Aetna Presentation HIV/AIDS and Latinos


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HIV/AIDS and Infectious Diseases: Prevalence and Attitudes Among U.S. Latinos

Dr Li Loriz, PhD, ARNP, BC, Director, School of Nursing, University of North Florida

July 22, 2005 - UNF Hispanic Health Issues Seminar

This is part 6 of an 8 part series of seminars on Hispanic Health Issues brought to you by the University of North Florida’s Dept. of Public Health, College of Health, a grant from AETNA, and the cooperation of Duval County Health Department.

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Aetna Presentation HIV/AIDS and Latinos

  1. 1. HIV/AIDS and Infectious Diseases: Prevalence and Attitudes Among U.S. Latinos Dr Li Loriz, PhD, ARNP, BC Director, School of Nursing College of Health University of North Florida
  2. 2. Description of Latinos <ul><li>Largest ethnic/racial minority group in the US (13% of the population) </li></ul><ul><li>Mexican Americans -60% </li></ul><ul><li>Puerto Ricans -15% </li></ul><ul><li>Cuban Americans -10% </li></ul><ul><li>Other Immigrants -15% </li></ul><ul><ul><li>Dominican Republic </li></ul></ul><ul><ul><li>Central America </li></ul></ul><ul><ul><li>South America </li></ul></ul>
  3. 3. Prevalence of HIV/AIDS <ul><li>Latinos represent 14% of the US population </li></ul><ul><li>20% cases of AIDS cases are Latinos (8,000+) </li></ul><ul><ul><li>This percentage has increased from 18% in 1993 </li></ul></ul><ul><li>19% of deaths due to AIDS </li></ul><ul><li>HIV is the 2 nd cause of death for Latino males 35-44 (5 th for White men) </li></ul>
  4. 4. Prevalence of HIV/AIDS <ul><li>HIV is the 4 th cause of death for Latinas aged 35-44 and 25-34 (9 th and 8 th for White women) </li></ul><ul><li>Latino teens account for 21% of new AIDS cases </li></ul><ul><li>AIDS rate is five times more for Latinas than for White women </li></ul><ul><li>Latinos are more likely to test later in their illness than any other racial group </li></ul>
  5. 5. Prevalence of Sexually Transmitted Diseases <ul><li>Latinos are twice as likely to have gonorrhea or syphilis </li></ul><ul><li>Among minorities, Latinas report the second highest number of cases of gonorrhea </li></ul><ul><li>Latinos are at High-Risk of contracting the hepatitis C virus </li></ul>
  6. 6. HIV Transmission in Latinos <ul><li>Males </li></ul><ul><ul><li>42% men who have sex with men </li></ul></ul><ul><ul><li>34% contaminated syringes </li></ul></ul><ul><ul><li>8% heterosexually </li></ul></ul><ul><li>Females </li></ul><ul><ul><li>38% contaminated syringes </li></ul></ul><ul><ul><li>47% sex with HIV positive male </li></ul></ul>
  7. 7. Opinions on Key Issues <ul><li>40% view HIV/AIDS as the most urgent health problem in the US </li></ul><ul><li>64% consider the problem to be more urgent problem for the country than a few years ago </li></ul><ul><li>7 in 10 state AIDS is a problem for someone they know </li></ul><ul><li>53% are personally concerned about becoming infected </li></ul>
  8. 8. Information Needed <ul><li>64% want more information about HIV/AIDS </li></ul><ul><li>Most want guidance on how to talk about HIV transmission with their children </li></ul><ul><li>33% want more information on how to wear condoms </li></ul>
  9. 9. Misperceptions <ul><li>HIV is transmitted through kissing </li></ul><ul><li>You can become infected by touching a toilet seat or sharing a drinking glass </li></ul><ul><li>50% Inner city women stated using a diaphragm or having sex with a man who has had a vasectomy are successful ways of preventing HIV infection ( Hobfoll, 1994 ) </li></ul><ul><li>Unprotected sex means having sex with someone that you do not know. </li></ul>
  10. 10. Beliefs <ul><li>There is a cure for HIV, but not for AIDS. </li></ul><ul><li>HIV/AIDS is an agent of genocide created by the US government </li></ul><ul><li>HIV resulted from laboratory experiments that got out of control </li></ul><ul><li>There is a cure for HIV, but the government is withholding this information from minorities </li></ul><ul><li>AIDS is a disease that affects gays and foreigners </li></ul><ul><li>Essien,E. J., Meshack, A, and Ross,M (2002) </li></ul>
  11. 11. Barriers to Prevention <ul><li>More than 1 in 5 Latinos live in poverty </li></ul><ul><li>Reluctance to acknowledge risky behaviors (males) </li></ul><ul><li>Reluctance to discuss condom use (females) </li></ul><ul><li>Barriers to access to appropriate health care </li></ul><ul><ul><li>Stigma </li></ul></ul><ul><ul><li>Funding </li></ul></ul><ul><ul><li>Racial discrimination </li></ul></ul><ul><ul><li>Fear of deportation </li></ul></ul><ul><ul><li>Cultural and language insensitivity </li></ul></ul><ul><ul><li>Weak or fragile community-based capacity </li></ul></ul>
  12. 12. Barriers to Prevention <ul><li>Machismo-female passivity, male dominance and virility </li></ul><ul><ul><li>Reduce safer sex practices and negatively influence </li></ul></ul><ul><li>Marianismo-women maintain traditional gender roles </li></ul>
  13. 13. Barriers to Prevention <ul><li>Lack of sex and health education at home and school </li></ul><ul><ul><li>Abstinence and virginity until marriage </li></ul></ul><ul><ul><li>Sexual knowledge promotes sexual activity </li></ul></ul><ul><li>Prohibition of contraceptive use by the Catholic Church </li></ul>
  14. 14. Barriers to Prevention <ul><li>Latinas </li></ul><ul><ul><li>Most approaches used to prevent HIV are based on men who have sex with men </li></ul></ul><ul><ul><li>View Latinas as not a “risk group” (being married protects them from infection) </li></ul></ul><ul><ul><li>Have other priorities and focus on HIV when it has a demonstrated impact on role in family </li></ul></ul><ul><ul><li>Ability to negotiate safer sex is difficult </li></ul></ul>
  15. 15. Prevention for Latino Youths <ul><li>School-based programs are critical before behaviors are established </li></ul><ul><li>Comprehensive programs with a focus on delaying sexual behavior and how sexually active can protect themselves </li></ul><ul><li>Community-based programs to reach out-of-school youth </li></ul><ul><li>Address sexual and drug-related risk </li></ul><ul><li>STD treatment </li></ul>
  16. 16. Prevention for HIV Drug Users <ul><li>Needle prevention programs </li></ul><ul><li>Drug treatment programs </li></ul><ul><li>Use community outreach programs to reach drug users on the streets </li></ul><ul><li>Improve access to quality substance abuse treatment centers </li></ul><ul><li>HIV prevention programs in jails and prisons </li></ul><ul><li>Education on safe injection use. </li></ul>
  17. 17. Prevention Programs <ul><li>Routine HIV testing as part of medical care </li></ul><ul><li>New models for diagnosing HIV infections outside medical settings </li></ul><ul><li>Preventing HIV infections by working with HIV-infected persons and their partners </li></ul><ul><li>Decreasing perinatal transmission </li></ul>
  18. 18. Specific Prevention Strategies <ul><li>Encourage adherence to antiretroviral therapy </li></ul><ul><ul><li>Decreased concentration in semen </li></ul></ul><ul><ul><li>Decreased maternal-fetal transmission </li></ul></ul><ul><li>Dual approach to risk reduction </li></ul><ul><ul><li>Abstinence/safer sex practices </li></ul></ul><ul><ul><li>Discontinuation of drug use/safer use practices </li></ul></ul>
  19. 19. Specific Prevention Strategies <ul><li>Disseminate prevention information through community organizations that represent and promote family life and health. </li></ul><ul><li>Tailor public information messages to emphasize the impact of HIV/AIDS on the family unit. </li></ul><ul><li>Market health promotion programs in a way that barriers originating in family structures are eliminated </li></ul>
  20. 20. Culturally Sensitive HIV Prevention <ul><li>Show respect for community </li></ul><ul><li>Hire culturally appropriate workers who speak the language </li></ul><ul><li>Provide services in culturally appropriate atmosphere </li></ul><ul><li>Develop peer-education training programs </li></ul><ul><li>Address survival needs </li></ul><ul><li>Promote confidentiality and anonymity </li></ul><ul><li>Include lesbian, gay, bisexual, and transgender communities </li></ul><ul><li>Do not make assumptions based on appearances </li></ul><ul><li>Post hours of operation and accept walk-in appointments </li></ul>
  21. 21. THANK YOU