely low among

migrant farm

workers. Would the money with be better spent on something else? Like screening

higher

risk patients ( prostitutes, rug abusers, etc.)? Even if the test is extremely

good, it's

still not 100%. The lower the rate of prevalence, the the higher the risk of

false

negatives and positives.

Secondly, there are issues with insuring that the results match the patient. Are

most of

the clients likely to give their real name for a test like HIV that can have

legal

implications? Is the same person likely to have the same alias as before? We had

many

patients never get their results before because we couldn't accurately match

anonymous

numbers from the patients records and our records.

Also when a client/patient has a positive result will there be treatment

options? As you

know the current retroviral standard of care is extremely expensive. Patients

that earn the

wages that migrants do can hardly afford it. Are their state programs tin place

that will

pay for medicines of undocumented workers? We have enormous problems getting

diabetes

medicine to patients that can't afford it, antivirals can cost up to a

$1,000/month.

Is there any negative impact in the community if they're singled out for HIV

screenings?

What about the rest of the community. Are we reinforcing the notion that

migrants have and

spread diseases?

Anyway, just a few thoughts on this important topic. I agree that all migrants

deserve

education about about this topic. I personally favor education for all, and then

only

selective screening based on risk factors and of course, symptoms. I wonder if

there are

any recent studies documenting the rate of infection? What about Hepatitis B?

What are other thoughts about this important topic?

Wilton Kennedy

MDuke@... wrote:

> o,

> We use the Orasure at our organization, the Hispanic Heath Council, and it

> has worked very well. Orasure is an HIV testing system that involves a

> client holding a swab-like device against their cheek for a minute or so.

> The devices are then sent to a lab and results are returned within 1-2

> weeks. It's definitely easier, not to mention less painful and intrusive,

> than blood draws. The results are apparently 99% reliable, which compares

> favorably with blood-based testing. I would highly recommend it.

> Best,

> Duke

>

> -----Original Message-----

> From: o Astorga [sMTP:manchego99@...]

> Sent: Wednesday, January 17, 2001 6:04 PM

> egroups

> Subject: [ ] Orasure

>

> Hello!

> My name is o AStorga. I work as a health

> educator. I need information about the ORA SURE.

> I am planning to implement anonymous HIV testing at

> the camps this summer.

>

> Thank you!

>

> =====

>

> Namaste!

>

> __________________________________________________

>

Link to comment
Share on other sites

Thank you Wilton for providing your perspective on this issue. I agree with your comments. I would add culturally competent and linguistically appropriate prevention education on all STDs, including HIV, along with the distribution of plenty of condoms (both for oral and vaginal/anal sex), and water-based lubricants, etc., and just as important skills training on how to use condoms correctly. I would particularly target men who are traveling/migrating solo and focus on education that protects him, his sex partner(s) including sex workers, and especially his wife or significant other who may be waiting for his return in Mexico or wherever. I would also be certain to cover the issue of sexual relationships with other men. Some Latino men do have sex with other men, particularly under the influence of alcohol. By the way this doesn't mean that I would exclude women, however we are seeing large numbers of men traveling solo--particularly young men.

Adolfo Mata

Bureau of Primary Health Care

-----Original Message-----

From: Kennedy [mailto:wkennedy@...]

Sent: Tuesday, January 23, 2001 3:45 PM

egroups

Subject: [ ] Orasure

I'm wondering what other perspectives are on testing migrant farmworkers with Orasure. I've

been involved with health education and migrant farmworkers for years and would like to

hear what others are doing with HIV screening.

While there is certainly a need for education with HIV/STD's, I'm wondering if health

screenings for a chronic disease in a population with low prevalence is the right approach?

The last studies that I have seen indicate that with the exception of very small

pockets(the Belle Glade study) rates of HIV infection are extremely low among migrant farm

workers. Would the money with be better spent on something else? Like screening higher

risk patients ( prostitutes, rug abusers, etc.)? Even if the test is extremely good, it's

still not 100%. The lower the rate of prevalence, the the higher the risk of false

negatives and positives.

Secondly, there are issues with insuring that the results match the patient. Are most of

the clients likely to give their real name for a test like HIV that can have legal

implications? Is the same person likely to have the same alias as before? We had many

patients never get their results before because we couldn't accurately match anonymous

numbers from the patients records and our records.

Also when a client/patient has a positive result will there be treatment options? As you

know the current retroviral standard of care is extremely expensive. Patients that earn the

wages that migrants do can hardly afford it. Are their state programs tin place that will

pay for medicines of undocumented workers? We have enormous problems getting diabetes

medicine to patients that can't afford it, antivirals can cost up to a $1,000/month.

Is there any negative impact in the community if they're singled out for HIV screenings?

What about the rest of the community. Are we reinforcing the notion that migrants have and

spread diseases?

Anyway, just a few thoughts on this important topic. I agree that all migrants deserve

education about about this topic. I personally favor education for all, and then only

selective screening based on risk factors and of course, symptoms. I wonder if there are

any recent studies documenting the rate of infection? What about Hepatitis B?

What are other thoughts about this important topic?

Wilton Kennedy

MDuke@... wrote:

> o,

> We use the Orasure at our organization, the Hispanic Heath Council, and it

> has worked very well. Orasure is an HIV testing system that involves a

> client holding a swab-like device against their cheek for a minute or so.

> The devices are then sent to a lab and results are returned within 1-2

> weeks. It's definitely easier, not to mention less painful and intrusive,

> than blood draws. The results are apparently 99% reliable, which compares

> favorably with blood-based testing. I would highly recommend it.

> Best,

> Duke

>

> -----Original Message-----

> From: o Astorga [sMTP:manchego99@...]

> Sent: Wednesday, January 17, 2001 6:04 PM

> egroups

> Subject: [ ] Orasure

>

> Hello!

> My name is o AStorga. I work as a health

> educator. I need information about the ORA SURE.

> I am planning to implement anonymous HIV testing at

> the camps this summer.

>

> Thank you!

>

> =====

>

> Namaste!

>

> __________________________________________________

>

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