The Influence of Perceived Immigration Context and Healthcare Utilization Immigration Law Concerns on Latinx Immigrants' HIV Testing

Although new Human Immunodeficiency Virus (HIV) infections have remained stable or decreased for most U.S. groups at risk for HIV, incidence among Latinx increased by 6% and among Latinx individuals, immigrants are disproportionately infected. One driver of these infections is low rates of HIV testing. While research shows the chilling effect that restrictive immigration laws can have on immigrants' health care utilization, few studies have examined the influence of perceived immigration context and healthcare utilization immigration law concerns on following a public health recommendation such as HIV testing. The purpose of the study is to test an exploratory model of immigration-related variables and their impact on U.S. Latinx immigrants' yearly HIV testing. U.S.-Latinx immigrants (N = 169) completed a cross-sectional survey assessing perceived enforcement of immigration laws, perceptions of law enforcement attitudes toward Latinx and immigrants, fear of deportation, concerns with the consequences of immigration laws for health care utilization, and yearly HIV testing. Path analysis findings indicated that perceived enforcement of immigration laws was related to perceived negative attitudes from law enforcement toward Latinx and immigrants which was associated with fear of deportation. Fear of deportation was associated with concerns with the implications of immigration laws for accessing publicly funded healthcare services and these concerns were negatively related to yearly HIV testing and mediated the association between fear of deportation and yearly HIV testing. Findings point to the need of developing and implementing individual- and policy-level interventions to increase HIV testing among Latinx immigrants in a restrictive immigration law environment.