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

Description of Latinos Largest ethnic/racial minority group in the US (13% of the population) Mexican Americans -60% Puerto Ricans -15% Cuban Americans -10% Other Immigrants -15% Dominican Republic Central America South America

Largest ethnic/racial minority group in the US (13% of the population)

Mexican Americans -60%

Puerto Ricans -15%

Cuban Americans -10%

Other Immigrants -15%

Dominican Republic

Central America

South America

Prevalence of HIV/AIDS Latinos represent 14% of the US population 20% cases of AIDS cases are Latinos (8,000+) This percentage has increased from 18% in 1993 19% of deaths due to AIDS HIV is the 2 nd cause of death for Latino males 35-44 (5 th for White men)

Latinos represent 14% of the US population

20% cases of AIDS cases are Latinos (8,000+)

This percentage has increased from 18% in 1993

19% of deaths due to AIDS

HIV is the 2 nd cause of death for Latino males 35-44 (5 th for White men)

Prevalence of HIV/AIDS HIV is the 4 th cause of death for Latinas aged 35-44 and 25-34 (9 th and 8 th for White women) Latino teens account for 21% of new AIDS cases AIDS rate is five times more for Latinas than for White women Latinos are more likely to test later in their illness than any other racial group

HIV is the 4 th cause of death for Latinas aged 35-44 and 25-34 (9 th and 8 th for White women)

Latino teens account for 21% of new AIDS cases

AIDS rate is five times more for Latinas than for White women

Latinos are more likely to test later in their illness than any other racial group

Prevalence of Sexually Transmitted Diseases Latinos are twice as likely to have gonorrhea or syphilis Among minorities, Latinas report the second highest number of cases of gonorrhea Latinos are at High-Risk of contracting the hepatitis C virus

Latinos are twice as likely to have gonorrhea or syphilis

Among minorities, Latinas report the second highest number of cases of gonorrhea

Latinos are at High-Risk of contracting the hepatitis C virus

HIV Transmission in Latinos Males 42% men who have sex with men 34% contaminated syringes 8% heterosexually Females 38% contaminated syringes 47% sex with HIV positive male

Males

42% men who have sex with men

34% contaminated syringes

8% heterosexually

Females

38% contaminated syringes

47% sex with HIV positive male

Opinions on Key Issues 40% view HIV/AIDS as the most urgent health problem in the US 64% consider the problem to be more urgent problem for the country than a few years ago 7 in 10 state AIDS is a problem for someone they know 53% are personally concerned about becoming infected

40% view HIV/AIDS as the most urgent health problem in the US

64% consider the problem to be more urgent problem for the country than a few years ago

7 in 10 state AIDS is a problem for someone they know

53% are personally concerned about becoming infected

Information Needed 64% want more information about HIV/AIDS Most want guidance on how to talk about HIV transmission with their children 33% want more information on how to wear condoms

64% want more information about HIV/AIDS

Most want guidance on how to talk about HIV transmission with their children

33% want more information on how to wear condoms

Misperceptions HIV is transmitted through kissing You can become infected by touching a toilet seat or sharing a drinking glass 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 ) Unprotected sex means having sex with someone that you do not know.

HIV is transmitted through kissing

You can become infected by touching a toilet seat or sharing a drinking glass

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 )

Unprotected sex means having sex with someone that you do not know.

Beliefs There is a cure for HIV, but not for AIDS. HIV/AIDS is an agent of genocide created by the US government HIV resulted from laboratory experiments that got out of control There is a cure for HIV, but the government is withholding this information from minorities AIDS is a disease that affects gays and foreigners Essien,E. J., Meshack, A, and Ross,M (2002)

There is a cure for HIV, but not for AIDS.

HIV/AIDS is an agent of genocide created by the US government

HIV resulted from laboratory experiments that got out of control

There is a cure for HIV, but the government is withholding this information from minorities

AIDS is a disease that affects gays and foreigners

Essien,E. J., Meshack, A, and Ross,M (2002)

Barriers to Prevention More than 1 in 5 Latinos live in poverty Reluctance to acknowledge risky behaviors (males) Reluctance to discuss condom use (females) Barriers to access to appropriate health care Stigma Funding Racial discrimination Fear of deportation Cultural and language insensitivity Weak or fragile community-based capacity

More than 1 in 5 Latinos live in poverty

Reluctance to acknowledge risky behaviors (males)

Reluctance to discuss condom use (females)

Barriers to access to appropriate health care

Stigma

Funding

Racial discrimination

Fear of deportation

Cultural and language insensitivity

Weak or fragile community-based capacity

Barriers to Prevention Machismo-female passivity, male dominance and virility Reduce safer sex practices and negatively influence Marianismo-women maintain traditional gender roles

Machismo-female passivity, male dominance and virility

Reduce safer sex practices and negatively influence

Marianismo-women maintain traditional gender roles

Barriers to Prevention Lack of sex and health education at home and school Abstinence and virginity until marriage Sexual knowledge promotes sexual activity Prohibition of contraceptive use by the Catholic Church

Lack of sex and health education at home and school

Abstinence and virginity until marriage

Sexual knowledge promotes sexual activity

Prohibition of contraceptive use by the Catholic Church

Barriers to Prevention Latinas Most approaches used to prevent HIV are based on men who have sex with men View Latinas as not a “risk group” (being married protects them from infection) Have other priorities and focus on HIV when it has a demonstrated impact on role in family Ability to negotiate safer sex is difficult

Latinas

Most approaches used to prevent HIV are based on men who have sex with men

View Latinas as not a “risk group” (being married protects them from infection)

Have other priorities and focus on HIV when it has a demonstrated impact on role in family

Ability to negotiate safer sex is difficult

Prevention for Latino Youths School-based programs are critical before behaviors are established Comprehensive programs with a focus on delaying sexual behavior and how sexually active can protect themselves Community-based programs to reach out-of-school youth Address sexual and drug-related risk STD treatment

School-based programs are critical before behaviors are established

Comprehensive programs with a focus on delaying sexual behavior and how sexually active can protect themselves

Community-based programs to reach out-of-school youth

Address sexual and drug-related risk

STD treatment

Prevention for HIV Drug Users Needle prevention programs Drug treatment programs Use community outreach programs to reach drug users on the streets Improve access to quality substance abuse treatment centers HIV prevention programs in jails and prisons Education on safe injection use.

Needle prevention programs

Drug treatment programs

Use community outreach programs to reach drug users on the streets

Improve access to quality substance abuse treatment centers

HIV prevention programs in jails and prisons

Education on safe injection use.

Prevention Programs Routine HIV testing as part of medical care New models for diagnosing HIV infections outside medical settings Preventing HIV infections by working with HIV-infected persons and their partners Decreasing perinatal transmission

Routine HIV testing as part of medical care

New models for diagnosing HIV infections outside medical settings

Preventing HIV infections by working with HIV-infected persons and their partners

Decreasing perinatal transmission

Specific Prevention Strategies Encourage adherence to antiretroviral therapy Decreased concentration in semen Decreased maternal-fetal transmission Dual approach to risk reduction Abstinence/safer sex practices Discontinuation of drug use/safer use practices

Encourage adherence to antiretroviral therapy

Decreased concentration in semen

Decreased maternal-fetal transmission

Dual approach to risk reduction

Abstinence/safer sex practices

Discontinuation of drug use/safer use practices

Specific Prevention Strategies Disseminate prevention information through community organizations that represent and promote family life and health. Tailor public information messages to emphasize the impact of HIV/AIDS on the family unit. Market health promotion programs in a way that barriers originating in family structures are eliminated

Disseminate prevention information through community organizations that represent and promote family life and health.

Tailor public information messages to emphasize the impact of HIV/AIDS on the family unit.

Market health promotion programs in a way that barriers originating in family structures are eliminated

Culturally Sensitive HIV Prevention Show respect for community Hire culturally appropriate workers who speak the language Provide services in culturally appropriate atmosphere Develop peer-education training programs Address survival needs Promote confidentiality and anonymity Include lesbian, gay, bisexual, and transgender communities Do not make assumptions based on appearances Post hours of operation and accept walk-in appointments

Show respect for community

Hire culturally appropriate workers who speak the language

Provide services in culturally appropriate atmosphere

Develop peer-education training programs

Address survival needs

Promote confidentiality and anonymity

Include lesbian, gay, bisexual, and transgender communities

Do not make assumptions based on appearances

Post hours of operation and accept walk-in appointments

THANK YOU