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H H S Department of Health and Human Services
Health Resources and Services Administration
HIV/AIDS Programs

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SPNS Initiative: Demonstration and Evaluation Models that Advance HIV Service Innovation along the U.S. - Mexico Border, 2001-2005


HIV is a significant problem along the 2,000-mile border between the United States and Mexico, which stretches from California to Texas. This region's HIV epidemic is made more complex by many factors, including Latino cultural norms regarding sexuality, the rural nature of the border resulting in geographic isolation and poverty, and the lack of access to culturally sensitive, high-quality health care. The challenge of reaching and providing care to individuals infected and affected by HIV is compounded by these social, economic, political, and cultural factors.  For example, many individuals cross back and forth over the border for seasonal work, making it difficult to identify people who are at high risk for HIV. Bringing people into testing is a critical component of HIV outreach because many people living with HIV along the border do not know their HIV status.
This Special Projects of National Significance (SPNS) initiative sought to develop models of community-based health care networks to effectively reduce barriers to early identification of HIV and assure entry to high-quality primary health care for individuals who live and/or work in the U.S. region of the U.S./Mexico border area. The target populations included people at high risk for HIV and people with HIV who live and/or work along the U.S. side of the U.S./Mexico border.  The University of Oklahoma served as the Evaluation Center for the initiative.

Demonstration project grant recipients included: Camino de Vida Center for HIV Services (Las Cruces, NM); Centro de Salud Familiar La Fé (El Paso, TX); El Rio Santa Cruz Community Health Center (Tucson, AZ); San Ysidro Health Center (San Ysidro, CA); and Valley AIDS Council (Harlingen, TX).

Journal Articles

Keesee MS, Natale AP, & Curiel HF. HIV Positive Hispanic/Latinos Who Delay HIV Care: Analysis of Multilevel Care Engagement Barriers. Social Work in Health Care, 2012; 51(5): 457-478. PubMed Abstract

Zúñiga ML, Blanco E, Brennan JJ, Scolari R, Artamonova IV, Strathdee SA. Binational care-seeking behavior and health-related quality of life among HIV-infected Latinos in the U.S.-Mexico border region. Journal of the Association of Nurses in AIDS Care, May-June 2011; 22(3): 162-172. PubMed Abstract

Carabin H, Keesee MS, Machado LJ, Brittingham T, Williams L, Sonleitner NK, Anderson KG, Cajina A, & Foster MW. Estimation of the prevalence of AIDS, opportunistic infections, and standard of care among patients with HIV/AIDS receiving care along the U.S.-Mexico border through the Special Projects of National Significance: a cross-sectional study. AIDS Patient Care and STDs, 2008; 22 (11): 887-895. PubMed Abstract

Zúñiga ML, Brennan J, Scolari R, & Strathdee SA. Barriers to HIV care in the context of cross-border health care utilization among HIV-positive persons living in the California/Baja California US-Mexico border region. Journal of Immigrant and Minority Health, June 2008; 10 (3): 219-227. PubMed Abstract

Olshefsky AM, Zive MM, Scolari R, & Zúñiga ML. Promoting HIV-Risk Awareness and Testing in Latinos Living on the US-Mexico Border: The Tú No Me Conoces Social Marketing Campaign. AIDS Education and Prevention, October 2007; 19 (5): 422-435. PubMed Abstract

Zúñiga ML, Baldwin H, Uhler D, Brennan J, Olshefsky AM, Oliver E, & Mathews WC. Supporting Positive Living and Sexual Health (SPLASH): a clinician and behavioral counselor risk-reduction intervention in a university-based HIV clinic. AIDS and Behavior, September 2007; 11 (5th Supplement): S58-S71. PubMed Abstract

Felderman-Taylor J & Valverde M. A Structured Interview Approach to Evaluate HIV Training for Medical Care Providers. Journal of the Association of Nurses in AIDS Care, July-August 2007; 18 (4): 12-21. PubMed Abstract

Torres K, Zive MM, Scolari R, Olshefsky AM, & Zúñiga ML. Acceptance of a Nutrition Curriculum for HIV positive Latinos Living on the U.S.-Mexico Border. Journal of Transcultural Nursing, April 2007; 19 (2):107-113. PubMed Abstract

Eldred L, Cheever L and Parham-Hopson D. Accessing Care for U.S./Mexico Border Populations Living with HIV/AIDS. Journal of HIV/AIDS & Social Services, 2006; 5 (2): 7-13. Publisher Abstract 

Keesee M, Shinault KA, Carabin H, Ahmad ASG, Anderson KG, Brittingham T, Williams L, Sonleitner NK, Cajina A, Schulhof R, Curiel H, & Foster M. Socio-Demographic Characteristics of HIV/AIDS Individuals Living and Receiving Care Along the U.S.-Mexico Border Through Five SPNS Demonstration Projects. Journal of HIV/AIDS & Social Services, 2006; 5 (2): 15-35. Publisher Abstract

Zúñiga ML, Organista KC, Scolari R, Olshefsky AM, Schulhof R, & Colón M. Exploring Care Access Issues for HIV Seropositive Mexican-Origin Latinos Living in the San Diego/Tijuana Border Region. Journal of HIV/AIDS and Social Services, 2006; 5 (2): 37-54. Publisher Abstract

Valverde M & Felderman-Taylor J. HIV/AIDS Outreach in Southern New Mexico: From Design to Implementation. Journal of HIV/AIDS and Social Services, 2006; 5 (2): 55-71. Publisher Abstract

Sinclair GL & Cantu Y. A Training Program Designed to Increase the Capacity of Community Health Centers along the United States-Texas-Mexico Border to Treat HIV Infection. Journal of HIV/AIDS and Social Services, 2006; 5 (2): 73-88. Publisher Abstract

Organista KC, Alvarado NJ, Balbutin-Burnham A, Worby P, & Martinez SR. An Exploratory Study of HIV Prevention with Mexican/Latino Migrant Day Laborers Camino de Vida Center for HIV Services. Journal of HIV/AIDS and Social Services, 2006; 5 (2): 89-114. Publisher Abstract

Keesee M, Ahmad ASG, Nelson W, Barney DD, & Duran ES. An Application of Borrayo's Cultural Health Belief Model to HIV/AIDS Seropositive Hispanics Living Along the US/Mexico Border. Journal of HIV/AIDS & Social Services, 2004; 3 (3): 9-34. Publisher Abstract