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Health and human service organizations are recognizing the need to enhance services for culturally and linguistically diverse populations.Providing culturally and linguistically appropriate healthcare services requires an understanding of cultural competence.For example, someone from the UK is likely to be more introverted than someone from the USA. If you mean by when do you 'star' dating then dating starts when you meet a person and decide that attraction between you both become enough to have a date (usually dinner or a movie) to try and see if that attraction between you both is strong and worth enough to move…If you can elaborate more on what you mean by "when does dating become? Does the clinic need to have weekend hours, when teens can more easily slip away from home?

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Although they imply understanding of cultural similarities and differences, they do not include action or structural change.(6) From Health Resources and Services Administration (HRSA) Care ACTION: Improving HIV/AIDS Care in a Changing Environment, August 2002, Mitigating Health Disparities Through Cultural Competence: The recent Institute of Medicine report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care states that "racial and ethnic minorities tend to receive a lower quality of health care than nonminorities, even when access-related factors, such as patients' insurance status and income, are taken into account."(7) These findings and others like them are not news to people concerned with the care of individuals living with HIV disease.

For example, HIV-infected injection drug users are less likely to receive antiretroviral therapy than non-drug users are.(10) It follows that disparities in access to quality HIV care are related to disparities in survival, which have been reflected in AIDS mortality data for some time.(11) Being competent in cross-cultural functioning means learning new patterns of behavior and effectively applying them in the appropriate settings.(12) For HIV/AIDS prevention and treatment to succeed, the special needs and life contexts of those who are marginalized because of race, ethnicity, socioeconomic status (SES), sexual orientation, age, or gender must be sensitively addressed.

Cultural competence must be demonstrated not only by intervention programs and staff, but also by surveillance staff, researchers (and their investigations), as well as by those delivering prevention services, care, and treatment programs to those who are HIV-infected.

Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.

'Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.

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