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NC Now: HIV/AIDS Among Latinos
We're setting ourselves up for a crisis. That's the word from state and local agencies after a significant and disproportionate increase in HIV and AIDS cases among Latinos in North Carolina. Now educators are racing to get ahead of the epidemic despite large obstacles in reaching the Latino population.
Adolfo Aguilar/Outreach Ccoordinator: HIV and STDs are one of the hardest things to talk about because it involves sex, and sex is kind of not allowed in our community, not much to talk about it.
But Adolfo Aguilar says Latinos need to talk about it because statistics show HIV and AIDS are growing problems for Latinos. The state Department of Health And Human Services says the number of new cases among Latinos jumped from 15 in 1998 to 125 in 2005. That's an eight-fold increase. Latinos represent seven percent of all cases in North Carolina.
Dr. Del Williams/Manager of Epidemiology & Special Studies, HIV/STD Prevention & Care Branch: The actual numbers are still relatively small. The disturbing trend is that we're seeing an increase every year. And it's not going to be long before that increase, really, unfortunately, I think will start to take off.
That's a red flag to health leaders across the state, like Dr. Rafael Torres. He's an HIV specialist at Tri-County Community Health Center in Sampson County, where he cares for more than 250 HIV and AIDS patients.
Dr. Rafael Torres: It's a one stop shopping, so basically we have all the way from medical through dental, pharmacy, case management, social work. We have everything that a patient with HIV might need.
The area he serves is very rural. Cows, barns, and tractors dot the landscape, and most Latinos make their living as migrant farm workers. Dr. Torres says for many, that lifestyle puts them at risk.
Dr. Rafael Torres: You might understand that if all your family is back home, you're working seven days a week, you have half a day to do recreation, probably the most common cause of happiness will be alcohol. With alcohol comes carefree behavior, and probably you'll be missing your wife and you'll be engaging in situations that might endanger your health.
He says access to medical care is also an obstacle in remote areas, which makes clinics like this critically important.
Dr. Rafael Torres: If you have to displace yourself 60, 90 miles to go and see a doctor, probably compliance and the access to that appointment is going to be close to zero. So here we just make things easier for the patient.
That's also the mission of Tri-County's HIV and AIDS outreach team, which will go just about anywhere.
John Bass/Peer Educator: We've gone to the migrant camps. We go and we set up at churches. We've set up at the college, at the Indian tribal center because we have a large American Indian population, and we'll set up what's called a nontraditional testing site.
Educators provide incentives such as gift certificates for people who get tested for HIV, and they distribute information in English and Spanish.
Dr. Rafael Torres: The most important issue is the bilingual access.
Outreach worker Adolfo Aguilar says speaking Spanish is just one of the keys to reaching the Latino community. He works for the Chatham Social Health Council in Siler City, where the Latino population has exploded in recent years. Aguilar says most Latinos work in factories, so that's where he does a big part of his work, too.
Adolfo Aguilar: Some of the companies allow me to go in there, to put a table of information, to display my condoms, and I can be free to talk about sex in the factory because this is a main door. This is the main door to approach them so they can have access to the services and to the information.
He also targets soccer leagues and Latino grocery stores, giving out free condoms and talking to people about how to reduce the risk of HIV. He says he's made significant progress.
Adolfo Aguilar: Three years ago, they won't think about it, won't even think about it. Say AIDS and HIV is only for gays, gays it's a big problem, only they can have AIDS. Now people are really open. You can walk on the street now and talk about condoms. It's like talking about the weather. So now they feel comfortable.
Aguilar says people are comfortable with him because he's part of the community and they trust him.
Adolfo Aguilar: Most of the time, some of the biggest agencies, they always hire a professional with a master's and all this kind of stuff, but he doesn't know the community. Because he comes from a different neighborhood, a different city or town, so how can people trust him?
That's the idea behind El Centro Hispano's Project Life in Durham. "Promotores," or peer educators, work in their own neighborhoods, going door-to-door with information. But health educator Oscar Garcia says building trust is just one barrier to overcome.
Oscar Garcia/Health Educator: One of the obstacles I see is religion because most of the Latinos are Catholic, and Catholics don't believe in condom protection. Sometimes when I go to the clubs, because we do outreach at the bars, and I give out the condoms, they're just like oh you don't respect me, you know.
Promotor Roberto Moench says it's also a cultural issue.
Roberto Moench/Promotor: Most people, no, they don't have an idea about AIDS or sexual disease because these words are in the Latino community a taboo.
While community agencies across North Carolina have a wide variety of prevention and education measures in place in the Latino community, very little has been done at the state level - until very recently.
Andy Sturdy/Statewide Community Planning Group: I think it was just that we forgot they were there because nobody was speaking on their behalf. Nobody was saying, hey how about us. And it wasn't until recently, particularly the last epidemiology report that came out, that demonstrated to us - oh yeah, we do have a problem.
Andy Sturdy heads up a statewide committee examining HIV and AIDS among Latinos. It includes Latino leaders and Latinos who have the disease or are affected by it.
Andy Sturdy: Out of this is going to come a good needs assessment and strong strategies that can be implemented statewide in order to address the disparities within this disease.
He admits that will take time but says the state is focused on doing it right and producing results.
Andy Sturdy: This is a priority, and we've already committed ourselves to the CDC through a cooperative agreement to make it happen, so there's a lot of eyes watching us and a lot of people that are paying attention. So, no, I think it's not going to be just lip service. I think there's going to be some productivity out of it.
Back at El Centro, Project Life coordinator Leslie deRosset says she believes the state's making a good effort. But it will take everyone working together to put a dent in the problem.
Leslie deRosset: We need to share resources. We need to share ideas. We need to share programs that are working. We're facing the possibility of epidemic proportions of Latinos infected with HIV if we don't take a quick and urgent stand in how we're going to try to educate this population, get this population tested, and get this population into care. |
