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Traditional Outreach Sidesteps HIV-Positive Latinos


As policy and health leaders and activists gather in Washington, D.C. for the 19th International AIDS Conference, we're having a series of conversations about HIV and prevention efforts here in the U.S. and around the world.

Today, we're focusing on AIDS and HIV among Latinos in the U.S. and the numbers are cause for concern. The Centers for Disease Control and Prevention tells us that Latinos make up just 16 percent of the population, but they accounted for 20 percent of new HIV infections.

We wanted to talk more about this, so we've called upon Jesus Aguais. He is the founder and executive director of AIDS International. That's an organization that promotes AIDS education, prevention and treatment across Latin America and for Latin American immigrants in the U.S. Also with us, Alicia Wilson. She is the executive director of La Clinica Del Pueblo. That provides health care to Latinos in and around Washington, D.C.

And I welcome you both and I thank you both so much for joining us.

ALICIA WILSON: Thanks for having us.

JESUS AGUAIS: Thank you.

MARTIN: Now, Jesus, I'm going to start with you. A lot of people ask, sometimes, you know, why is ethnicity important when we talk about health issues, particularly HIV/AIDS?

AGUAIS: Well, it is important to talk about ethnicity and it's important to talk about race. My experience working with Latino immigrants in New York metropolitan area and working in Latin American countries, I found that in order to send the message across, I need to understand the cultural differences among Latinos, and that's something that we don't talk about it much here in the United States.

MARTIN: Alicia, what about that? Can you talk a little bit about that?

WILSON: I think, unfortunately, a lot of the mainstream HIV prevention messages don't work for our community, for a couple ways. One is that there's this idea that if you just take a prevention message of some sort and translate it into Spanish, it's automatically going to be applicable. And I think marketers in the private sector figured this out a long time ago, that you have to generate marketing and products that are unique to the culture you're trying to reach.

An example that we have in our HIV prevention work is when we reach out to young gay men and young transgender women, we use young gay men and young transgender women who are Latino to spread those messages, to speak the language, not literally but figuratively. They speak the slang, they speak the cultural language, and their outreach is significantly more effective than somebody handing out a brochure that's a translation from English.

MARTIN: You were also saying, though, that some of the messages that do work well in other groups don't work particularly well with Latinos.

WILSON: Well, certainly we have run a number of health education campaigns, not just in HIV, but in all aspects of health care where, in doing focus groups and in surveys and in discussing things, our patients say things like, you know, I have enough people telling me what to do. I really don't need another person to say you shouldn't eat this, you should do that, you have to wear a condom or you're a bad person. It's not - that doesn't make me feel good. I'm already a person who's left out of society. I'm already a person who feels bad because I don't speak English well enough. I'd like something that makes me feel good.

And so our messages that do work are positive, very familial, very friendly, very engaging, and what they do is help people feel like we're all in this together, and together we can really make an impact.

MARTIN: Mr. Aguais, did you want to add something to that?

AGUAIS: I 100 percent agree with what Alicia is saying. Fear-based prevention campaigns particularly affect the Latino community in a negative way and what we have found is, when you have fear-based campaigns, what it does is also fit into stigma and discrimination and also fit into self-stigmatize and self-discrimination, so the person also isolate themselves from the rest of the world and engage themselves, eventually, into risky behavior.

MARTIN: Could you talk a little bit more about the number that I cited at the beginning of our conversation? According to the Centers for Disease Control and Prevention, their most recent data suggested that Latinos make up 16 percent of the population, but 20 percent of new HIV infections.

And Jesus, I wanted to ask you first. Why do you think that is?

AGUAIS: It's several things. And lack to access to proper education, access to proper medical care. Also it's - for many Latinos and Latino immigrants, health is not necessarily their priority, and people are busy working and once they get tested, they get tested very close, having an AIDS diagnose(ph) or a month before they get an AIDS diagnose. And that's why we need to reach out to our Latino population in a more effective way.

I mean, there's incredible people doing work, and I just visited La Clinica Del Pueblo in Washington and I was very impressed. It's a model that should be replicated all over the United States.

MARTIN: If you're just joining us, you're listening to TELL ME MORE from NPR News. Health policy leaders, activists, people living with AIDS are gathering in Washington, D.C. for the International AIDS Conference. That's the 19th such conference that's been held, but the first that's been held in the United States for some 20 years.

Today, we're focusing on fighting HIV and AIDS among Latinos. Our guests are Alicia Wilson of La Clinica Del Pueblo here in Washington, D.C., and also Jesus Aguais of Aid for AIDS International. He's with us from New York.

I do feel that there's something we're kind of sidestepping, and that is the question of whether or not, you know - it's been reported that African-Americans and Latinos have more hostility toward same-sex relationships than others and that HIV/AIDS is still seen as a gay disease and that that might be one factor in people coming forward to get tested and to get treated, and I wanted to know whether either of you thinks that that's true.

WILSON: Certainly from our perspective, the folks that we see in our HIV prevention work absolutely report feeling, if they are gay or transgender, they absolutely report feeling discriminated and marginalized, and that is(ph) a factor in their risk-taking behaviors. Getting kicked out of your house because you're gay when you're 18 years old or not being able to get a job because you're a transgender - that impacts your financial status, which impacts your HIV risk.

I think that there's a lot of positive change and as our country is growing and changing in acceptance of sexual minorities, I think that minority communities are doing that as well. It's just - it takes a lot of work.

MARTIN: Is there anything that the two of you are optimistic about?

WILSON: Sure. I'm extremely optimistic about the innovative programs I see around the country. There have been committed activists for 30 years now working in this epidemic and, in the work with the immigrant community it's been running uphill for a really long time, trying to just have the voices heard to show up in the statistical data to try and make sure that the Latino community is considered a priority in AIDS policy and in practice.

I'm starting to see that tide turn a little bit. There are more programs focused on that. There's more federal funding. There's more local funding. Not enough, of course, but there are opportunities for creative programs that can really build on the expertise that's gained over the last 25 years.

MARTIN: Jesus, is there anything you're optimistic about?

AGUAIS: Yeah. I am. I'm very optimistic, and I always get very excited when I join my young groups, and we have a program called How Much Do You Know About HIV (foreign language spoken). And that's particularly exciting because it doesn't only talk about HIV prevention, education. It also has a big component on stigma and discrimination and seeing young people all together, it doesn't matter if they're rich or poor, if they're gay or straight. Talking and working together about the same issues is hope. It's a real hope that I see, and I see more and more young people are getting involved, talking on these issues.

And there's a lot more to do, but there is light at the end of the tunnel. At least that's how I see it.

MARTIN: Jesus Aguais is the founder and executive director of Aid for AIDS International. That's an organization that promotes AIDS education, prevention and treatment across Latin America, and for Latin American immigrants in the U.S. He joined us from NPR's bureau in New York.

Here with us in Washington, D.C., Alicia Wilson. She's the executive director of La Clinica Del Pueblo. That's a health center with a particular focus on Latinos here in Washington, D.C., and she joined us in our studios here.

Thank you both.

WILSON: Thank you so much.

AGUAIS: Thank you. Transcript provided by NPR, Copyright NPR.