CDC: HIV/AIDS Infections Growing Among Latinos
CHERYL CORLEY, host:
This Is Tell Me More from NPR News. I'm Cheryl Corley. HIV and AIDS is on the rise among Latinos. Latinos are the largest and fastest growing minority population in the United States, about 13 percent of the country's population.
The Center for Disease Control says Latinos account for 18 percent of newly diagnosed cases of AIDS and HIV, although blacks still represent the largest portion of the population infected with the disease.
The epidemic has additional complications for Latinos: cultural barriers, stigma and legal issues make it difficult to battle the rise of AIDS.
Just ahead, we'll hear from two Latinos, both suffering from HIV. But first we turn to Dr. Ken Dominguez. He's an epidemiologist for the Center for Disease Control and specializes in the spread of HIV/AIDS. Also with us is Catalina Sol, the director of the HIV program at Clinica del Pueblo in the Washington, D.C. area. Welcome to the program.
Ms. CATALINA SOL (Director, HIV Program, Clinica del Pueblo, Washington, D.C.): Glad to be here.
Dr. KEN DOMINGUEZ (Epidemiologist, Center for Disease Control): Thank you, Cheryl.
CORLEY: Dr. Dominguez, lets start with you. I'm going to start with some figures from the CDC that I'm sure that you're probably familiar with. Hispanics have the second-highest rate of HIV diagnosis among all racial groups. And Latino males get infected at a rate three times higher than their white counterparts. What seems to be causing this increase?
Dr. DOMINGUEZ: Multitude of reasons that Latinos have a greater vulnerability to HIV. I can sort of describe a few of those. First on the list would probably be, you know, limited health care access. We know that about 34 percent of Latinos are uninsured compared to 13 percent of whites and 20 percent of blacks.
Language barriers play a big role in terms of quality of care, being able to clearly communicate with your patients. Denial contributes to risk, the cultural value of machismo. A number of Latino men still feel strongly that, you know, machismo is very important.
The high rates of STDs facilitate transmission. We know that Latinos...
CORLEY: And when you say STDs, you're talking about?
Dr. DOMINGUEZ: Sexually transmitted diseases.
CORLEY: Tell me a little bit about how the CDC actually gathers these statistics and who is really included in the count when we're talking about Latinos and AIDS.
Dr. DOMINGUEZ: State health departments, labatories across the country report cases of HIV and other STDs to the CDC, and then the CDC then reports overall numbers to the overall population. For HIV, just to it more clear, we have about 33 states that as of 2006 report HIV directly to the CDC and have mature reporting systems. So when you hear about a lot of the numbers in terms of the epidemic, they're based on those states that have mature reporting systems.
CORLEY: Catalina Sol, your program oversees eight clinics in the Washington, D.C. area and primarily tests Latinos for HIV. I was wondering if your clinic system, if you're seeing an increase in the number of people testing positive, as well?
Ms. SOL: Just to clarify, we're only a single clinic but we have multiple programs outside of our - out of our main unit. I would say that we are with better and newer statistics in our area. We're able to finally see a reflection of what's for us been an invisible epidemic for many years.
We have rising numbers of cases among Latinos who have - who are men who have sex with men, but also among heterosexual women and men. And I would say that one additional factor of vulnerability that I would like to mention, for Latinos, is the condition of being an immigrant. And in our population, which are mostly Latino immigrants, being an immigrant really increases your risk for contracting HIV along a number of different routes.
CORLEY: How so?
Ms. SOL: Disorientation and the differences in culture, particularly in terms of sexual norms and what people discuss, what people do, where they do so, an increased level of freedom, as it were, makes negotiating basically better, less risky behaviour harder.
Being an immigrant also means that you're more isolated. It means that you don't really know the system and what services you are eligible for. The increased hostility towards immigrants in our area has also - also drives people further underground.
And I would say that for us, one thing that many of the groups that are considered to be at risk have in common is that vulnerability from being an immigrant, being recently arrived and being disorientated within the system.
CORLEY: I was wondering how all of these kind of barriers and factors that you talk about really complicate the efforts to, A, diagnose the disease, and then to actually treat the disease.
Ms. SOL: In our case, the outstanding characteristic is that 50 percent of our clients that we diagnose newly with HIV are also diagnosed with AIDS, which means that they have been walking around with the virus for quite some time, and it supports what we already know nationally, that there is a great number of people that have HIV and don't know their status, but among Latinos in our just small instance, I would say that maybe half of the people who we believe to have HIV don't know that they have the virus.
And that makes it much more difficult to get people to take medications early to prevent transmission. So we really want to be able to get people at an earlier place in their diagnoses.
CORLEY: Dr. Dominguez, so what is the CDC doing to combat the spread of AIDS in Latinos?
Dr. DOMINGUEZ: You know, we feel that there's really no single solution to stopping HIV amongst the Latino communities, and we really support using, sort of, a broad-based approach to preventing HIV in the Latino population, one that's very comprehensive.
And so just to give you a few examples of some of the things that we're doing, at least about 20 percent of our domestic prevention budget is spent on fighting HIV in the Latino communities, and some examples of where we spend our money in prevention, we fund about 59 community-based organizations that serve Hispanic Latinos..
CORLEY: And that will be one that - something like Cataolina Sol's organization?
Dr. DOMINGUEZ: Exactly. Exactly. And another thing that we do is we work to expand access to proven prevention programs for Latinos. So there are behavioral interventions that are focused on Latinos, and we also actually have a toll-free number that people can call for testing purposes, and that's 1-800-CDC-INFO, and they can call any time of the day and find out where's the closest place to get tested in their community.
CORLEY: Catalina, we've heard a number of ways that the CDC is going about trying to contact clinics and things like that, but how exactly does your clinic and other organizations really get the word out to people about treatment and prevention? We've talked about some of the barriers that exist as far as, perhaps, fear of testing and language, so what is that interaction with the community actually like?
Ms. SOL: Well, the strategy that has worked for us for many years is the use of peer educators or (Spanish Spoken), as they're known in our community, which are people from the communities that we'd like to reach, who we train, and who serve not only to deliver messages but also to tell us what's happening on the ground, where people are, what they're thinking, and so forth. And it's really the work of ants working - many small ants working together over time that has made a difference.
When we started working around the area of HIV in the early '90s, people wouldn't want to test at all for HIV if they were in public. Now it's much easier for people to test and they seek a test if it's readily accessible to them. However, our community is moving further and further out of the cities and into more rural areas or suburban areas, and it means that we have greater geographic challenges in reaching them, so radio is also a very important strategy that works with Latino immigrants, and we try to develop partnerships with Latino radio stations as well as television to deliver the messages. It's a regular and ongoing communication that we need to have also because of the large numbers of new people entering our system as new immigrants. I don't know, that's just a few examples.
CORLEY: Catalina Sol is a director of the HIV program at Clinica del Pueblo. Dr. Ken Dominguez is an epidemiologist at the Center for Disease Control. Thank you both.
Ms. SOL: Thank you.
Dr. DOMINGUEZ: Thank you.