The alarmingly disproportionate rate in which Latinos are affected by HIV/AIDS was highlighted at the 2005 National Conference on Latinos and AIDS July 25-26. Healthcare professionals and social workers were urged to educate themselves and their patients about the impact the epidemic has on the Latino community. The national forum, held in Chicago, also served as a stepping stone to revive the national discourse about HIV and the Latino community and to recommit to the struggle.
by Amy Wooden
Dr. Patricia Herrera of Cook County's Stroger Hospital opened the day by speaking about the epidemiology of HIV in the United States. According to Herrera, 1.2 million people in the U.S. are living with HIV/AIDS. Unfortunately, the Latino community is affected at a disproportionate rate. Hispanics make up 14 percent of the U.S. population, but 20 percent of AIDS cases, she said.
In the U.S., Latino men who have sex with men make up 39 percent of HIV cases among Hispanics, she continued.
'Latinos have become a political and economic source that will have to be heard,' Herrera said. She added that by 2020, 100 million Latinos will be living in the U.S. They are the fastest growing minority population in the country, making up one-seventh of all people. 'In a city as diverse as Chicago,' Herrera continued, 'we need to be able to target those special populations.'
Herrera said that in a Stroger Hospital study, she and others found that their Latino patients are more commonly infected through heterosexual contact and show signs of advanced disease. 'Long-term survival is a lot less for Hispanics' after hospitalization, the study also found. A large percentage of patients also never returned for follow-up treatment. Also, Herrera said that Stroger is seeing an increase in Latinos co-infected with Hepatitis.
Herrera stressed that there are many barriers which prevent Latinos from getting the treatment and information they need. Some of these barriers include language, lack of knowledge, limited access to healthcare, migration and immigration issues, cultural beliefs and mistrust in healthcare. Also, gay men living on the 'down low' and a culture that stresses 'machismo' adds to the issue.
In order to help combat the problem, healthcare professionals need to take action. 'It's only through our education that we will be able to control this epidemic,' Herrera said. 'We, as a whole, have done a very poor job of educating our community.'
Hispanic soap opera star Erik Estrada made it out to Monday's forum to voice his support as the face of the Latino and AIDS movement. Estrada spoke of the loss of a close friend to HIV many years ago. 'It's a nightmare that people are afraid to talk about,' Estrada said. Estrada is the UNICEF Ambassador and an honorary conference chair.
Estrada stressed the role of parents to educate their children about HIV/AIDS. As a parent of a 5-year-old daughter and two teenage boys, the former 'Chips' co-star said he has learned how to approach youth. In his opinion, parents need to be realistic and educate their kids about ways to protect themselves. Also, they need to keep the lines of communication open.
While other subsets of the United States' population are seeing some declines in infection rates, Estrada told the audience that the opposite is occurring among Latinos. Between 1999 and 2003, infection rates among Latinos increased 8 percent. Estimated death increased 17 percent among Latinos compared to an 18 percent decline in whites—the 'only group that experienced an increase,' he said. In Latino men 35-44, HIV is the second leading cause of death. It is the fourth leading cause for Latinas.
Estrada said that HIV among Latinos is a 'public health catastrophe' with 'global influence' because of how quickly their population is growing. Latinos need to share a 'passionate commitment to our families' by being involved and educating each other, Estrada continued. A good start, he said, is to break the silence that plagues the community.
'This is an unparalleled health crisis, even for the wealthiest nation in the world,' Estrada added.
'I urge you to make partnerships with people,' he said. 'Don't be afraid of what people think. Just get out there.' Estrada told Windy City Times/Identity that it is important for people to be involved in any small way they can. Attending city council meetings and speaking to church leaders to get the word out can help. 'You know, unfortunately, a lot of the Latinos just get shoved aside,' he said. 'Twenty percent of Latinos [ are ] affected by AIDS. It's like wow, who's not talking to who?
William Paul, the acting commissioner of the Chicago Department of Public Health ( CDPH ) , said the city has learned a lot about the importance of responding to crises since the 1995 heat wave. 'It's important to keep learning those lessons and move ahead,' he said.
Paul stressed the importance of having good information and science, persistence, working as a team and engaging the community to discover 'who is marginalized and who are you not reaching.'
Collecting data is crucial, Paul said, to figuring out exactly what occurred during an epidemic. However, 'if people won't accept [ the data and information ] , if we don't get it to the right people, it won't do any good,' he added. The community needs to be engaged in order for the city to help. 'There's always going to be someone on the margin,' he said, adding that creative approaches need to be used to reach marginalized individuals.
Finding out who needs to be part of the team to combat the epidemic is also significant, Paul said. During and after the 1995 heat wave, he said the city added 'people the public health department doesn't normally deal with' to its team.
Paul also stressed that those involved in correcting the problem need to 'keep it fresh and keep the pressure on.' After a problem has been around a while, people get complacent, he said. The CDPH and other public healthcare workers need to be prepared for the future and keep fighting, he added.
by Andrew Davis
The second and last day of the conference featured speakers talking about everything from the church to homelessness to a fall campaign aimed at getting politicians to take action against AIDS.
Ronaldo Cruz, executive director of the U.S. Conference of Catholic Bishops, spoke on the role of the Catholic church in HIV outreach and prevention programs. Cruz concentrated on four areas: the Catholic Church's response to the HIV/AIDS pandemic; the dissemination of information about the disease to Latino Catholics in the United States; a workshop that educates trainers; and promotion of HIV/AIDS as a discussion topic among families. 'I'll admit that the Catholic Church does not do a good job of telling the story, particularly of our role in outreach of persons with HIV/AIDS and their families,' Cruz said. He said that most dioceses through the country have some sort of HIV-related service, with Atlanta having an HIV ministry office. He then delivered a surprising statistic: Internationally, the Catholic Church is responsible for 25 percent of the world's HIV care.
Cruz admitted that HIV/AIDS can be a tough issue for the church to discuss because the topic of sexuality is inextricably linked to the disease, a contention reflected by one attendee during the question-and-answer session that followed. The participant talked about how some dioceses offer AIDS care but no HIV counseling because of the issue of sexuality. Cruz responded that the problem is that spiritual leaders receive information and that it is up to them to 'pick and choose what information to disseminate.' The director also challenged local parishes to become even more involved in AIDS training. Other recommendations included promoting self-esteem, organizing community events for observances such as World AIDS Day, providing basic health services, and the controversial suggestion of discussing abstinence.
Charles King, president and CEO of New York City's Housing Works, Inc., discussed the connection between homelessness and HIV infection rates. The statistics he presented regarding the link are undeniably grim. For example, homeless persons are four times more likely to use hard drugs and six times more likely to engage in sexually risky behavior. Another set of numbers that was relevant for those who are economically minded is that the estimated lifetime medical treatment cost of each new infection ranges from $155,000 to $195,000. However, what was probably most shocking is that 25 percent of those with HIV/AIDS do not know they are infected—and are transmitting the disease at a rate of 8.5-11 percent annually. All of these things are happening among a demographic that is growing at an alarming rate: King said that in New York City alone, homeless numbers have gone up 62 percent since 1998. Homeless facilities now shelter 34,000 people each night, up from 21,000.
King, a gay, HIV-positive Baptist minister, stressed that housing is healthcare. Providing a residence is vital to improving access to care and treatment success, he contended. An encouraging statistic is that HIV-positive people who do not have medical care are four times more likely to enter into a healthcare program if they have housing. If they have housing, King said, they can access all-important antiretroviral treatments. He also stated that among some of the key housing issues are the need for HIV-specific resources; cost-effectiveness; and the disproportionate impact on communities of color ( because of unemployment, domestic violence and chemical dependence ) . In emphasizing the need for housing, he came up with a four-word mantra: 'Dead addicts don't recover.'
Another highlight of the day involved a presentation concerning The Campaign to End AIDS, a coalition consisting of HIV/AIDS-infected persons, their families and advocates. The featured speakers were King; Frank Oldham, executive director of the Harlem Directors Group; and David Munar of the AIDS Foundation of Chicago.
Oldham started off by saying that 'all of us living with HIV/AIDS and those dedicated to saving the lives of people affected by HIV/AIDS are locked into a painful struggle to hold on to the progress that we have made over the past two decades.' He added that, as a gay, HIV-positive African-American man, he is 'a survivor, not a victim' and is 'a warrior, not a slave.' In addition, Oldham declared that the HIV/AIDS community must still battle complacency and stigma while trying to spread information to prevent HIV infection rate increases. He also dispensed disturbing facts, including that 250,000 gay men and 500,000 African-Americans have died of AIDS since the beginning of the epidemic.
King, considerably more fiery than in his previous speech, said that he was dismayed after the last election because of 'our utter failure to get AIDS into the public discourse,' and he cited the inability of Dick Cheney and John Edwards to talk competently about the disease in the memorable debate moderated by Gwen Ifill. King also bemoaned the lack of a national figure who is taking on the pandemic: 'We do not have a single national leader—civil, political, or religious—who is articulating a vision of a world without AIDS. The problem is that if we can't even articulate that as a vision, we are never going to be able to come up with a plan.' King labeled the excuse of having no resources as 'a damn lie,' opining that 'if we can spend $80 billion on a war over the last four years, we can spend ... a few billion on AIDS.'
King then talked about the campaign's National Caravan and March on Washington, D.C., which will involve ten caravans traveling across the country over September and October. ( The 'American Heritage' caravan will stop in Aurora, Batavia and Chicago on Sept. 30 and leave for Gary, Ind., on Oct. 1. The caravans will converge in the nation's capital Oct. 8-12. See www.C2EA.org . ) King described the caravan as 'a mass movement to muster political will' and compared the event to the Civil Rights March in Washington by saying that they are both aimed for 'social and economic justice.'
Munar talked about what is being done on the local level. He discussed the need for activism: 'There are people living with and affected by AIDS in every community in every town in this country so this campaign is meant to mobilize those people.' Munar also mentioned the need for 'uncomfortable conversations' with those who may not be as understanding as those attending the conference. 'We have to talk to our children [ and other relatives ] as well as church leaders,' he said. Munar, a Colombian-American, said that common issues ( and fallacies, he pointed out ) are that the Latino community is not hit as hard as the African-American demographic and that the infection rate is proportionate. He stated, among other things, that the Puerto Rican HIV infection rate is actually higher than the Black rate.
K. Mary Hess, president of Minority Health Care Communications as well as the conference's founder and director, told Windy City Times that the conference is necessary because 'other [ meetings ] don't go into great detail and don't have the space and time to deal with [ each ] population. The Latino community is quite diverse and there are many issues, such as underrepresentation and undocumented people. The conference is meant to be a national forum to highlight [ all types of ] issues in the national discourse, such as Latinas being promiscuous and Latinos being thugs [ as well as ] barebacking and the 'down low' phenomenon.' However, Hess, while urging the attendees to be advocates, also expressed her frustration with the lack of attendance. She indicated that several organizations who were contacted never received any information—and that other agencies that received complementary tickets did not use them: ' [ One agency ] was given 150 tickets and most were not used. [ Another ] was given 100 and only half were used.'
Vendors set up displays in front of the conference area, complete with product information and spokespeople. Among the companies/agencies were the Chicago Department of Public Health, Abbott Laboratories, GlaxoSmithKline, Test Positive Aware Network and Minority Health Care Communications. Attendees could also make squares to add to AIDS quilts, some of which were displayed prominently behind speakers.
The third annual conference will take place July 24-25 in Miami.