Recent Latino Immigrant Study:
Examining the Influence of Pre-Immigration
Assets on the Substance Use and HIV Risk
Behavior of Recent Latino Immigrants
Mario De La Rosa, Ph.D.
Mariana Sanchez, Ph.D. Candidate
ACKNOWLEDGEMENTS This study was supported by award
number P20MD002288 from the National Institute on Minority Health and
Health Disparities. The content is solely the responsibility of the authors and
does not necessarily represent the official views of the National Institute on
Minority Health and Health Disparities, or the National Institutes of Health
.
Background:
Latino Immigrants in the U.S.
102.6
87.6
73.0
59.7
47.8
35.3
22.4
9.6
1970
14.6
1980
1990
Census
2000
2010*
2020*
2030*
2040*
Projections
(Source: U.S. Census Bureau, 1970, 1980, 1990, and 2000 Decennial Censuses;
Population Projections, July 1, 2010 to July 1, 2050)
2050*
Latino Immigrants in
Miami-Dade County
• Latinos make up 62.5% of the 2.5 million people
living in Miami-Dade County
• Miami-Dade County is also the only county in the
Unites States with an immigrant majority (U.S.
Census, 2009)
• Over the past four decades, net migration into the
County has accounted for more than 75% of its
population growth (Miami-Dade County, 2009)
Immigration
point
1 month
prior
Alcohol Use
Latino Paradox
U.S. Born
Immigrants
Time
Study Objectives
• Determine how the HIV risk behavior of recent Latino
immigrants are influenced by pre-immigration assets
(e.g., family functioning, social capital, religious
coping), early in their immigration process.
• Central hypothesis: The relationship between preimmigration assets and post-immigration HIV risk
behaviors will be mediated by post-immigration
acculturation stress and substance use over a twoyear time period in the U.S., while controlling for preimmigration HIV and substance use risk behaviors.
PreImmigration
Assets
Baseline
Substance
Use & HIV
Risk Beh.
to the U.S.
Immigration
Conceptual Framework
Acculturation
Stress
HIV Risk
Behavior
Substance
Use
T0
Time
T1
12 mo.
T2
24 mo.
Research Aims
Aim 1: Examine the influence of pre-immigration assets
on post-immigration HIV risk behaviors among recent
Latino immigrants over time.
Hypothesis 1: Recent Latino immigrants with higher
levels of pre-immigration assets will exhibit lower
levels of HIV risk behaviors over the two-year time
period.
Aim 2: Examine the effects of pre-immigration assets on
post-immigration acculturation stress and substance use
among recent Latino immigrants over time.
Hypothesis 2: Recent Latino immigrants with higher
levels of pre-immigration assets will have lower levels
of post immigration acculturation stress and substance
use over the two-year time period.
Research Aims
Aim 3: Examine the influence of pre-immigration assets
on post-immigration HIV risk behaviors among recent
Latino immigrants over time.
Hypothesis 1: The relationship between preimmigration assets and post-immigration HIV risk
behaviors will be mediated by post immigration
acculturation stress and substance use over the twoyear time period in the U.S. while controlling for preimmigration HIV risk behaviors.
Methods
Study Design
Three waves of data collection (baseline and two follow
ups) spaced twelve months apart over a period of two
years.
Sample
• N=527 Latino immigrants
• Living in Miami-Dade County (only county in the
U.S. with an immigrant majority- 51%)
• 18-34 years of age
• < 1 year since immigration into the U.S.
• Primarily recruited through respondent driven
sampling
Data Collection Procedure
Face-to-face administered interviews using
psychometrically sound instruments
Significance of the RLIS
•
Conducting innovative research that,
acknowledges the importance of pre-immigration
factors in predicting post-immigration HIV risk
behavior, an often neglected area in the
literature.
•
Identify important predictors of HIV and
substance use behavior trajectories for Latino
immigrants in the U.S.
•
Enhance existing and develop new HIV and
substance abuse prevention programs that
identify, sustain, and incorporate assets of Latino
populations into culturally grounded
interventions.
Initial Findings from the RLIS:
Baseline Sample Demographics
N=527 Latino immigrants representing 18 Latin American Countries
Mean age: 26.87 years
Mean time in the US: 6.77 months
Legal Status: Undocumented immigrants (30%), documented
immigrants (70%)
Education: 18% of RIS participants had college degrees, 34% had
attended some college, 29% had a high school or equivalent degree,
and 19% had not completed high school.
Income: Mean total household income in the three months prior to
immigration was $5265.11 (SD = $5148.32), which translates to an
annual average household income of approximately $21,000.
Alcohol users= (n=365); Drug users= (n=82)
Initial Findings from the RLIS:
Challenges and Strategies in Recruiting, Interviewing,
& Retaining Recent Latino Immigrants in Substance
Abuse and HIV Epidemiologic Studies
Data collection activities of this study have provided
insights in identifying, recruiting, interviewing, and
retaining Latinos in community based studies:
• Utilizing a combination of translation techniques
ensured the development and implementation of
culturally appropriate questionnaires
• Respondent driven sampling facilitated identifying
participants
• Establishing rapport and trust was critical for
interviewing
• Maintaining a tracking protocol was most important for
retention
Initial Findings from the RLIS:
Alcohol Use among Latinos: A Comparison of PreImmigration, Post Immigration, & U.S. Born Latinos
Study Design
Compared alcohol use of pre-immigration Latinos utilizing
baseline data from the RLIS (N=527) toAlcohol use of post-immigration and U.S. born Latinos utilizing
NSDUH report focusing on trends in alcohol use among persons
18 years of age and older between 2004 and 2009.
NSDUH Sample
•
Approximately 6500 Latinos ages 18-34 of South or Central
American, Dominican, and Cuban descent
Hypothesis
•
Regular, heavy, and binge alcohol will be lower among both
Latino male and females immigrant ages 18-25 and 26-34
prior to their immigration as compared to their U.S. born
Latino and post immigration Latino counterparts.
Measures
•
Past month regular alcohol use was measured
as having at least one drink in the past 30
days.
•
Past month heavy alcohol use was defined as
drinking 5 or more drinks on the same
occasion on each of five or more days in the
past 30 days (SAMHSA, 2010a).
•
Past month binge drinking was measured as
drinking 5 or more drinks on the same
occasion on at least 1 day in the past 30 days
Alcohol Use Among Pre-Immigration,
Post Immigration, & U.S. Born Latinos
80
70
PreImmigration
60
50
NSDUH (U.S.
Born)
40
30
NSDUH (PostImmigration)
20
10
0
Alcohol Use Alcohol Use Binge Alcohol Binge Alcohol Heavy Alcohol Heavy Alcohol
(Ages 18-25) (Ages 26-34) (Ages 18-25) (Ages 26-34) Use (Ages 18- Use (Ages 2625)
34)
Past Month Regular Alcohol Use
By Gender
80%
% Engaging in Regular Alcohol Use
70%
60%
50%
40%
30%
20%
10%
0%
Males
Females
Preimmigration
(Ages 18-25)
64%
56%
PreImmigration
(Ages 26-34)
68%
49%
0%
Post
Immigration
(Ages 18-25)
43%
Post
Immigration
(Ages 26-34)
56%
61%
37%
35%
U.S. Born
(Ages 18-25)
U.S. Born
(Ages 26-34)
66%
60%
Past Month Heavy Alcohol Use
By Gender
24.4%
21.2%
18.1%
16.3%
10.0%
6%
7.4%
6.8%
4%
Pre- immigration
(Ages 18-25)
Pre-Immigration
(Ages 26-34)
U.S. Born (Ages
18-25)
Males
U.S. Born (Ages
26-34)
Females
2.6%
4.4% 4.0%
Post Immigration Post Immigration
(Ages 18-25)
(Ages 26-34)
Immigration
point
1 month
prior
Alcohol Use
Discussion
U.S. Born
Immigrants
Time
Why these results?
Future Research Directions
Pre-immigration stresses
• Stressors associated with the loss of close ties with
friends and family from the country of origin as well
as formal support systems (health care providers,
schools) prior to immigration
• Stressors associated with level of tangible and
intangible social capital immigrants have or plan to
bring with them prior to immigration (immigration
status, financial resources, reasons why they
immigrate, plan to bring or join family in the U.S.,
level of financial resources)
Why these results?
Future Research Directions
Psychological factors related to the post immigration
experience soon after immigration
• Optimistic expectations of beginning a new life with a host of
•
•
opportunities for themselves and their families.
Leaving behind stressful life conditions such as long term
unemployment, which is common among many young professionals in
Latin America
Fear of political persecution because of their political affiliations or
ideology.
Social factors related to the post immigration experience soon
after immigration
• Association with new non-drinking networks.
• New social norms in the U.S., such as criminal penalties for driving while
•
•
intoxicated, that are enforced (Social Control theory).
Fear of deportation, particularly for undocumented immigrants.
Wanting to fit into new host culture (often impacted by the cultural milieu
of communities immigrants initially settle in after immigration)
Limitations
• All intended analyses could not be completed due to NSDUH
data on past month alcohol use for U.S. born Latino males
ages 26-34 not being unavailable.
• Participant-level demographic differences in income and
education levels between the RLIS and NSDUH samples could
also explain differences in alcohol patterns between groups.
For instance:
• RLIS sample reported higher higher education
• NSDUH sample reported higher income
• Issues with recall of alcohol use both for the RLIS and NSDUH
sample.
• Nonrandom nature of RLIS sample
Initial Findings:
The Influence of Religious Coping on the
Acculturative Stress of Recent Latino
Immigrants
Aim:
Examine the association between pre-immigration
religious coping styles (internal and external religious
coping) and post-immigration acculturation stress
among recent adult Latino immigrants.
Hypothesis:
After controlling for socioeconomic status and legal
status (legal or illegal immigrant), participants with
higher levels of religious coping will experience lower
rates of acculturative stress.
Background:
Acculturative Stress
Acculturation: Acculturation is the exchange of cultural features
that results when groups of individuals having different cultures
come into continuous first hand contact; the original cultural
patterns of either or both groups may be altered, but the
groups remain distinct.
Acculturation stress: a form of psychological or social stressors
encountered by an individual due to an incongruence of beliefs,
values, and other cultural norms between their country of origin
and the country to which they have immigrated.
Examples of social stressors:
 legal status stress
 language barriers
 difficulties assimilating to beliefs, values, norms of the
dominant culture
 perceived feelings of inferiority and discrimination
Background:
Religious Coping
 Tix & Frazier (1998) define religious coping as “The use of cognitive
and behavioral techniques, in the face of stressful life events, that
arise out of one’s religion/spirituality.”
 Religious coping can be beneficial by providing belief framework
which:

facilitates cognitive restructuring of the meaning of an event

social support of a religious community

sense of control over stressful situations
 Various forms of religious coping mechanisms:
 internal (cognitive) religious coping
 external (behavioral) religious coping
Religious Coping among Latinos
•
When controlling for education and other SES disparities, Latino’s
use religious coping more frequently than do Non-Latino Whites.
•
Less acculturated Latinos use religious coping strategies more
frequently than those with higher levels of acculturation.
•
Finch and Vega (2003) investigated the effect of social support
on acculturation stress with a sample of 3012 participants of
Mexican-origin.
•
Lowest rates of acculturative stress were displayed by
participants with the highest religious support seeking behaviors.
•
Ellison and colleagues (2009) reported that religious involvement
appeared to exacerbate the effects of acculturative stress on
depressive symptoms of Mexican-origin adults.
Measures
Religious Coping: Ways of Religious Coping Scale
(Boudreaux et al., 1995). This instrument is a 40-item
questionnaire measuring internal and external
religious coping cognitions and behaviors. Total scale
(Cronbach’s α = .95), internal scale (α =.97), and
external scale (α =.93).
Acculturative Stress: The immigration stress
subscale of the Hispanic Stress Inventory Scale –
Immigrant Version (Cervantes, Padilla, & Salgado de
Snyder, 1990). The instrument is in a 5 point Likert
scale format and the subscale used contains 18
questions. (Cronbach’s α = .85).
Measures
Socio-economic status (SES): Measured by
creating a total SES index score by multiplying
participant’s total household income during the 3
months after immigration and level of education (1
= less than high school, 2 = high school, 3 = some
training / college after high school, 4 = bachelor’s
degree, 5 = graduate / professional studies).
Legal status: Participants were asked to report
their current legal status in the U.S. A total of
fourteen possible categories were provided. These
categories were then recoded into a dichotomous
variable of legal (1) or illegal (0) immigration
status.
Results:
A Path Model of Acculturative Stress
.66**
Internal Religious
Coping
External Religious
Coping
-.01
-.27**
.03
-.23**
.05
.19**
Immigration
Status
Socioeconomic
Status
-.10*
-.47**
Acculturation
Stress
*p < .05, **p < .01
Discussion
• Dramatic loss of valuable religious resources, soon after
immigration could make recent immigrants more
vulnerable to experiencing acculturative stress.
• Negative religious coping
 passively leaving the responsibility for resolving crisis
entirely up to divine intervention
 feelings of divine abandonment and anger
 found to have negative impacts on mental health by
fostering feelings of guilt and shame; eroding feelings
of competence and worth, and hopefulness; and
distracting persons from more productive coping
responses.
Limitations
•
No random sampling
•
Self report measures
•
Cross-sectional research design
Significance
• Improve prevention/intervention skills and strategies
necessary to assist recent Latino immigrants in
mediating the negative aspects of the acculturation
process (i.e., acculturative stress).
• Gaining better insight into these coping mechanisms
would provide valuable knowledge in targeting
cognitions and behaviors that may need to be addressed
when providing prevention and other intervention
services to Latino immigrants
• Development of culturally appropriate interventions that
incorporate issues of religiosity when applicable into the
clinical process