Completed Projects or Data Collection Completed
Trans Citizenship: Improving the Gender-Affirming Identification Process in South Florida
Identification documents like passports, ID cards, and birth certificates are a cornerstone of citizenship. Trans and non-binary people face extensive barriers to changing their identification documents. Without gender-affirming identification, trans and non-binary people struggle to access their citizenship and face discrimination from prospective employers, landlords, healthcare providers, and police. Trans and non-binary activists have started organizations to help others complete the process of changing their identification documents. However, despite the importance of gender affirming identification for millions of trans and non-binary people, very little research has studied the process or the effects of having affirming documentation. In collaboration with TransSOCIAL, a Trans-led organization serving our TLGBQ+ community in Florida, we are piloting a study to track the document name change process and evaluate the impacts of gender-affirming identification on trans and non-binary people in Florida. This project is lead by Dr. Callan Hummel in the UM Department of Political Science and TransSOCIAL, with Associate Dean Charlton Copeland in the UM School of Law, and is funded by the University of Miami’s ULINK initiative. Read our publications in American Journal of Public Health and Health & Justice.
Preventing Acquisition, Supporting Success, and Providing Opportunities for Research and Testing (PASSPORT) Study
We propose a concurrent mixed-method community engaged pilot observational study to assess the potential for gender-affirming IDs to reduce HIV-related risk for trans, nonbinary, and intersex people in Florida. Trans people struggle to get identification documents (IDs) like drivers’ licenses that match their gender identity. Showing an old ID to doctors, employers, landlords, police and others can out a person as trans and lead to discrimination. Trans activists point to IDs as a barrier to HIV-related healthcare. The Preventing Acquisition, Supporting Success, and Providing Opportunities for Research and Testing (PASSPORT) study will interview 20 trans Floridians and professionals and enroll 60 trans, nonbinary, and intersex Floridians who are updating their IDs to study how having an ID that reflects one’s gender identity impacts behavior, healthcare including PrEP, and employment. This study is led by Calla Hummel, PhD with TransSOCIAL and The McKenzie Project. This study is funded by an EHE supplement through Miami CFAR (5P30AI073961-17). Read our publications in American Journal of Public Health and Health & Justice.
Gender-Responsive Policing Project
We are working with a community advisory group to conduct a community assessment of law enforcement responses to gender based violence in Miami. The goals are to (1) assess law enforcement responses to incidents of gender-based violence; (2) provide feedback on community confidence in law enforcement; and (3) suggest non-law enforcement alternatives for responding to gender based violence. We are surveying as many community-based organizations as possible about the organization’s background, its interactions with law enforcement, and its viewpoints about law enforcements crisis response and investigatory approaches. This project is funded by the University of Miami’s Racial Justice Grant Program in partnership with Camillus House, Rosario Concha, PhD candidate UM Department of Sociology, and Donna Coker, JD, MSW in the UM School of Law. This is part of a larger collaboration with the COURAGE Initiative (Community Oriented and United Responses to Address Gender Violence and Equality) at the Human Rights Program in the UM School of Law.
SPECS: Study on Personal Experiences with Accessing Care in the South
The SPECS study is a 5-year, longitudinal cohort study with sites at the University of North Carolina at Chapel Hill, The University of Miami, and The University of Kentucky. The overall aim of the project is to assess the acceptability, utilization, and barriers/facilitators of preventative healthcare treatment for individuals with recent criminal justice experience. This study is guided by the Social Ecological Model and the NIMHD Minority Health and Health Disparities Research Framework, which both have a focus extending beyond the individual and acknowledge that multi-level (individual, social, and structural) factors play a role in the perpetuation of persistent health disparities. This study is funded by the National Institute on Minority Health and Health Disparities. Papers that have been published from this project can be found here.
We received funding from the University of Miami College of Arts and Sciences to conduct a nested COVID-19 study with this ongoing cohort. We completed comprehensive surveys about the social and health consequences of the COVID-19 pandemic with 185 adults under community supervision. Read the findings from the study published in Health & Justice.
Tirando Muros: Salud Sin Fronteras
This study examines the health status of floating populations (those who move back and forth between the US and Mexico either voluntarily or forced), the influence of migration history on health, and how social and environmental factors affect health outcomes. Mexican and other Latino immigrant populations coming to the US face health risks and stress arising from poverty, discrimination. and cultural differences. This is exacerbated by contemporary US anti-immigrant sentiments, immigration policy enforcement, and ICE detention and deportations. We are recruiting 600 participants, including recent immigrants (within past 5 years) that have arrived to Los Angeles and a group of immigrants who have returned to Mexico City either voluntary or forced. This project is funded by the National Institute on Minority Health and Health Disparities and is directed by Drs. Alice Cepeda and Avelardo Valdez at the University of Southern California. This is an international collaboration with Clinica Especializada Condesa.
COVID Prison Project
The COVID Prison Project (CPP) grew out of the critical health crisis occurring in incarcerated settings during the COVID pandemic in early 2020. Incarcerated populations face especially high risk for transmission of infectious diseases due to close living conditions that make social distancing impossible, as well as limited access to soap, hand sanitizer, and personal protective equipment (PPE). COVID-19 has been particularly devastating to incarcerated populations given their high prevalence of certain chronic health conditions such as diabetes, heart disease, and respiratory illness, which can exacerbate the severity of symptom presentation. This has made stark racial and ethnic health disparities all the more apparent and a call to action all the more urgent.
Publicly available data from 53 state and federal prison systems are aggregated daily by CPP staff and are presented on the CPP website, www. covidprisonproject.com, to keep a running record of the number of tests completed, as well as rates of transmissions and deaths among prison staff and incarcerated populations. In the immediate, the goals of the CPP are to shine a light on the COVID-19 health crisis in incarcerated settings and to provide up-to-date information to researchers and advocates to help shape humane healthcare policies. This project is funded by the Robert Wood Johnson Foundation and the Langeloth Foundation. Follow us on Twitter @CovidPrison. Papers that have been published from this project can be found here.
Preexposure Prophylaxis (PrEP) for HIV Prevention in Mexico City
Preexposure prophylaxis (PrEP) for HIV prevention is practically 100% effective in keeping HIV negative people exposed to HIV from acquiring the virus and is an important tool for ending the HIV epidemic worldwide. By 2020, it was estimated that just less than 1 million people had initiated oral PrEP, far less than the 2020 UNAIDS target of 3 million, with the USA accounting for approximately one fifth of total PrEP initiations. Despite high HIV transmission rates relative to other Latin American countries, PrEP use in Mexico remains low. Therefore, we are conducting preliminary research on PrEP uptake and barriers and facilitators to PrEP use in Mexico City. The specific research objectives are to (1) document the clinical characteristics of a cohort of PrEP patients at Mexico’s largest HIV clinic through chart review, and (2) conduct formative qualitative interviews with PrEP patients about their initiation and uptake of PrEP, perceptions of HIV risk, and perceived barriers and facilitators to PrEP sustainment in Mexico City. This is an international collaboration with Clinica Especializada Condesa that is funded by the University of Miami Institute for the Advanced Study of the Americas.
COVID-19 Testing and Prevention in Correctional Settings
Transmission of the COVID-19 virus (SARS-CoV-2) is magnified in correctional settings due to restricted access to sanitizing supplies and personal protective equipment, close congregant living conditions, and exposure to correctional staff who unknowingly transmit the infection from the community. These populations are also more likely to experience severe and life-threatening symptoms of COVID-19, due to higher rates of underlying medical conditions. Therefore, there is an urgent need for the development and implementation of long-term testing strategies targeting incarcerated populations and correctional staff. RADx-UP (Rapid Acceleration of Diagnostics for Underserved Populations) is a short-term funding mechanism that is designed to capitalize on the existing infrastructure and networks of funded projects to quickly engage historically at-risk and under-served populations in significant COVID-19 testing efforts.
Miami Transitions Clinic
We are conducting formative research to establish a Miami Transitions Clinic at the University of Miami based on the Transitions Clinic Network (TCN) model. The TCN is an evidence-based program designed in partnership with formerly incarcerated individuals, with locations within safety-net community health centers in neighborhoods most impacted by incarceration. Each TCN clinic provides linkages with correctional partners to provide continuity of care; easy access to comprehensive primary care; culturally competent, patient-centered medical services; community health workers with a history of incarceration as part of an integrated medical team; and close partnerships with local reentry organizations and other agencies to address social determinants of health (e.g., housing, education). We are conducting a community needs and resource assessment study with the following aims: (1) identify the primary health needs and existing service gaps in reentry from the perspective of people who are formerly incarcerated and professionals working directly with people who are formerly incarcerated; (2) document, map, and assess community assets (e.g., agencies, organizations, institutions) that can be mobilized to support the Miami Transitions Clinic. This study is funded by the University of Miami Office of the Provost.
Check out the Miami Reentry Resource Map here. And see the main findings published here.
Justice Affected Care Syndemics
Justice involvement is syndemic with infection with HIV, mental illness, substance use, and exposure to violence; and mass incarceration is both a cause and consequence of US racial health disparities. The post-release period following confinement in prison or jail is a particularly vulnerable period for people who are formerly incarcerated. Thus, the justice-involved population living with HIV is a key priority population for HIV care and treatment interventions. We are using a qualitative life history calendar study design to interview 30 people. The objective of this study is to provide foundational knowledge on syndemic pathways and risk subjectivities for suboptimal HIV care among justice-involved persons living with HIV and the social and structural contextual factors that shape these pathways. This study is funded by Center for HIV and Research in Mental Health (CHARM).
Proyecto SALTO
Data collection for Proyecto SALTO concluded in 2020. This study was funded by the National Institute on Drug Abuse and directed by Drs. Alice Cepeda and Avelardo Valdez at the University of Southern California. The purpose of this study was to identify and determine how distinct drug use and intimate partner violence victimization trajectories that emerge in adolescence through young adulthood contribute to physical and mental health outcomes among Mexican American women within the context of a highly disadvantaged community. Survey and biomarker data collection was completed with 225 women, along with nested qualitative interviews (n=37). Papers that have been published from this project can be found here.
As a follow up, we are conducting a solicited diary study with a subsample of Latina women who have sex with women and men. These women occupy multiple, intersecting stigmatized statuses, which result in unique stressors and health risk. The minority stress model posits that members of highly stigmatized groups experience chronically high levels of stress resulting from discrimination (e.g., overt, internalized), disproportionate exposure to stressful life events (e.g., violent victimization, criminal justice involvement), and low socioeconomic status. These factors are predicted to increase psychological distress and, subsequently, high-risk substance use, but can be buffered by protective factors such as social support (e.g., chosen family, family of origin). We use an intersectional approach to apply this model and elucidate these complex processes over the life course. This study is funded by Center for Latino Health Research Opportunities (CLaRO) at Florida International University and University of Miami.
National Survey of Health Care in U.S. Jails
The primary objectives of this study were to generate population estimates for admission screening of HIV, and other infectious diseases and comorbid conditions, as well as the use of HIV prevention measures (e.g., Pre-Exposure Prophylaxis (PrEP) for HIV prevention, and medication assisted therapy (MAT) for opioid addiction). The study was funded by the Miami Center for AIDS Research (CFAR) and The Lifespan/Brown Criminal Justice Research Training Program with additional in-kind support from the American Jail Association, and concluded in 2020. The final report is available for download. See the published manuscripts here.
