HIV-Positive Gay Latino Spreads Safe Sex Education

The global HIV infection rate dropped about 21 percent from 1997 to 2010, says the U.N. But only 28 percent of carriers in the U.S. are getting effective treatment, according to the CDC. Host Michel Martin speaks with Jose Ramirez, a gay Latino who lives with HIV and works with a non-profit health center. (Advisory: This segment contains language that may not be suitable for all audiences.)

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MICHEL MARTIN, HOST:

I'm Michel Martin, and this is TELL ME MORE from NPR News.

Coming up, we're going to go to South Africa where critics are trying to sound the alarm about a new bill that would classify many documents as secret and impose stiff penalties on those who view them. Critics are saying this is the most serious blow to press freedom in South Africa in years. We'll find out why they're saying that in just a few minutes.

But first, this is World AIDS Day and we decided to ask where things stand in the fight against this 30-year-old epidemic. The global rate of HIV infection dropped 21 percent from 1997 to 2010. That's according to a new report from the joint United Nations program on HIV/AIDS. But in the U.S., the latest numbers from the Centers for Disease Control show that more than a million people are infected here but only 28 percent are getting effective treatment. And Washington, D.C. has the highest rate of infection among any metropolitan area in the country.

We wanted to know more about all this, so we called upon Jose Ramirez. He is the youth program's coordinator for La Clinica Del Pueblo. That's a nonprofit health center serving everybody, but particularly Latinos living in the nation's capital. Mr. Ramirez himself is HIV positive. And I do want to mention that this segment contains some frank discussion about sex that might not be suitable for everybody. So with that being said, Mr. Ramirez, welcome. Thanks so much for joining us.

JOSE RAMIREZ: Thank you for having me.

MARTIN: You're 30 now?

RAMIREZ: Yeah, I'll be 30 in January.

MARTIN: So, you're the same age as the epidemic?

RAMIREZ: Basically, yes.

MARTIN: So, by the time you were old enough to become sexually active, which I believe was in your teens, you were old enough to know about HIV/AIDS, right? But was it something that was part of your decision making when you were thinking about being sexually active?

RAMIREZ: No, it wasn't actually and I did know and I feel like it's like that for a lot of young people. You get educated about it. You hear it on the streets, but it's something that you really don't think is going to happen to you and...

MARTIN: Why not?

RAMIREZ: You just don't think about it. And that's something you don't think about while you're having sex. You think about it afterwards. But during, you know, you really don't think about it. People don't have conversations about it. You don't ask right away: Hey, are you positive? Have you ever had an STD? Questions that people should be asking, especially young people.

MARTIN: At what age did you find out that you had become HIV positive. that you were infected?

RAMIREZ: I was 17.

MARTIN: Are you pretty clear about how you got infected? Do you know?

RAMIREZ: Yeah, yeah.

MARTIN: Do you think you know?

RAMIREZ: No, I know. Actually, you know, coming from an immigrant family, a single mother, the guy that I was actually dating at the time was what we call a sugar daddy. He actually helped me out, gave me money but also did a lot of things that my parents couldn't do for me and gave me that love. So, I felt like secure with him. So, I didn't know he was positive, but know now.

MARTIN: How did you find out that he was infected?

RAMIREZ: Actually the way I found out...

MARTIN: So, he was your most significant relationship. So you're very clear that he was the source of the transmission?

RAMIREZ: Yeah, yeah.

MARTIN: So, how did you find out?

RAMIREZ: Well, I found out because we were, you know, dating for a while and all of a sudden he disappeared. So, one night I went to a nightclub where we used to go because his friend was a bartender there and I had asked his friend. I was like, what's up with Joey? He had this look like, oh, my gosh, no. And he's like you know he's sick. And I was like, yeah, he has diabetes because I remember he used to take a lot of pills. But then his friend had told me, well, he's really sick. He actually has full blown AIDS and he's in Norfolk being taken care of by his mom.

MARTIN: And then you went and got tested yourself?

RAMIREZ: So, the first time I got tested it came back negative, you know, because there's a window period. But, of course, Nurse Sally(ph), I remember her, she told me, she was like, you need to come back and, you know, you might actually be infected. And, you know, of course we did a whole counseling thing. I explained to her, like, how many times we had unprotected sex and what went on. And so, she told me to come back to get tested and that's what I did.

MARTIN: And that's how you found out?

RAMIREZ: Yeah, yeah.

MARTIN: How common do you think your story is?

RAMIREZ: I think it's very typical especially for young people of color, especially when you come from a low-income family and, like, no resources and not the support that you have and especially because a lot of people who are infected are afraid of rejection. So, I felt that Joey was afraid of me rejecting him, which it actually made me mad because I would have never rejected him. So...

MARTIN: But do you think that the lack of honesty and the lack of honesty around health issues that was part of your relationship is typical?

RAMIREZ: Yeah, I mean, in general, like, healthy relationships don't exist. I always go back to, you know, being a person of color is that we're not taught and we see unhealthy relationships. So, we carry on unhealthy relationships throughout our lives and unless somebody actually shows us and explains to us what a healthy relationship is and how to have a healthy relationship and how to have conversations about not only sex but different issues.

MARTIN: If you're just joining us this is TELL ME MORE from NPR News.

We're acknowledging World AIDS day with a conversation with Jose Ramirez. He's living with HIV. He works for a nonprofit health center that serves Latinos in Washington, D.C., which has the highest rate of infection among any metropolitan area in the United States and we're talking about why that might be.

Jose why do you think that is? It's - I just think it's stunning to many people that Washington, D.C., which is the nation's capital, is an affluent area, you know, very educated people in this area. Of course, there's still poverty in the area and a lot of all the other stuff that people associate, you know, with a metropolitan area. Why do you think Washington, D.C. has the highest rate of HIV infection in the country?

RAMIREZ: One, I feel like the U.S. in general is focusing on other areas, you know, like Africa which is good but we need to focus on here. Also, just in schools, young people are not getting education, the right education they need to get around healthy relationships. What, you know, healthy sex is, safe sex is and then also going back to families.

Not having those conversations, you know, your parents talking to you about sex and how to use a condom. What STDs are, what are the symptoms, and then also the messages that we're getting nowadays through the media, through music. Sex is everywhere. So, you hear all these lyrics, but you never hear people talking about wearing a condom, putting on a condom. And then also people are afraid to talk about sex. Like, we all have sex, but we can't sit down and talk about sex and like what safe sex is.

MARTIN: Is there anything that might have kept you from becoming infected that would have allowed your life to take a different course? And of course I think people appreciate the trajectory you've gone on. You've decided to become - part of the reason you're on the mission you're on which is to educate young people. That is your life's work now. But what do you think would have made a difference for you?

RAMIREZ: One would have been for sure having my mom talk to me about safe sex, but also schools. I found out in North Carolina. So, they really didn't talk about sex ed in school. And being a queer person, you know, wait until marriage. Well, now we can get married but back then I would say, OK, that isn't me, like, it's not towards me.

MARTIN: The message is that you were getting on HIV/AIDS you felt had anything to do with you?

RAMIREZ: No. And they were really boring. They would just like talk, talk, talk. Like, why don't you, you know, explain to me what safe sex is. Show me tricks like I show my young people, like, things that people want to listen to and hear out and messages that are actually going to stick to them.

MARTIN: I do want to mention that HIV disproportionately affects certain groups. I think many people are familiar with the concept of how African-Americans are more likely to be infected but also Latinos are as well. The Centers for Disease Control reports that in 2009 Latino men had two and a half times the rate of estimated new infections compared to white men. In Latino women, it was four and a half times the rate of white women. Why do you think that is?

RAMIREZ: One, it's going back to just Latinos in general not getting being afraid to get tested and especially with a lot of stuff around immigration right now, they might be afraid of, you know, going to a place to get tested because they might ask for ID. But I really think it's going back to, like, it's just not part of our culture. Like, our parents don't tell us, go get tested, or we just don't know where to go get tested.

MARTIN: When you think about what most needs to happen, I know you talked about the need for more explicit conversation around these issues, telling kids what they really want to hear. But is this really about sex or is it about relationships?

RAMIREZ: I think it's about both because, in a relationship, of course, you're going to have sex. So - and it also plays out to what that person's going through. So, if you're homeless, if you're dealing with domestic violence, like, you really kind of look at the issues that that person's going through before even talking about HIV and AIDS.

You know, if I have a person who comes to me and is being beat, I'm not going to be like, oh, you need to get tested, because that person might be getting beat because she or he wants to use a condom, but their partner doesn't want to and is hitting that person because they want to use condoms. Or if someone's homeless and, of course, especially a lot of young immigrant youth turn to commercial sex working because...

MARTIN: Because the place gives them a place to stay, a place to go?

RAMIREZ: Not only that. Like, someone who's going to pick you off the street is not going to ask you for a social security number and ID. So, the only work that you have is, you know, commercial sex working. So all those issues, you've got to look at. So, like, for a lot of our young people that do work the streets, we actually educate them on negotiating safe sex with their client.

MARTIN: What do you see for yourself for the future?

RAMIREZ: Well, you know, HIV - I've been doing it for a while and I'm always going to do it, but I'm actually thinking of becoming a probation officer, eventually. I know it's a big 360, but I have a lot of, you know, family members, young people, people in my family who have been on probation and I see that they don't get that guidance. They always end up back in the system. And my thing is I want to help people so they don't end up back in the system and they don't have the resources and stuff like that. And then, eventually, you know, maybe having some kids and finding me a nice husband, which are hard to find nowadays. But...

(SOUNDBITE OF LAUGHTER)

MARTIN: Really?

(SOUNDBITE OF LAUGHTER)

RAMIREZ: Yeah. But I've done projects in (unintelligible), so going out there and continuing that and educating the communities out there because there's not that much (unintelligible).

MARTIN: As I mentioned, you know, we're 30 years in to the AIDS epidemic around the world. Right? Thirty years since the disease was identified and it was understood to be a discreet, you know, condition. We're sort of - we're 30 years in. If you and I were to get together 30 years from now, I know it's hard to envision, what kind of conversation do you think we'll have? I know you'll have to reassure me about how fabulous I still look because gravity's going to be really doing its work on me, but...

RAMIREZ: Women are always fabulous.

MARTIN: ...you'll still be fine. But what conversation do you think we'll have around HIV? What kind of conversation do you hope we'll have?

RAMIREZ: That, one, I mean, it'd be cool if there was a cure for it, but you never know, you know. But just that less people are being affected with more education. People are actually using condoms, are liking condoms. That's the big thing. Are actually practicing safe sex or having, you know, conversations around healthy relationships and safe sex. And, of course, that there's immigration reform in this country and all the young people that I work with, which are mostly immigrants, know that's not going around. So, I think that will lower, like, especially HIV rates among young, queer men and transgender women.

MARTIN: Jose Ramirez is the youth programs coordinator for La Clinica Del Pueblo. That's a nonprofit health center serving mainly Latinos in D.C. He's openly gay. He's living with HIV, as he told us, and he was kind enough to join us here in our Washington, D.C. studios. Jose Ramirez, thank you so much for speaking with us.

RAMIREZ: Thank you so much for having me.

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