RENEE MONTAGNE, HOST:
Of the many challenges immigrants face, especially those without documents, getting health care is high on the list. And in New York, one group faces the special problem of a high rate of HIV infection. They are the Garifuna people, who are of African descent and live mostly in Honduras. As Alexandra Starr reports for NPR's Code Switch, one doctor is trying to get more of these immigrants tested for HIV and in treatment.
ALEXANDRA STARR, BYLINE: At a recent ceremony in the Bronx, men and women decked out in red-and-white checkered shirts and headscarves sang, shook maracas and drummed. Speeches were given in English, Spanish and Garifuna.
UNIDENTIFIED WOMAN: (Through interpreter) We want to give thanks to Dr. Julie Hoffman for giving the opportunity for our ancestors to do this program.
STARR: Julie Hoffman was the guest of honor. She's a doctor specializing in treating patients with HIV. In Spanish, she offered words of thanks.
JULIE HOFFMAN: (Through interpreter) Too many members of this community continue dying. That's why I'm here. I want to work with you.
STARR: At least 100,000 Garifuna live in the Bronx. That's where Jacobi Medical Center, the hospital where Dr. Hoffman works, is located. In recent years, she noticed that a growing portion of her patients were Garifuna and many only sought treatment after they had developed full-blown AIDS.
HOFFMAN: I've seen many Garifuna in the hospital dying because they came way too late.
STARR: There are no reliable figures of how high the HIV infection rate is among the Garifuna living in New York. Dr. Hoffman suspects it may be roughly the same as the rate in Honduras. About 4.5 percent of the Garifuna living there have the virus, according to the Centers for Disease Control and Prevention. That's the highest rate among all ethnic groups in Central America.
HOFFMAN: (Speaking Spanish).
STARR: That's the doctor greeting a long-time patient. He's Garifuna and HIV positive. He's also an undocumented immigrant, and for that reason he asked us not to identify him by name. The man is a faith healer, or buyei in the Garifuna community. A year and half ago, he brought one of his patients to Dr. Hoffman. That patient turned out to be HIV positive. And Dr. Hoffman wondered if buyeis could serve as a bridge to the community.
HOFFMAN: I thought, why don't I give him a test kit? And then from there he can bring the patients to me.
STARR: She ended up giving him 20 home HIV test kits. Three of his patients tested positive, and they are now in care. He says they're grateful.
UNIDENTIFIED MAN: (Through interpreter) They didn't realize they could get access to free medication and have medical coverage.
STARR: Dr. Hoffman's hospital does provide service, irrespective of a patient's immigration status or ability to pay. But she believes outreach is imperative to help Garifuna men and women who have HIV.
HOFFMAN: There's really no way we're going to get a handle on this except if we can get sort of into the community and have them start doing the testing themselves.
STARR: Back at the ceremony, Dr. Hoffman made the case for a partnership.
HOFFMAN: (Through interpreter) The buyeis have pledged to work with me. We share the same goal - reducing the incidence of AIDS in this community.
(SOUNDBITE OF DRUMMING)
STARR: After the speeches, the drumming started again. Dr. Hoffman hopes the ceremony marks just the beginning of the collaboration. She says finding even one HIV-positive person would make the outreach effort a success. But she's hoping to identify and provide care to many more. For NPR News, I'm Alexandra Starr in New York.
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